MULTIPLE SCLEROSIS

• Multiple Sclerosis (MS)


  Chronic, progressive, degenerative, autoimmune disorder of the central nervous system
• No cure for MS
• Etiology of MS

  • immune system
  • genetics
  • environment
• Prevalence & Statistics of MS in Canada

  • Canada has one of the highest rates of MS in the world (1 in every 400 people)
• Associations with MS

  • gender - affecting more women than men
  • race - caucasians of northern european descent
  • family history - small increased risk
  • environment - cool climate, little sunshine
  • diet - low vitamin D levels
• Assessment: Recognize cues


  History - vision, mobility, and sensory perception changes. Aggravation of symptoms. Personality or behavior changes. Family history.

  signs and symptoms

  psychosocial assessment - mental health, understanding of illness, support system, change in cognition

  laboratory assessment - lumbar puncture

  other diagnostic assessments - magnetic resonance imaging, evoked potential testing
• Signs & Symptoms of MS

  • fatigue
  • weakness
  • depression
  • shaking (tremor) and loss of coordination
  • cognitive impairment
  • numbness and tingling/sensory impairment
  • pain
  • bladder and bowel dysfunction
  • visual loss (optic neuritis)
  • double vision
  • sexual dysfunction
  • unsteadiness and dizziness
  • heat intolerance
  • spasticity
  • dysarthria
  • dysphagia
• Analyze cues & prioritize Hypotheses


  Impaired immunity d/t the disease and drug therapy for disease management
• Managing impaired immunity


  Increased risk of infection
• Improving mobility


  MS symptoms affect mobility: spasticity, tremor, pain, fatigue

  referral to PT and OT

  plan and space out activites
• Managing decreased visual acuity & cognition

  Visual Acuity - Regular eye exams, Eye patches, Scanning techniques, Glasses
• Care coordination & management

  Home care management
• drug therapy

  • disease modifying therapies - immunomodulators
  • relapse management medications - corticosteroids