blood

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.

15. Thank You