Multiple sclerosis

1. SEMINAR ON
MULTIPLE SCLEROSIS
Submitted to:- MS.NAZIMA THOMAS
Submitted by:- KAMAKSHI

2. CONTENT
• Introduction
• Types of MS
• Etiology
• Risk Factors
• Pathophysiology
• Clinical Manifestation
• Diagnostic Evaluation
• Management
• Complications
• Summary and Conclusion
• Evaluation

6. DEFINE Multiple sclerosis (MS)
is an autoimmune
disease affecting the
central nervous system,
causing nerve damage,
impaired movement,
vision issues, and
cognitive difficulties.

9. INCIDENCE
•Multiple sclerosis in women is 2-3
times more prevalent that in men
•It is not contagious
•Worldwide :- 1.1-2.5 million

11. RELAPSING
REMITTING MULTIPLE
SCLEROSIS
( most common initial
pattern)
Episodes of acute
worsening with recovery
and stable course in
between relaps

12. SECONDARY
PROGESSIVE
MULTIPLE
SCLEROSIS
Gradual neurological
deterioration , disability
worsening over time,
often steady with
occasional relaps.

13. PRIMARY
PROGRESSIVE
MULTIPLE
SCLEROSIS
Gradually it is
characterized by steady
worsening of the
neurological function
over the time.

14. PROGESSIVE
RELAPSING
MULTIPLE
SCLEROSIS
Gradual neurological
deterioration from the
onset of manifestation
but with sub sequent
superimposed relapses

15. ETIOLOGY

17. PATHOPHYSIOLOGY

24. CLINICAL
MANEFESTATIONS

35. DIAGNOSTIC
EVALUATION

43. MEDICAL
MANAGEMENT

45. TREATMENT OF
ACUTE RELAPS
1. Corticosteroid therapy
Anti -inflammatory and
immunosuppressive property
Eg. METHYL
PREDINSOLONE,
CYCLOPHOSPHAMIDE

46. DISEASE MODIFYING
TREATMENT
1.Interferon Beta 1b
Eg. BETASERON
2. Interferon Beta 1a
Eg. AVONEX

47. SYMPTOMATIC
TREATMENT
1.For bladder dysfunction
Eg. OXYBUTYNINE
2. For Constipation
Eg. SUPPOSITORIES
3. Fatigue
Eg. AMANTIDINE
4. For Tremors
Eg. PROPANLOL
5. For Trigeminal Neuralgia
Eg. CARBAMEZEPINE , PHENYTOIN

48. LIFESTYLE
1.Nutritional Therapy
2.Physical and Speech
Therapy
3.Exercise
4.Water Exercise

49. SURGICAL
MANAGEMENT

50. DEEP BRAIN
STIMULATION

51. •DBS is an invasive surgical procedure where
electrodes are permanently implanted into
specific deep brain regions, most commonly the
thalamus. These electrodes are connected by
wires to a small battery-powered device
(neurostimulator or "brain pacemaker")
implanted under the skin, usually near the
collarbone. The device sends continuous
electrical impulses to the brain, which helps to
block or regulate abnormal nerve signals.

53. •Implantation of a drug catheter in multiple
sclerosis typically involves placing a catheter into
the spinal fluid (intrathecal space). This allows for
direct delivery of medications, such as baclofen
for severe spasticity, bypassing the blood-brain
barrier and minimizing systemic side effects. It's
often used for symptom management when oral
therapies are ineffective.

54. NURSING
MANAGEMENT

55. Chronic Pain related to nerve damage
(neuropathic pain), muscle spasm as
evidenced by patient report of pain
1. Assess the general condition
2. Provide hot and cold application
3. Position the patient comfortably
4. Administer Analgesics
5. Provide Emotional Support

56. Impaired physical mobility related to
muscle weakness as evidenced by
difficulty in performing ADL
1. Assess the general condition
2. Provide comfortable position
3. Assist the patient in performing ADL
4. Assist the patient in ambulation
5. Ensure safety precautions

57. Fatigue related to increased energy need as
evidenced by facial expression of client
1. Assess the general condition
2. Teach the patient about energy conserving
techniques
3. Encourage the patient to perform passive ROM
4. Promote sleep hygiene

58. Risk for injury related to impaired balance
and muscle weakness
1. Assess the general condition of the patient
2. Provide comfort devices to the patient
3. Assist the patient in ambulation
4. Educate the patient about assistive devices

59. Risk for adult fall related to neurological
impairment
1. Assess the general condition of the patient
2. Raise the side rails of patient bed
3. Provide comfort devices
4. Assist the patient in ambulation

60. COMLPICATIONS

65. SUMMARY

66. • Define multiple sclerosis
• Types of MS
• Etiology
• Risk Factors
• Pathophysiology
• Clinical Manifestation
• Diagnostic Evaluation
• Management
• Complications

67. CONCLUSION

68. Multiple sclerosis is a
progressive autoimmune
disease affecting the
nervous system. Though
incurable, early diagnosis,
disease-modifying
therapies, and symptom
management improve
quality of life. Ongoing
research offers hope for
better treatments and
potential cures.

69. BIBLOGRAPHY
▪GERARD TORTORA; BRYAN DERRICKSON. PRINCIPLES OF
ANATOMY AND PHYSIOLOGY. 14th EDITION. PAGE NO. 332-
350
▪USHA UKANDE, JAIDEEP HERBERT,SHWETA PATTNAIK, ANIL
SHARMA. TEXTBOOK OF ADULT HEALTH NURSING. 2nd
EDITION.PAGE NO. 408-415
▪MJ KUMARI. ADULT HEALTH NURSING-I. 3rd EDITION. PAGE
NO. 205-218
▪JAVED ANSARI, DAVINDER KAUR. PEE VEE. TEXTBOOK OF
ADULT HEALTH NURSING. 4th EDITION. PAGE NO. 303-316

70. EVALUATION