MULTIPLE-SCLEROSIS.pptx Perception and coordination

Perception and coordination

1. Other topics - Semi-Finals Responses to Altered Perception Neurological Disturbance a. degenerative: -Multiple Sclerosis -Parkinson’s Disease -Myasthenia Gravis

2. Multiple Sclerosis

3. Multiple Sclerosis Sclerosis - ?

4. Multiple Sclerosis Sclerosis - in medicine it refers to the stiffening or hardening of a tissue or anatomical feature, often caused by the replacement of normal tissue with scar-like connective tissue

5. Multiple Sclerosis MS) is a chronic condition unpredictable disease of the central nervous system where the immune system mistakenly attacks nerve fibers' protective covering ( myelin sheath) , leading to various neurological symptoms.

6. Multiple Sclerosis MS is an autoimmune disease that affects the M yelin S heath of the neurons (nerves) in the CNS (brain and spinal cord)

7. Multiple Sclerosis - pathophysiology The neuron which is attack become inflamed and result to scarring of the neuron

8. Multiple Sclerosis - pathophysiology Inflamed neurons will result in a decrease in nerve signal transmission This will lead to motor and sensory symptoms

9. Multiple Sclerosis - facts Immune related – immune cells going to the CNS and attack the myelin sheath Note : myelin sheath protects the axons in our neurons and axons are responsible for the transmission of electrical signals to other neurons

10. Multiple Sclerosis - facts Symptoms vary – this is so because of its effects in the CNS Example: cerebellar area: Sx are tremors, dysarthria (issues in articulating speech), ataxia (balance), cognitive

11. Multiple Sclerosis - facts Different forms Relapsing-remitting MS (most common) on and off Affects women 20-40 yrs.

12. Multiple Sclerosis – cause & cure and management Unknown No cure Can be managed by: improved lifestyle like exercise Medications (prescribed) to improve symptoms

13. Multiple Sclerosis – diagnosis How to diagnose? Diagnosing takes time Neurologist has to assess various things. The signs and symptoms should rule out other diseases

14. Multiple Sclerosis – diagnosis 2. MRI (magnetic resonance imaging) of the brain and spinal cord; to look for inflammation and scarring of the neuron 3. Lumbar puncture

15. Multiple Sclerosis – diagnosis 3. Lumbar puncture – CSF to look for the presence of oligoclonal bands (OCBs), specifically IgG oligoclonal bands (IgG OCBs), in the cerebrospinal fluid (CSF) - a significant indicator, detected in nearly 90% of MS patients.

16. Multiple Sclerosis – diagnosis 3. Lumbar puncture – CSF to look for the presence of oligoclonal bands (OCBs), specifically IgG oligoclonal bands (IgG OCBs), in the cerebrospinal fluid (CSF) - a significant indicator, detected in nearly 90% of MS patients – which explains of inflammation in the CNS

17. Multiple Sclerosis – diagnosis 4. Evoked potential study measures electrical activity in the brain in response to stimulation of sight, sound, or touch. When the brain is stimulated by sight, sound, or touch, signals travel along the nerves to the brain.

18. Multiple Sclerosis – diagnosis Difference between Evoked potential study and EEG (electroencephalogram) EEG measures and records our brain's electrical signals as they naturally happen. While Evoked potential tests measure how quickly your nerves respond to certain stimulation.

19. Multiple Sclerosis – signs and symptoms Emotion and cognitive Drained (fatigued) Depressed Speech issues (dysarthria) Dysphagia Mood swings 9easily be happy and switch to sadness) Trouble – thinking (focus, problem solving

20. Multiple Sclerosis – signs and symptoms sensation Tremors Spasm 9very painful) Clumsy Numbness (tingling sensation) in the face and extremities Dizziness, vertigo

21. Multiple Sclerosis – signs and symptoms sensation Coordination issues Romberg’s sign (balance while standing with feet together and eyes closed)

22. Multiple Sclerosis – signs and symptoms Lhermitte’s sign As the patients move the head in various motions, they can experience an electric shock sensation in their body

23. Multiple Sclerosis – signs and symptoms vision Nystagmus - involuntary movement of the eyes Optic neuritis – inflamed optic nerve - Double vision - Blurry - Dull/gray vision - Pain in moving the eyes - Dark spots vision

24. Multiple Sclerosis – signs and symptoms elimination Can’t hold urine -Nocturia - Overactive bladder Problems with contracting to void – retention Bowel – constipation or diarrhea Can’t hold stool

25. Multiple Sclerosis – signs and symptoms Uhthoff’s sign Heat makes the signs and symptoms worse

26. Multiple Sclerosis – nursing interventions Safety Issues in vision, coordination, decreased perception of pain, bowel/bladder (how to educate), RRMS prevention, meds

27. Multiple Sclerosis – nursing interventions Safety Prevention of RRMS (Relapsing-remitting multiple sclerosis with common issues: Fatigue, numbness or tingling, vision problems, difficulty with balance and coordination, and cognitive difficulties, often occurring in relapses followed by period of remission

28. Multiple Sclerosis – nursing interventions Safety medication

29. Multiple Sclerosis – nursing interventions Prevent increase in S/ Sx avoid exposure to too much heat Avoid stress Protect from infection Avoid overexertion

30. Multiple Sclerosis – nursing interventions Prevent increase in S/ Sx Avoid overexertion Exercise is very important to increase energy and decrease depression, but do not overdo it

31. Multiple Sclerosis – nursing interventions Assistive devises Like shower chair Clutter-free environment Scanning the environment before walking or getting out of bed

32. Multiple Sclerosis – nursing interventions Sppech language pathologist and physiotherapies & support groups

33. Multiple Sclerosis – nursing interventions Easy access to the bathroom Self-catheterization 1-2 L fluid Skin care Increase fiber Stool softener Skin care

34. Multiple Sclerosis – medications Beta interferon – decreases the number of relapses of symptoms by decreasing the inflammation and the immune response Risk of infection because it decreases WBCs - Drugs : Avonex (interferon beta 1a), Rebif, Betaferon

35. Multiple Sclerosis – medications Corticosteroids – for relapses of MS symptoms - Decease MS symptoms - Drugs : methylprednisolone, prednisone

36. Multiple Sclerosis – medications Bladder issues Drugs: Oxybutynin – an anticholinergic that helps with overactive bladder by relaxing the bladder muscle to prevent contraction

37. Multiple Sclerosis – medications Bladder issues Drugs: bethanechol–cholinergic that helps with emptying the bladder by helping with bladder contraction

38. Multiple Sclerosis – medications Fatigue Drugs: Amanthadine – (antiviral & antiparkinsonian) has CNS effects that helps improve fatigue in patients with MS

39. Multiple Sclerosis – medications Fatigue Drugs: Modafinil – CNS stimulant

40. Multiple Sclerosis – medications Spasm Drugs: baclofen– skeletal muscle relaxant that acts centrally

41. Multiple Sclerosis – medications Spasm Drugs: Diazepam

42. Multiple Sclerosis – medications tremors Drugs: Propranolol – beta blocker Isoniazid – an antibiotic used for infections, especially TB - Helps certain tremors