Multiple sclerosis (MS) is a disease of the nervous system that affects the brain and the spinal cord. In this condition, the nerve fibers and myelin sheathing (the protective sheath that covers nerve fibers) are being attacked by the immune system. This results in inflammation, disrupting nerve cell processes. MS can be a highly debilitating disease.
Quick Facts
- The nerve cells in the body are covered by a myelin sheath.
- Multiple sclerosis is an autoimmune disease. Meaning, the healthy cells are being attacked by the body’s immune system.
- There are about 2 million people affected by Multiple Sclerosis in the entire world.
- The cause of MS is unknown.
- Women are more frequently affected.
- There is no known cure for MS.
- Initial symptoms are blurry/double vision. Next is distortion in red-green color and blindness in one eye.
- Common symptoms of Multiple Sclerosis:
- Muscle weakness
- Visual disturbance
- Having problems with balance and coordination
- Memory and thinking problems
- Numbness, pricking, or “needles and pins sensations”
Disease Course
MS is broken down into categories based on the disease course:
- Relapsing-remitting (RR): Initial onset of the disease. Symptoms may last up to 48 hours. It develops for over days to weeks. Almost 70 percent of patients show this course.
- Primary progressive (PP): This course has a gradual deteriorating change from the onset. Almost 20 percent of the patients experience this. There is no relapse in this course.
- Secondary progressive (SP): Relapses of symptoms can be experienced in this course. The symptoms are muscle weakness or memory problems. There is a gradual deterioration from the onset of the RR course.
- Progressive relapsing (PR): the pattern is the same as in the SP course. This can be seen in almost 5 percent of patients.
- Clinically isolated syndrome: the classification of this course is inflammatory CNS demyelination.
- Fulminant: this course of the disease is characterized by severe multiple sclerosis. Multiple relapses are seen in this course that may lead to disability.
- Benign: this course of the disease is characterized by mild disability and relapses are not very rare.
Risk factors
- Age
- Sex
- Family history
- Certain infections
- Race
- Climate
- Vitamin D deficiency
- Certain autoimmune diseases
- Smoking
Signs and Symptoms
Early
- Vision problems
- Muscle weakness
- Tingling sensation
- Clumsiness
- Bladder control problems
- Intermittent or constant dizziness
Later
- Mental or physical fatigue
- Mood changes
- Cognitive dysfunction
- Pain: this is rarely felt. Yet, most times it is experienced with optic neuritis and trigeminal neuralgia
Other signs and symptoms
- Stiffness
- Speech difficulties
- Swallowing disorders
- Pseudobulbar affect
- Sleep issues
- Uhthoff’s syndrome
New symptoms are progressing when a relapse of the symptoms occurs. This can be mild or severe to the extent that the patient may have difficulty in dealing with activities of daily living.
Tests
- CSF Analysis: This helps diagnose conditions that affect the brain and the spinal cord. The cerebrospinal fluid is drawn out from your back using a special needle. The patient may be asked to stay lying on the bed for about two hours to prevent headaches.
- CSF Immunoglobulin G (IgG) Index: This test helps with the diagnosis of MS. Your doctor will take a sample of your spinal fluid. This fluid looks clear. You may encounter headaches that would last for hours or a week.
- CSF Oligoclonal Banding: This test is used to look for inflammation-related proteins that may be found in the cerebrospinal fluid. Lumbar puncture is one of the common ways to take a sample for this test.
- Magnetic resonance imaging (MRI)
Diagnosis
As of the moment, there are no known ways to diagnose MS. Yet, doctors organize a strategy to identify MS at an early stage. These strategies are:
- Careful medical history
- Neurologic exam
- Tests: spinal fluid and blood test
Treatment
There is no known treatment for multiple sclerosis but there are alternative ways to lessen the signs and symptoms of MS. The American Academy of Neurology had made a summary of the evidence-based guideline. This is CAM: Complementary and Alternative Medicine for Multiple Sclerosis. Please note that the FDA had only approved some of these medicines:
- Magnetic Therapy
- Reflexology
- Ginkgo Biloba (GB)
- Bee Venom, low-fat diet, and Cari Loder regimen
- Medical Marijuana (Cannabis)
- OCE and Synthetic THC: THC (chemical compounds tetrahydrocannabinol) otherwise called cannabinoids. They came from the cannabis plant.
- Oromucosal Cannabinoid Spray (Nabiximols)
- Smoked Cannabis
Nursing Interventions
- Provide bed rest during exacerbation.
- Inform the patient about the importance and benefits of safety measures.
- Check the patient’s heating pad before applying.
- Educate the patient to use assistive devices to aid with their loss of motor abilities.
- Give an eye patch for diplopia.
- Monitor and observe patients for possible complications from other conditions.
- Help the patient to start a regular exercise and rest program and educate the patient to balance moderate activity with rest periods.
- Assess the need for and provide assistive devices.
- Start physical and speech therapy.
- Educate the patient to avoid fatigue, stress, infection, overheating, and chilling.
- Educate the patient to increase fluid intake and eat a balanced diet, including low-fat, high-fiber foods and foods high in potassium.
- Train the patient in the self-administration of prescribed medications.
- Provide information about the National Multiple Sclerosis Society.
