Multiple sclerosis

Multiple sclerosis is a progressively disabling demyelinating disease affecting nerve fibers of the brain and spinal cord and marked by periodic exacerbations and remissions. Incidence is greater for women than men and is highest in temperate climates. Onset is between ages 20 and 40. The cause of multiple sclerosis is unknown but theories suggest that myelin damage is the primary event and that it results from a viral infection early in life. Defective immune response has a major role in the pathogenesis of Multiple Sclerosis.

Manifestations show that there is a major problem in the optic nerve like visual disturbances such as blurred vision, nystagmus and diplopia. Motor dysfunctions like muscle weakness that typically worsens throughout the day, paralysis, spasticity, hyperreflexia, tremors and gait ataxia. Other manifestations are body malaise, bladder and bowel incontinence. Mental changes such as mood swings, irritability and depression.

Laboratory and diagnostic findings reveal that through lumbar puncture and cerebrospinal fluid analysis is increase. Magnetic resonance imaging may confirm the presence of demyelinating plaques.

To decrease the chance to progress multiple sclerosis several management needs to be practice. Administer prescribed medications like corticosteroids and muscle relaxants. Hormones such as corticotrophin may be prescribed to stimulate release of adrenal cortex hormones, which help to improve nerve conduction. Instruct the client to notify the health care provider if serious adverse effects, such as fluid retention, muscle weakness, abdominal pain or headache occur.

Measures to avoid fatigue needs to be promoted. Like sleeping and rest patterns needs to be assessed. Adequate rest should be encouraged. Lifestyle modifications must be implemented like decreasing stress and fatigue to maximize functional abilities. Relaxation and coordination exercises will be encouraged improving muscle efficiency. Self-care will be promoted, complications of immobility will need to be prevented and maximize effective communication. Eye patch will be applied if diplopia occurs to avoid dryness and entry of foreign bodies that will infect the eyes. Appropriate care during exacerbations needs to be provided such as help the client establish bladder and bowel control, prevent and treat muscle spasticity.

For effective communication, assess the client and family's understanding of the disease to identify ways to provide efficient communication. Listen closely to the client and allow the client time to communicate needs. Have the client blink, wiggle his fingers for yes and no questions, or allow other gestures. Use a communication board or pictures and encourage lip reading. Simple commands like gestures such as pointing to objects needs to be implemented.

Clients with multiple sclerosis will show evidence of adequate cerebral tissue perfusion such as being alert and oriented to time, place and person. Improvement in cognitive functioning and problem solving is a sign that he is returning to normal behavior. There should be no signs of infections to fully declare that the client is back to healthy lifestyle.