Multiple Sclerosis.pptx

Multiple Sclerosis Module 202 Outline • Clarify “demyelination” as a term • What is affected in MS • Understand “dissemination” as a term • Investigations in MS • Treatments in MS • Nursing perspective “Demyelination” Peripheral nervous system Neuropathy Central nervous system Inflammation “...

Multiple Sclerosis Module 202 Outline • Clarify “demyelination” as a term • What is affected in MS • Understand “dissemination” as a term • Investigations in MS • Treatments in MS • Nursing perspective “Demyelination” Peripheral nervous system Neuropathy Central nervous system Inflammation “Demyelination” Demyelinating Axonal Peripheral nervous system Neuropathy Central nervous system Inflammation “Demyelination” Demyelinating Guillain-Barre CIDP etc MS etc Axonal Diabetes Alcohol Autoimmunity etc Toxins Autoimmunity Infection etc Peripheral nervous system Neuropathy Central nervous system Inflammation “Demyelination” Demyelinating Guillain-Barre CIDP etc MS etc Axonal Diabetes Alcohol Autoimmunity etc Toxins Autoimmunity Infection etc Peripheral nervous system Neuropathy Central nervous system Inflammation What areas are affected? What areas are affected? • • • • • Brain Cerebellum Brainstem Spinal cord Optic nerves What signs might we find? • Brain - weakness, sensory, cognitive • Cerebellum - ataxia • Brainstem - diplopia, dysarthria, dysphagia • Spinal cord - weakness, sensory, sphincters, • Optic nerves - visual loss Dissemination in time and space Dissemination in time and space “Types” of MS Investigations Lumbar puncture Lumbar puncture • Glucose and protein normal • Mildly raised white cells • Positive oligoclonal bands – Synthesis of IgG in CNS but not in peripheral blood – Used to demonstrate dissemination in time MRI MRI MRI MRI MRI MRI Treatment Treatment • Acute treatments of relapse – steroids • Symptomatic treatments • Disease modifying therapies Symptomatic treatment • • • • Physiotherapy and OT Muscle relaxants for spasticity Medication for fatigue Treating depression, pain, sexual dysfunction, insomnia, bowel and bladder dysfunction Disease modifying therapies Disease modifying therapies Disease modifying therapies Nursing perspective