Multiple sclerosis is a chronic autoimmune disorder that affects the central nervous system by damaging the myelin sheaths surrounding nerve fibers in the brain and spinal cord. It typically presents in young adults between ages 20-50 and affects women more than men. The disease causes demyelination which interrupts nerve impulses and results in a variety of symptoms that may include problems with motor function, sensation, vision, and cognition. While there is no cure for MS, treatments can help manage symptoms and reduce relapses.

1. MULTIPLESCLEROSIS

2. 
Multiple sclerosis is an
autoimmune disorder of the
central nervous system that
affects the nerve cells (
neuron and axon) .
INTRODUCTION

3. 
STRUCTURE OF A NEURON

4.  Multiple sclerosis (MS) is a
chronic, progressive,
degenerative disorder of the
CNS characterized by
disseminated demyelination
of nerve fibers of the brain
and the spinal cord.

7. Multiple Sclerosis
typically presents in
young adults ages 20 to
50, and it affects women
more frequently than
men.

8. Idiopathic
Viral infections
Immunologic factors
Genetic Predisposition(human
leukocyte antigen)

9.  Precipitating factors like
infections, physical injury,
emotional stress, excessive
fatigue and poor state of health.
 Vitamin D deficiency – Most
prevalent in cold areas

10. 1. Relapsing-Remitting
2. Primary Progressive
3. Secondary
Progressive
4. Progressive-relapsing

12.  MS characterized by clearly acute
attacks with full recovery or with
sequelae and residual deficit upon
recovery.

13.  MS is characterized. by disease showing
progression of disability from onset
without remissions and temporary minor
improvements .

14.  MS begins with an initial
relapsing-remitting course,
followed by progression of
variable rate, which may also
include occasional relapses and
minor remissions.

15.  MS shows progression from onset but
with clear acute relapses with or
without recovery.

16. virus
Auto reactive
T-lymphocytes
Remain in the CNS
Infiltrations of agents which damage
the immune system

17. Destroys the myelin sheath
and oligodendroglial cells
Demyelination and
plaque formation
Interruption of nerve impulses
Clinical manifestations

18. *

19. •Disease may not be
diagnosed until long after the
onset of the first symptom.
The clinical manifestation
vary according to the areas of
CNS involved. Common
signs and symptoms include
motor, sensory, cerebellar,
and emotional problems.

20. •Motor manifestations
•Weakness or paralysis of
limbs, trunk, and head
•Diplopia
•Scanning speech
•Spasticity of muscles

21. •Sensory manifestations
•Numbness and tingling
•Blurred vision
•Vertigo and tinnitus
•Decreased hearing
•Chronic neuropathic

22. •Cerebellar
manifestations
•Nystagmus
•Ataxia
•Dysarthria
•Dysphagia

23. •Emotional
manifestations
•Anger
•Depression
•Euphoria

24. •Bowel and bladder functions
may be impaired
Constipation
Spastic bladder: small capacity for
urine results in incontinence
Flaccid bladder: large capacity for
urine and no sensation to urinate

25. •Sexual dysfunction can occur
in MS
Erectile dysfunction
Decreased libido
Difficulty with orgasmic
response
Painful intercourse
Decreased lubrication

26. DIAGNOSTIC STUDIES
History and physical
examination
CSF analysis
Computed Tomography scan
Magnetic resonance imaging
Magnetic resonance
spectroscopy

27. MANAGEMENT

28. CORTICOSTEROIDS EG: PREDINISONE
IMMUNOSUPPERESSANTS Eg:
CYCLOPHOSPHAMIDE
IMMUNOMODULATORS Eg: INTERFERON
BETA-1b
CHOLINERGICS Eg: Acetylcholine
ANTICHOLINERGICS EG: ATROPINE
MUSCLE RELAXANTS eg: VALIUM
MEDICAL MANAGEMENT

29. SURGERY IS INDICATED IN
UNMANAGABLE
CONDITIONS
THALAMOTOMY
NEURECTOMY
SURGICAL MANAGEMENT

30. Diet consisting of low fat and raw
vegetables
High –protein diet with
supplementary vitamins is
recommended
A diet high in roughage may help
to relieve the problems of
constipation.
Nutritional therapy

31. 1. IMPAIRED PHYSICAL MOBILITY
RELATED TO MUSCLE WEAKNESS
OR PARALYSIS AS EVIDENCED BY
INABILITY TO AMBULATE.
2. RISK FOR INJURY RELATED TO
SENSORY AND VISUAL
IMPAIREMENT AS EVIDENCED BY
INABILITY TO AMBULATE.
NURSING DIAGNOSIS

32. 3. IMPAIRED URINARY ELIMINATION
PATTERN RELATED TO SENSORY
MOTOR DEFICITS AS EVIDENCED BY
BLADDER DISTENTION.
4.INTERUPTED FAMILY PROCESS
RELATED TO FLUCTUATING
PHYSICAL CONDITIONS AS
EVIDENCED BY VERBALISATION