Multiple Sclerosis is a chronic yet progressive degenerative disease of the central nervous system. It is non-contagious however very damaging for the individual. The breakdown of the myelin or termed as
demyelination makes the nerve cells unable to conductelectrical impulse thus making the muscles weak. This process affects the white matter of the central nervous system. As the condition takes its course, patients may suffer from difficulty in acquiring normal vision, disturbance in speech, as well as in their penmanship.
The existence of multiple sclerosis in the early adult life may be related to autoimmunity. Most the cases are recorded to be occurring in colder climate, common to age groups between 20 years old to 40 years old. The whole course of the disease may last between 10 to 20 years. As it is more apparent in colder areas, in United States for instance, approximately 350,000 were found out to have multiple sclerosis. Most of the known cases are Caucasians.
Pathophysiology in Sequence:
- Demyelination of nerve fibers within long conducting pathway of spinal cord and brain.
- Impaired transmission of never impulses.
- Degenerative changes myelin sheath are scattered irregularly throughout the central nervous system. Nerve axon also deteriorates. The area involved are not consistent when it comes to deterioration thereby showing the signs and symptoms appear whenever the nerve conduction is interrupted.
- There are periods of remission also, however there are cases that symptoms are exacerbated especially when nerve impulse travel through the patchy never fibers.
Signs and Symptoms:
- Spastic weakness – the most common sign
- Charcots Triad: A combination of symptoms that includes nystagmus, intention tremor ( motor weakness in coordination), scanning speech which is elicited by slowing enunciation with tendency to hesitate at beginning of a word.
- Hyper in emotions as well as euphoria
- Visual disturbances
- Nausea and vomiting
- Urinary retention or urinary incontinence
- Dysphagia – difficulty in swallowing
- Ataxia – a problem in coordination
Nursing Management:
- The goal of management is focused only on alleviating the symptoms.
- Sympomatically, allow the patient to work on his or her own in order to let him or her to know that the situation is still under control.
- Comply with the medications such as cortisone or corticotrophin. These medications help in decreasing edema and inflammation at areas of demyelination.
- Coordinate with a physical therapist in order to facilitate daily living. This prevents complications of immobility.
- Provide proper skin care as the patient is prone in decubitus ulcers as the demyelination progresses.
- Allow the patient to get in touch with the world, his family and friends to emotionally support as he keeps his mind intact in battling this degenerative condition.
- Provide a safe environment for the patient always. Use prescribed equipment for transport, transferring the patient as well as in mobilization.