multiple sclerosis
disabling disease of the brain and spinal cord
demyelination and gliosis (scarring) of the nerves
job of myelin
increase speed and enhance transmission of electrical impulses
first sign of MS
vision changes
relapsing
attacking
remitting
disease free state
relapsing-remitting
clear relapses / exacerbations with full recovery and no lasting disability and no worsening of the disease between attacks
primary-progressive
steadily progressing / worsening with minor recovery
secondary-progressive
beginning as a pattern of clear-cut relapses and recovery but becoming steadily progressive and worsening between acute attacks
progressive-relapsing
steadily progressing from onset but also involving clear, acute attacks
teaching pt with unsteady gait
walk with feet apart
motor manifestations
muscle weakness, spasticity, paralysis
diplopia
bowel and bladder dysfunction
fatigue!!
hyperactive deep tendon reflexes
sensory manifestations
numbness or tingling
burning or crawling sensations
scotomas (patchy blindness)
vertigo
chronic neuropathic pain
cerebellar manifestations
ataxia
nystagmus
dysarthria
dysphagia
ataxia
unsteady, staggering gait
nystagmus
repetitive uncontrolled eye movements
dysarthria
slow, slurred speech
dysphagia
difficulty swallowing
shock
when you flex neck
MS will have positive...
babinski sign
emotional manifestations
anger
depression
euphoria
sexual dysfunction
cognitive function
euphoria
state of intense excitement or happiness
diagnostics
no definitive test
diagnosis of exclusion
MRI with contrast-detection
LP with analysis of CSF
EMG
electromyogram
measures electrical activity of muscles at rest
immunomodulators
decrease destruction of myelin
urinary retention
give cholinergics
urinary frequency
give anticholinergics
kegel exercises
identify and contract for 5-10 seconds
alternate therapy
acupuncture
beestings
supplements
medical marijuana
plasmapheresis
plasmapheresis
pull PTS plasma out and is cleansed then put back into the PT
nursing interventions
adequate rest
energy conservation measures
heat exhausts them
cold relaxes them
exercise during remission
anti-embolism stockings
patient teaching
space out activities
avoid triggers--> stress, infection, fatigue, heat
use protective clothing and sunscreen
coping strategies
support groups