Multiple Sclerosis

Copyright © by All Care Visiting Nurse Association of Greater Lynn, Inc. 

Note: Best viewed at 800x600 resolution

go to Table of Contents

Return to All Care's Home Health Aide Department Page 

Multiple Sclerosis

Table of Contents

Note: Click on topic

Objectives

What is Multiple Sclerosis?

Diagnosis

Caring for the Patient with MS

Quiz

References

go to Title page

Multiple Sclerosis

Objectives

After completing this section, you should be able to;

1. Define Multiple Sclerosis

2. List common signs and symptoms.

3. Describe the causes of Multiple Sclerosis

4. Identify preventative interventions related to Multiple sclerosis

5. Identify treatments associated with Multiple Sclerosis

go to What is Multiple Sclerosis

Multiple Sclerosis

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is a chronic degenerative disorder affecting the Central Nervous System: the Brain and Spinal cord.   MS is one of the leading causes of neurological disabilities in young adults.   MS affects both genders more common in women than men do.   It is more prevalent in the northern regions of the US, more so than in the southern regions, also MS affects people in the Northeast, the Great Lakes region, and the Pacific Northwest as well.

The Mayo Clinic lists four main patterns of Multiple Sclerosis:

Relapsing remitting. This type of MS is characterized by clearly defined flare-up, followed by periods of remission.   The flare-ups typically appear suddenly, last a few weeks or months, and then gradually disappear.   Most people with MS have this form at the time of diagnosis.

Primary Progressive. People with this less common form of MS experience a gradual decline, without periods of remission.   People with this form of MS are usually older than 40 when symptoms begin.

Secondary Progressive. More than half the people with relapsing remitting MS eventually enter a stage of continuous deterioration referred to as secondary progressive MS.   Sudden relapses may occur, superimposed upon the continuous deterioration that characterizes this type of MS.

Progressive relapsing. This is primary progressive MS with the addition of sudden episodes of new symptoms or worsened existing ones.   This form is relatively rare. (MayoClinic.com 1998, 2004)

go to Diagnosis

Multiple Sclerosis

Diagnosis

"Comprehensive neurological exam and complete medical history rule out other diseases, not one definite test" ( nationalmssociety.org ).   Examining the cerebrospinal fluid after a spinal tap confirms the diagnosis of MS.   Magnetic Resonance (MRI) help to identify areas affected by the disease process in both the brain and the extremities.   CT scan reveals changes within the brain.   The signs and symptoms of MS are fatigue, weakness, numbness, and difficulty with coordination and loss of balance.   A percentage of patients complained of visual disturbances including blurry vision, patchy blindness and total blindness.

The cause of MS is unclear at this time.   Presently research is done in the areas of viral, immunology and genetic factors.   Autoimmune response triggered by the exposure to a virus or environmental trigger in genetically susceptible individuals.   The exposure to a virus causes reactions that form antibodies to fight the virus.   Antibodies attack the myelin instead of the virus- an autoimmune response.   There is no cure for MS. The medications given to the patient are for the management and relieve of symptoms.   Side effects of these medications are: weak, fatigue, groggy, decreased in alertness, all these symptoms can interfere with the performance of Activity of Daily Living (ADL).

The disease process of MS involves the nerve cells called neurons.   In Multiple sclerosis nerves are hardened in multiple location of the body, the breakdown is scattered irregularly throughout the body, decreasing aspect of functional abilities, depending on which nerves are affected.

go to Caring for the Patient with MS

Multiple Sclerosis

The neurons of the brain in some clients may also be affected, resulting in alteration in personality and moods.   Symptoms of bipolar disorder may be present; client moods fluctuate between euphoria (extreme feeling of happiness) and depression.   Personality may be affected and the client can be inappropriate at times, may appear to overreact.   The importance of not taking the client’s mood swings, as a personal offense cannot be stressed enough.   The MS client may be forgetful and easily distracted and may exhibit emotional liability.   Patients with MS may often conceal their emotions.   Compassion and significant emotional support is needed to help these clients deal with the disruption of their normal life and loss of function.   Encourage client to maintain normal routine, and socialization.

Safety in the home is a must; changes such as visual loss in many patients can put them at risk for falls.   Keeping hallways free of clutter and equipment within reach is essential. Due to physical disability clients may use devices such as walker, cane, braces, or crutches.   Some patients may be wheelchair or bed bound.

Sensory is also affected, when assisting with bathing, observe the skin integrity for breakdown.   Often clients may not feel open sores or lesions due to the loss of sensation.   Pay special care to pressure areas, massage over bony prominence to improve circulation and repositioning every two hours for bed and wheelchair bound clients.

Alteration in muscle tone and physical disabilities can lead to signs and symptoms of constipation, diarrhea, fecal incontinence, and urinary tract infections.   These symptoms can be very difficult for many clients to cope with emotionally.   Be sensitive to this.

Presently there is no cure for Multiple Sclerosis, treatments recommended for disease modifying medications as soon as possible.   Medications such as Beta interferon or Glatiramer (Copaxone) are forms of protein derivatives approved for people with relapsing forms of MS who can still walk.   Some medication help in relieving symptoms of progressive MS, they include Corticosteroids, to reduce inflammation in nerve tissue and to reduce the duration of the flare-ups; muscle relaxants, baclofen and tizanidine for muscle spasticity and antidepressant medications to reduce fatigue.

Treatments of the MS client focus on maintaining as much independence as possible.   Care plans may need to be modified according to the disease process and the client coping mechanism.   Encourage client to perform as much of his personal care as able to promote independence and to maintain range of motion.

take a Quiz

Multiple Sclerosis

Quiz