AM Henderson
Deborah Henderson
READINGS NOTES
Ouellette, D., (2019). Nursing
Management: Chronic Neurological Multiple sclerosis (MS) - a chronic,
Problems. In S.L. Lewis, L. Bucher, progressive, degenerative, autoimmune
M.M. Heitkemper, M.M. Harding, M.A. disorder of the CNS
Barry, J. Lok, J. Tyerman, & S. -> characterized by the spreading of
Goldsworthy, Medical-surgical nursing demyelination of nerve fibres in the
in Canada (4th Canadian Edition.), brain, spinal cord, and optical nerves
(pp. 1546-1551). Elsevier. -> ALSO chronic inflammation and gliosis
(scarring) in CNS
● HIGH prevalence in temperate
climates (e.g., Canada, US,
Australia)
● Considered a disease of young
to middle-aged adults (average
onset age: 30)
● Ratio of 3:1 with females being
more affected than males
Biology & Pathophysiology
Causes: unknown - research findings
suggest environmental, infectious
(viral), and muscular factors, as well as
vitamin D deficiency.
● Genetic susceptibility up to 3rd-degree
relatives
Possible precipitating factors (NOT
confirmed): infection, trauma,
emotional stress, excessive fatigue,
pregnancy, and a state of poor health.
● Disease process: loss of myelin,
the disappearance of
oligodendrocytes, and
proliferation of astrocytes
● Result in plaque formation
(sclerosis) -> plaques scattered
throughout CNS
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AM Henderson
Clinical Manifestations
The onset of MS is slow - multiple
vague symptoms occurring
intermittently over a span of months or
years.
-> disease may be diagnosed long after the
first symptom
● MS occurs as a chronic,
progressive deterioration in
some and remissions &
exacerbations in others
● Clinical manifestations
VARY depending on the part
of the CNS affected
Common signs & symptoms: motor,
sensory, cerebellar, and emotional
impairments.
● Motor - weakness or paralysis,
diplopia (double vision),
scanning speech, muscle
spasticity
● Sensory - numbness, tingling (+
other paresthesias), scotomas
(patchy blindness), blurred
vision, vertigo, tinnitus,
decreased hearing, and chronic
neuropathic pain
● Cerebellar - nystagmus,
ataxia, dysarthria, and
dysphagia
● Emotional - severe fatigue, increased
energy needs, deconditioning,
depression, and medication
adverse effects
❖ Bowel & bladder function may
be impaired, as well as sexual
dysfunction may occur
❖ NO impact on pregnancy,
labour, delivery, or lactation;
however, in the postpartum
period, women are more likely
to go into remission relapse
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