Multiple sclerosis( neurological disorders)
- 1. Multiple sclerosis BY , J .HANNA B.SC(N). NUSRING TUTOR ORTUS COLLEGE OF NURSING
- 2. INTRODUCTION Multiple sclerosis (MS) is a long-lasting (chronic) disease of the central nervous system. It is thought to be an autoimmune disorder, a condition in which the body attacks itself by mistake. MS is an unpredictable disease that affects people differently.
- 3. DEFINITION Multiple Sclerosis (MS) is a chronic, autoimmune disease of the central nervous system (CNS), which includes the brain, spinal cord, and optic nerves. In MS, the body's immune system mistakenly attacks the protective covering of nerve fibers called the myelin, leading to inflammation and damage
- 4. ETIOLOGY/RISK FACTORS Age: People aged 20 to 50 are more likely to get MS Gender: Women are more likely than men to get MS. Family history: Having a brother, sister, or parent with MS may increase the risk. Epstein-Barr virus: Having had the Epstein-Barr virus may increase the risk Stress: Stress may be a risk factor. Genetics: Variations in dozens of genes are thought to be involved, with changes in the HLA-DRB1 gene being the strongest genetic risk factor. Vitamin D: Low levels of vitamin D may contribute to the development of MS. Vitamin D regulates the immune response, and high levels of vitamin D
- 5. CLASSIFICATIONS MS Relapsing-Remitting MS (RRMS): Characterized by flare-ups or relapses of symptoms (neurological deficits) followed by partial or complete recovery (remission). Primary Progressive MS (PPMS): Progressive from the start, with gradual worsening of symptoms without distinct relapses or remissions. Secondary Progressive MS (SPMS) A rare form of MS,It is steady worsening of the disease from the beginning, with acute relapses superimposed on the progressive decline. Progressive-Relapsing MS (PRMS) a period of relapses and remissions, the disease transitions to a more progressive form, with gradual worsening of symptoms and fewer remissions.
- 6. Clinical manifestation • Muscle weakness, spasticity • Paralysis or numbness in the limbs • Numbness or tingling (paresthesia) in the limbs, face, or trunk. • Visual disturbances, such as blurry vision, double vision (diplopia) • Difficulty with memory, concentration • Speech and swallowing difficulties • Bladder and bowel dysfunction
- 7. DIAGNOSTIC EVALUATION History and physical examination Magnetic Resonance Imaging (MRI):MRI can identify plaques (areas of demyelination) in the brain and spinal cord Cerebrospinal Fluid (CSF) Analysis: indicating an abnormal immune response in the CNS. Management Injectables: Interferon beta (e.g., Avonlea, Rebif), glatiramer acetate (Copaxone). Oral therapies: Dimethyl numerate (Tecfidera), teriflunomide (Aubagio), fingolimod (Gilenya), siponimod (Mayzent). Monoclonal antibodies: Ocrelizumab (Ocrevus), natalizumab (Tysabri), alemtuzumab (Lemtrada).
- 8. Continue….. High-dose corticosteroids (e.g., methylprednisolone) Muscle relaxants (e.g., baclofen, tizanidine) to treat spasticity. NURING MANAGEMENT • Nurses perform a comprehensive assessment that includes a medical history, neurological exam, and symptom assessment. • teach patients about self-care and wellness • Nurses coordinate referrals to other providers, such as physiotherapists, counselors, or support groups. • Nurses encourage patients to establish regular activity and rest patterns, stay hydrated, and follow a nutritious diet.
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