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MULTIPLE SCLEROSIS
DEPARTMENT
OF
MEDICAL SURGICAL NURSING
Smt. Radhikabai Meghe Memorial College
of
Nursing
Learning Objectives
At the end of the class the students are able
to:
• define multiple sclerosis
• enlist The etiology of multiple sclerosis
• explain The pathophysiology of multiple
sclerosis
• explain the clinical manifestation and
diagnostic evaluation of it
• describe the management of multiple
sclerosis
DEFINITION
• Multiple sclerosis (MS) is an immune-
mediated progressive demyelinating disease
of the CNS.
ETIOLOGY
• Autoimmune activity
• Genetic predisposition the presence of human
leukocyte antigens (HLA)
PATHOPHYSIOLOGY:
• Sensitized T cells typically cross the blood–
brain barrier; their function is to check the CNS
for antigens and then leave.
• In MS the sensitized T cells remain in the CNS
and promote the infiltration of other agents
that damage the immune system.
Clinical Manifestations
• fatigue, depression, weakness, numbness,
difficulty in coordination,
• loss of balance, and pain.
• Visual disturbances due to lesions in the optic
nerves
• Diplopia
Clinical Manifestations
• patchy blindness
• total blindness.
• Depression
• Pain may be due to demyelination of pain
fibers, mechanical stress on muscles, bones,
and joints due to disability, or treatment
measures
Assessment and Diagnostic Findings
• MRI
• Electrophoresis of CSF
• urodynamic studies
• Neuropsychological testing to assess cognitive
impairment
• A sexual history helps to identify changes in
sexual function
Medical Management
PHARMACOLOGIC THERAPY
• Mitoxantrone (Novantrone)
• Corticosteroids high-dose IV
methylprednisolone followed by an oral
prednisone taper.
• Amantadine (Symmetrel), pemoline (Cylert),
or fluoxetine (Prozac).
• to treat ataxia include beta-adrenergic blockers
• antidepressants, opiates, or antiseizure
medications Management of bladder and bowel
controlidepressants, opiates, or antiseizure
medications
• Ascorbic acid (vitamin C).
NURSING PROCESS:
Assessment
• actual and potential problems
• patient’s movements and walking
• assessed for weakness, spasticity, visual
impairment, incontinence, and disorders of
swallowing and speech
• Impaired urinary and bowel elimination
(urgency, frequency,incontinence,
constipation) related to nervous system
dysfunction
• Impaired speech and swallowing related to
cranial nerve involvement
Summary
• So far we have discussed about Definition,
causes, pathophysiology, clinical
manifestation, diagnostic evaluation and
management of multiple sclerosis.
Bibliography
• Lewis et al, Medical Surgical Nursing, Mosby
Elsevier,7th edition.
• Joyce.M.Black et al, Medical Surgical Nursing,
Saunders publication.
• Brunner and Siddhartha, Medical Surgical
Nursing, Lippincott Williams and Wilkins.
Thank You

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multiple sclerosis.pptx

  • 1. MULTIPLE SCLEROSIS DEPARTMENT OF MEDICAL SURGICAL NURSING Smt. Radhikabai Meghe Memorial College of Nursing
  • 2. Learning Objectives At the end of the class the students are able to: • define multiple sclerosis • enlist The etiology of multiple sclerosis • explain The pathophysiology of multiple sclerosis • explain the clinical manifestation and diagnostic evaluation of it • describe the management of multiple sclerosis
  • 3. DEFINITION • Multiple sclerosis (MS) is an immune- mediated progressive demyelinating disease of the CNS.
  • 4. ETIOLOGY • Autoimmune activity • Genetic predisposition the presence of human leukocyte antigens (HLA)
  • 5. PATHOPHYSIOLOGY: • Sensitized T cells typically cross the blood– brain barrier; their function is to check the CNS for antigens and then leave. • In MS the sensitized T cells remain in the CNS and promote the infiltration of other agents that damage the immune system.
  • 6. Clinical Manifestations • fatigue, depression, weakness, numbness, difficulty in coordination, • loss of balance, and pain. • Visual disturbances due to lesions in the optic nerves • Diplopia
  • 7. Clinical Manifestations • patchy blindness • total blindness. • Depression • Pain may be due to demyelination of pain fibers, mechanical stress on muscles, bones, and joints due to disability, or treatment measures
  • 8. Assessment and Diagnostic Findings • MRI • Electrophoresis of CSF • urodynamic studies • Neuropsychological testing to assess cognitive impairment • A sexual history helps to identify changes in sexual function
  • 9. Medical Management PHARMACOLOGIC THERAPY • Mitoxantrone (Novantrone) • Corticosteroids high-dose IV methylprednisolone followed by an oral prednisone taper. • Amantadine (Symmetrel), pemoline (Cylert), or fluoxetine (Prozac).
  • 10. • to treat ataxia include beta-adrenergic blockers • antidepressants, opiates, or antiseizure medications Management of bladder and bowel controlidepressants, opiates, or antiseizure medications • Ascorbic acid (vitamin C).
  • 11. NURSING PROCESS: Assessment • actual and potential problems • patient’s movements and walking • assessed for weakness, spasticity, visual impairment, incontinence, and disorders of swallowing and speech
  • 12. • Impaired urinary and bowel elimination (urgency, frequency,incontinence, constipation) related to nervous system dysfunction • Impaired speech and swallowing related to cranial nerve involvement
  • 13. Summary • So far we have discussed about Definition, causes, pathophysiology, clinical manifestation, diagnostic evaluation and management of multiple sclerosis.
  • 14. Bibliography • Lewis et al, Medical Surgical Nursing, Mosby Elsevier,7th edition. • Joyce.M.Black et al, Medical Surgical Nursing, Saunders publication. • Brunner and Siddhartha, Medical Surgical Nursing, Lippincott Williams and Wilkins.