Multiple sclerosis (MS) is a demyelinating disease of central nervous system which includes brain and spinal cord. it affect the myelin and by damaging the the myelin producing cell -Oligodendrocytes, which leads to sensory, motor and cognitive problems.

1. Mr.Sachin Dwivedi
M.SC. Medical surgical Nursing
K.G.M.U Institute of Nursing , Lucknow

4. • Multiple sclerosis (MS) is a demyelinating disease
of central nervous system which includes brain
and spinal cord.
• This myelin is produced by oligodendrocytes
which are a group of cells that support neurons.
•
• In multiple sclerosis, demyelination happens
when the immune system inappropriately attacks
and destroy the myelin , which make
communication between neuron break down,
ultimately leading sensory , motor and cognitive
problem.

5.  MS was first described in
1868 by Jean-Martin Charcot.
 The name multiple sclerosis
refers to the numerous scars
(sclerae—better known as
plaques or lesions) that
develop on the white matter
of the brain and spinal cord.

6.  Multiple sclerosis (MS) OR Disseminated sclerosis.
 Multiple sclerosis (MS) is a demyelinating disease
in which the insulating covers of nerve cells in
the brain and spinal cord are damaged.This
damage disrupts the ability of parts of the
nervous system to communicate, resulting in a
range of signs and symptoms,

7. • 2.5 million people are affected with MS
worldwide.
• Reported mostly in women (approximately 3
times more often than in men)

8.  Idiopathic.
 Genetic factor:
 Female
 Genes encode for HLA-DR2(Identify and bind
foreign molecule)
 Environmental factor
 Infections such as measles, mumps and
rubella, Epstein–Barr virus.
 Vitamin D deficiency

20.  Bouts of
autoimmune
attacks
happening
months or even
years and causing
an increasing in
the level of
disability.
 80-85 % .
Time(Life span)
Severity
Relapsing
Remission

21.  similar to RRMS
but after some
time immune
attacks become
constant which
cause a steady
progression of
disability.
 60-65%.
Time(Life span)
Severity
Relapsing
Remission

22.  Constant attack
on myelin which
cause a steady
progression of
disability over a
person’s lifetime.
 10%. Time(Life span)
Severity

23.  Constant attack
but bouts
superimposed
during which the
disability
increase even
faster.
 1-2%.
Time(Life span)
Severity
Relapsing
Remission

24.  Charcot’s neurologic triad of multiple sclerosis
Multiple sclerosis
Intention
Tremor
Nystagmus
Dysarthria

25.  Dysphagia
 Loss of vision (optic neuritis)
 Blurring of the vision

26.  Muscles weakness & spasm
 Ataxia (Loss of balance or
coordination)
 Paresthesias(Tingling,iching)
 LHERMITTE’S SIGN (Electric
shocks runs down back &
radiate to limbs when
bending neck forword)

28.  Physical therapy.
 Cognitive Rehabilitation therapy

29.  Corticosteroid,
 Cyclophosphamid (Cell cycle inhibitor)
 Intravenous immunoglobulin
 Plasmapheresis (Remove disease causing
antibodies)
 Chronic MS Immunosuppressants like
Recombinant beta-IFN
 Vitamine D

30.  Deep brain stimulation
a surgeon places an
electrode in thalamus. The
electrodes are connected to
a pacemaker-like device by
wires.
“brain pacemaker,” deep
brain stimulation works by
blocking errant signals from
damaged brain cells to
“reset” the brain’s natural
rhythm.
This can help decrease or
stop tremors entirely.

31.  Intrathecal baclofen
pump therapy
a Surgeon will implant a
pump near the spinal
cord. This pump is
programmed to deliver the
medication on a regular
basis. For most people,
the surgery is easily
managed. Some people
may experience soreness
around the incision site.
The pump will need to be
refilled every few months.

32.  Impaired physical mobility
 Fatigue related to decrease energy
production
 Self-Care Deficit
 Potential for Ineffective Family Coping
 Sleep Disturbance.

33.  MULTIPLE SCLEROSIS is a Chronic &
progressive Autoimmune disorder and the
most common pattern is the relapsing-
remitting type and slightly worsening their
over all condition.
 T-cells cause inflammation and damage to
oligodendrocytes in the CNS which leaves
behind scarred areas of demyelinated
neurons called plaques which cause variety
of symptoms depending on the location.