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A&P Signs & Symptoms Management of condition

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1 A&P Signs & Symptoms Management of condition
Multiple Sclerosis Carol Forde-Johnston, Lecturer Practitioner Oxford, UK. A&P Signs & Symptoms Management of condition

2 What is Multiple Sclerosis?
MS is a common demyelinating disease characterised by focal disturbance of function & relapsing & remitting course MS usually occurs in young adults with a peak age of incidence of years. Slightly more females affected than males There is a 3 % risk of the disease if a sibling or parent is affected

3 Pathology Scattered lesions with a greyish colour, 1mm-several cm in siz34e are present in the white matter of the brain & spine & are referred to as plaques the lesions lie in close relationship to veins

4 Causes Immune deficiency has been suggested. This might explain the possible persistence of a latent virus & could be the basis of ‘relapses & remissions’ Hereditary / genetic factors appear significant with an increased familial incidence of MS. Affected women transmit MS to offspring more frequently than affected men

5 Other Causes?? Viruses may be important in the development of MS, infection perhaps occurring in a genetically/immunologically acceptable host In summary, the causation is probably multi factorial e.g. genetic predisposition, disordered immune response, environmental exposure

6 Clinical Features Usually characterised by S&S of white matter disease with a relapsing & remitting course Initially may have vague symptoms such as lack of energy, headache, depression and aching limbs These may lead to more precise symptoms

7 Precise Symptoms Sensory disturbance (40%)
Retrobulbar neuritis (optic neuritis) (17%) Limb weakness (12%) Diplopia (11%) Vertigo, Ataxia & Sphincter disturbance (20%)

8 Investigations Neurophysiology / Visual Evoked potentials : positive wave may be delayed CSF examination via Lumbar Puncture may detect oligoclonal bands in 95% patients with MS MRI: abnormal plaques/lesions may be found on MRI scan

9 Treatments Steroid therapy such as prednisolone or methylprednisolone
Anti-spasmodics / cannabis trials to relieve leg spasms Much of the treatment aims to reduce / relieve symptoms

10 Nursing care Aim: To control/relieve/prevent symptoms
Aid comfort & mobility Elimination needs e.g. constipation, self catheterisation Nutritional requirements eg poor swallow Issues with sexuality, social/occupational issues

11 Psycho/social Care MDT Community services: Continence advisors
Voluntary services: MS Society / Relate MS Specialist Nurses Respite Care Rehabilitation services

12 Research Immune Disease? Viruses? Gene therapy?
Cannabis to control spasms/pain Betainterferon effects progression Chemotherapy drugs

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