Multiple Sclerosis

MULTIPLE SCLEROSIS His disease in which the fatly meln Sheath around the axon of the brain & Spinal cord are damaged, leading demyelination & scarming. to Causes Unknown Auto immune disorder. Genetic predisposition presence of specatic cluster of human leukocyte antigen who live -Environmental factors - Person farther from equator. Decreased Vit D production. Pathophysiology Hypoxemia, toxic chemicals, vascular insufficieng or autoimmune responses. autoimmy Injury and Inflammation of myelin sheath Break down of myelin sheath membrane Layers into smaller components ↓ Demyelingtion Impairs normal conduction; partial/dispersion of action potential ↓ Consequent neurologic dysfunction Muttiple sclero99 Classification •Relapsing remitting muttiple sclerosis. Acute attack partial recovery Owith either full recovery/ with disability. "Primary progressive It is progression of by disease shouling I disability from onset. Setondary Begins progressive. as with relapsing permitting but the diskase steadily becombes cworst between exacerbationg •Progressive Relapsing Shows progression from onset but with clear acute relapses with or without recover. C/M • Some of the most common symptom include: problem with thinking, Learning Ee plannig. 9 Depression and ankiety Sexual problems Bladder problems A bocued problems. • Speech and Swallocuing difficulties, Fatique Vision problems • Numbrias & tingling parasthesia) • Murde spasms, Ostittness & creatness. •Mobility problems Pain. (kinaria-movement) Other Symptoms • Loss of vision in the affected eye, • Colour blindness. Fye pain, cohich is curcually moving the eye. coorge cohen. Other problems that can occur in the eyes Double vision. • Involuntary eye movements, which can mabell Drem a thou Occassionally, both of your eyes may be offere D.E H.C MRI PE PET Scan . gic Examination Neurologic analysis. Treatment • Corticosteroids, such as oral prednisone & intravenous methyl prednisolone, bore prescribed to reduce include -The ind lammation. Side effectomay Increased B.P. insomnia, Increased blood level, mood swings Ee fluid retention, glucose Plasma exchange Cplasmapheresis): The Liquid portion of part of your blood (plasma) is removed and seperated from your blood cells. The blood cells are then pachang misad with a proten Solution Calbumin) Ec put hack indo your body. Plasma exchange may be ased f or symptoms are new, severe Ee haven't responded to steroids. •Disease Moditying therapy Interferon beta medications. These drugs used to be the most prescribed medication's-to treat. - They cwork by inter-lering attack the body with diseases that mdy & inflammation te 1 nerve growth. • They and injected under the skin or into. muscle Ea căn redure the frequency & severity of relapses. Glatiramer acetate • Glatiramer acetate (Copaxone, Glatopa: This medication may help to block immune System's attack on myelin & must be injected beneath the skin. Side efferts may include. Skin irritation at the injected site.. Monoclonal antibodies Ota-tumumab targets nervous system. calls that damage the These cellg are called Beeth Olatumamab is given by an injection under the skin & can decrease multiple sclerosis brain Lesions & worsening symptoms. Possible side effects are infection, Local reaction to the injection. Management of Spasticity • Therapy A physical / occupational therapist Can-teach Stretching and atrengthening exercise Ce show how to devices to make it leagier to perform daily - tasks. Walkers are provided to atazic patient. Speech-therapy & occupational therapy to the poctient. Nursing Management Nursing assessment 1 Colllet complete history regarding viral illnesses, exposure to physical & emotional stressors, geographical residence as child, medications, onsel Top symptoms & severity of manifestation. 2 Physical assessment include mood, speech, eye movement, gait, tremors, vision, hearing, reflexes, muscle strength & movement & Sensation assessment Promote Physical activity (a) Advice the patient to perform musde straa -ing exercises to minimize joint contractures 6 Advice patient to prevent muscle - fatigue with frequent rest periods. Administer muscle relaxants as ordered. Reeive Fatigue periods during activity programm • Advice the patient to avorld temperature Extreme such as hot showers or exposure to cold as heat can delay impulse-transmission & cause more. Hatique 3 Avoid skin possure and immobilsly. Change patient's position every Ihre even if patient is in wheelchair Give careful attention to sacral and perineal hygiene Support patient with bladder disturbana • Observe patient closely for retention Es catheterize. as ordered •Administer urinary antiseptica as ordered. 5 Assist the patient to establish a routine of regular bowel evacuation. Administer corticosteroids, as ordered duwving. periods of exacerbation. a) May reduce severity of exacerbation by redung edema and inflammation 7 Support the patient with optic & speech detect • Eye patch to black vision impulses for patient with diplopia Obtain Gervices of speech therapist. 8 Discharge planning consideration int & family Instruct patient & in activities of daily living using assistive & sett-help.