NURS 308 - Multiple Sclerosis

20-50

multiple sclerosis has a gradual onset, and commonly occurs at age _____

permanent loss of function

as ongoing inflammation from multiple sclerosis occurs, there is:

- blurred or double vision, color distortions, blindness in one eye

- weakness in extremities; problems with coordination, balance, walking and standing

- paresthesias in the lower extremities and hands

- lhermitte’s sign

- fatigue

- pain, aches

- dysarthria

- tremors

- dizziness

- hearing loss

- nystagmus

- bowel and bladder dysfunction

- sexual dysfunction

- ataxia

- cognitive function changes

- remission during pregnancy

*has a ‘spotty’ distribution in the CNS: manifestations vary according to the area involved

clinical manifestations of multiple sclerosis:

lhermitte's sign

transient electric shock radiating down the spine or into the limbs with flexion of the neck - AKA: barber chair sign

progressive-relapsing multiple sclerosis

pattern of multiple sclerosis: steady decline in function since onset with superimposed attacks

secondary progressive multiple sclerosis

pattern of multiple sclerosis: initial relapsing-remitting multiple sclerosis that suddenly begins to have decline without periods of remission

primary progressive multiple sclerosis

pattern of multiple sclerosis: steady increase in disability without attacks

relapsing-remitting multiple sclerosis

pattern of multiple sclerosis: unpredictable attacks which may or may not leave permanent deficits followed by periods of remission - most common

sclerotic plaques in the brain - inflammation - atrophy of the brain - tissue destruction

an MRI of a patient with multiple sclerosis may show:

evoked potential response

tests for the speed of transmission through nerves - if the speed is delayed, then MS is considered

expanded disability status scale (EDSS)

questionnaire that focuses on symptoms, exacerbations, remissions, and impact on ADLs - a good tool to use to diagnose and to follow the effectiveness of treatment

baclofen

a skeletal muscle relaxant used for patients with muscle spasms

intrathecal baclofen

a catheter is inserted into the spinal column and a medication is administered through a pump to help prevent muscle spasms

dorsal column electrical stimulation

a probe is inserted into the spinal column and electrical impulses are delivered to speed the rate of impulses through the nerve

water exercises: water exercises do not put any stress or strain on the affected limbs while allowing the patient to move freely in the water

what type of exercise therapy would be beneficial for a patient with multiple sclerosis?

apathy - inattentiveness - depression

often are signs of cognitive dysfunction associated with MS

prevent injury and infection

what is the main focus for a patient with multiple sclerosis?