1. Multiple sclerosis

2. Multiple sclerosis
A chronic, progressive, degenerative disorder of the central nervous system, characterised by isolated patchy demyelination of the neurones of the CNS. It is usually associated with progressive impaired motor nerve conduction and muscle weakness. The name multiple sclerosis refers to scars or lesions in the white matter of the brain and spinal cord, which is mainly composed of myelin.

3. incidence
It is common in people within the ages of years and more common in females.

4. aetiology
The specific cause is unknown
It is associated with climatic influence; that is, low in the tropics and high in the temperate regions
Familial
Autoimmunity
Viral infections e.g. measles
Aggravated by pregnancy and infections

5. pathophysiology
Multiple sclerosis affects the ability of nerve cells in the brain and spinal cord to communicate with each other. Nerve cells communicate by sending actions potentials down axons which are wrapped in myelin. In Multiple sclerosis, the body's own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer effectively conduct signals. Leading to progressively impaired motor nerve conduction and muscle weakness.

6. Clinical features
Weakness in the limbs of one side of the body that often results in dragging of the feet.
Paraesthesia e.g. numbness, tingling of the feet, needles and pin pricks in the limb
Lhemetti’s Sign:
Blurred vision, double vision [diplopia], amaurosis fugax and nystalgmus,
Paralysis,
Speech difficulty,
Euphoria,
Diminished position sense.

7. Diagnostic investigations
Lumber puncture [to obtain CSF for analysis]
CT scan
EEG

8. management Medications:
Corticosteroids: e.g. prednisone
Immunosuppressants: e.g. cyclophosphamide
ATBs:
Diet: high calorie diet, high protein, high vitamin, low fat, gluten free

9. Sexual dysfunction related to neuromuscular deficits
NURSING MANAGEMENT
Impaired physical mobility related to muscle weakness, paralysis and muscle spasticity
Sexual dysfunction related to neuromuscular deficits
Altered urinary elimination pattern (retention) related to sensorimotor deficits
Interrupted family processes related to changing family roles, fluctuating physical condition