Pathophysiology

Probably autoimmune disease

Antibodies and white blood cells
attack the proteins in the neurons
myelin sheath
Multiple areas of scarring +
Sclerosis (Hardening) of nerve fibers
Usually in spinal cord, stem and optic
nerves

Risk Factors
More women than men
More common in Caucasians
Children of parents with MS have a
higher rate of incidence (15 20%)
cause of debilitation in young people
(ages20 - 40)

Multiple Sclerosis
Medications
For Disease Process:
Avonex IM Weekly (interferon beta
1a)
Betaseron SQ Daily (interferon beta
1b)
Copaxone SQ Daily
Rebif SQ given 3 x week
For Symptom Management:
Baclofen/Dantrium (for spasms)
NSAIDS (for flu-like side effects and
pain)
Analgesics (pain)
Corticosteroids (limit severity by
modulating immune response which
decreases inflammation)
Beta blockers for tremors (like
Inderal)
Anticonvulsants for paresthesia (like
Tegretol)
Anticholinergics for bladder
dysfunction (Pro-Banthine)

Progressive
Degenerative
No Cure
Affects nerve fibers in the brain and
spinal cord
Most common neurological cause of
debilitation in young people (ages 20
- 40)

Treatment
Control symptoms
Prevent complications
Provide adaptive devices to increase
mobility and self-care

Nursing Diagnoses
Fatigue

Self-care Deficit

Low Self-Esteem

Powerlessness/Hopelessness

Risk for Ineffective Coping

Ineffective Family Coping

Impaired Urinary Elimination

Knowledge Deficit

Risk for Caregiver Role Strain

Signs & Symptoms

Fatigue
Muscle Weakness
Muscle Spasticity
Dysarthria
Ataxia
Lhermitte's sign (Electrical sensation
down the spine on neck flexion)
Dysphagia
Tinnitus
Uhthoffs Sign (Exertion or Heat
causes sudden exacerbation of S&S)
Paresthesia
Pain
Bowel, bladder and sexual
dysfunction
Vision Disturbances