Multiple Sclerosis

MULTIPLE MANY, MORE

THAN ONE
S C L E RO S I S H A R D E N I N G O F
TISSUE, USUALLY DUE TO
SCARING AFTER
INFLAMMATION OR DUE TO
AGING

 body's immune system eats away

Definition

at the protective sheath (myelin)

that covers your nerves
Damage to myelin causes
interference in the
communication between your
brain, spinal cord and other areas
of your body affects CNS
This condition may result in
deterioration of the nerves
themselves, a process that's not
reversible.

Symptoms
Numbness or weakness in one or more limb
Tingling or pain in parts of your body
Paresthesias of the lower half of the body
Electric-shock sensations that occur with certain head

movements
Tremor, lack of coordination or unsteady gait
Slurred speech
Fatigue
Dizziness
Partial or complete loss of central vision, usually in one eye,
often with pain during eye movement (optic neuritis)
Double vision or blurring of vision

Etiology/Causes
Unknown
Autoimmune disease
When myelin is damaged, the messages that travel

along that nerve may be slowed or blocked.

Risk Factors
Age. most commonly affects people who are ages 20 to 40.
Gender. Women are about twice as likely as
Family history.
Certain infections. A variety of viruses, such as Epstein-

Barr virus and others

Ethnicity. White people, particularly those whose
families originated in northern Europe
Geographic regions. Multiple sclerosis is far more
common in areas such as Europe, southern Canada,
northern United States, New Zealand and southeastern
Australia

Complications
Muscle stiffness or spasms
Paralysis, most typically in the legs
Problems with bladder, bowel or sexual function
Mental changes, such as forgetfulness or difficulties

concentrating
Depression
Epilepsy

Investigation / Diagnostic
Blood tests Elevated WBC
Spinal tap (lumbar puncture) abnormal levels of

white blood cells or proteins. Increased

immunoglobulin G (IgG)
Magnetic resonance imaging(MRI)/CT Scan
reveal lesions, which may appear due to myelin loss in
your brain and spinal cord.
EEG - Evoked potential test measures electrical
signals sent by your brain in response to stimuli

Treat Attacks
Treatment And
Drugs
No treatment for
Multiple Sclerosis

Corticosteroids e.g Prednisone

Methylprednisolone, Dexamethasone
Plasma exchange
(plasmapheresis) procedure
removes some blood from your body
and mechanically separates your blood
cells from your plasma, the liquid part
of your blood. Doctors then mix your
blood cells with a replacement solution
and return the blood to your body.

Slow Progress of Disease

Treatment and
Drugs

Beta interferons Avonex, Betaseron,

Extavia and Rebif
Glatiramer acetate (Copaxone)
glatiramer acetate works by blocking
your immune system's attack on myelin
Fingolimod (Gilenya) trapping
immune cells in lymph nodes
Natalizumab (Tysabri) interfering
with the movement of potentially
damaging immune cells from your
bloodstream to your brain and spinal
cord
Cyclophosphamide, Azathioprine
immunosuppressant medication

Treat symptoms
Treatment and
Drugs

Physical therapy stretching and

strengthening exercises
Muscle relaxants baclofen (Lioresal)
and tizanidine (Zanaflex) may improve
muscle spasticity.
Reduce fatigue amantadine modafinil

Nursing Diagnosis
Deficit knowledge related to disease process
Fatigue related to muscle weakness
Intolerable pain related to insufficient rest
Increased attacks related to poor stress management
Self care deficit related to muscle stiffness and pain

during movement
Risk for paralysis or the lower limbs related to
disease process and non compliance to treatment.

Nursing Intervention
Assess patients ability to do ADL ( assisted/ independent)
Assess for S&S of acute exacerbation of progression of

disease
Provide catheter care and bowel care to improve comfort
and reduce risk of secondary infection
Place patient in a cool and stress free area
Encourage family participation in coping and
understanding disease process
Provide written and verbal information about treatment
and drugs , stress importance of drug compliance and
time drug should be taken

Health Education
Medication teach patient to take medication as

prescribed. Do not discontinue medications abruptly

Get plenty of rest
Exercise - improved strength, muscle tone, balance
and coordination
Cool down (temperature) - keep the body cool
avoid extreme heat or hot environments
Eat a balanced diet - strong immune system and
maintain bone health.
Relieve stress relaxation techniques or spiritual
meditation / prayer