Multiple sclerosis

Prepared by:
1- Rana ayman
2- Mohamed abdelaty

Supervised by:
Dr. Asmaa Hamed

Degree year one

Semester one
2021-2022
 Definition

Multiple sclerosis (MS) is one of the most common diseases of

the central nervous system (brain and spinal cord). Today more
than 2.8 million people around the world have MS.

MS is an inflammatory demyelinating condition. This means it

is caused by damage to myelin – a fatty material that insulates
nerves, acting much like the covering of an electric wire. Myelin
allows a nerve to transmit its impulses rapidly. It is the speed
and efficiency with which these impulses are conducted that
permits smooth, rapid and coordinated movements to be
performed with little conscious effort.

In MS, the loss of myelin (demyelination) is accompanied by a

disruption in the ability of the nerves to conduct electrical
impulses to and from the brain. This produces the various
symptoms of MS. The sites where myelin is lost (plaques or
lesions) appear as hardened (scar) areas: in multiple sclerosis
these scars appear at different times and in different areas of the
brain and spinal cord. The term multiple sclerosis means ‘many
scars’.
 Causes
The cause of multiple sclerosis is unknown. It's considered an
autoimmune disease in which the body's immune system attacks
its own tissues. In the case of MS, this immune system
malfunction destroys the fatty substance that coats and protects
nerve fibers in the brain and spinal cord (myelin).

Myelin can be compared to the insulation coating on electrical

wires. When the protective myelin is damaged and the nerve
fiber is exposed, the messages that travel along that nerve fiber
may be slowed or blocked.

It isn't clear why MS develops in some people and not others. A

combination of genetics and environmental factors appears to be
responsible.
 Symptoms
MS-related nervous system damage
Myelin damage and the nervous system Open pop-up dialog box
Multiple sclerosis signs and symptoms may differ greatly from
person to person and over the course of the disease depending
on the location of affected nerve fibers. Symptoms often affect
movement, such as:

Numbness or weakness in one or more limbs that typically

occurs on one side of your body at a time, or your legs and trunk
Electric-shock sensations that occur with certain neck
movements, especially bending the neck forward (Lhermitte
sign)
Tremor, lack of coordination or unsteady gait
Vision problems are also common, including:
Partial or complete loss of vision, usually in one eye at a time,
often with pain during eye movement
Prolonged double vision
Blurry vision
Multiple sclerosis symptoms may also include:

Slurred speech, Fatigue, Dizziness, Tingling or pain in parts of

your body, Problems with sexual, bowel and bladder function
 Treatments for MS attacks

Corticosteroids, such as oral prednisone and intravenous

methylprednisolone, are prescribed to reduce nerve
inflammation. Side effects may include insomnia, increased
blood pressure, increased blood glucose levels, mood swings
and fluid retention.

Plasma exchange (plasmapheresis). The liquid portion of part of

your blood (plasma) is removed and separated from your blood
cells. The blood cells are then mixed with a protein solution
(albumin) and put back into your body. Plasma exchange may
be used if your symptoms are new, severe and haven't responded
to steroids.
 Nursing interventions
1-Recommend participation in groups involved in fitness or exercise and/or
the Multiple Sclerosis Society.

2-Stress need for stopping exercise or activity just short of fatigue.

3-Assist with physical therapy. Increase patient comfort with massages and
relaxing baths.

4-Identify and review factors affecting the ability to be active: temperature

extremes, inadequate food intake, insomnia, use of medications, time of day.

5-Note behaviors indicative of powerlessness or hopelessness. The patient may

say statements of despair.

6-Discuss increased risk of osteoporosis and review preventive measures, e.g.,

regular exercise, intake of calcium and vitamin D, reduced intake of caffeine,
cessation of smoking.

Complications :

• Spasms

• Paralysis , usually in legs

• Problems with the bladder , bowel , or sexual

function
• Mental changes , such as forgetfulness or mood
swings

• Depression

• Epilepsy

Lab Investigation :

• MRI

• X_rays

• CSF
 • CT

Some medication :

• Ritalin

• Zanaflex

• Pradnisons

• Methylprednisolone

• Plasma exchange