Multiple Sclerosis - Fact Sheet
What is Multiple Sclerosis?
Multiple Sclerosis (MS) is a disease of the central nervous
system (CNS), which affects the covering of the nerve fibres located in brain
and spinal cord. This covering, made of protein and fatty material, is called
the myelin sheath. With MS, the myelin, which is needed for nerve transmission,
becomes damaged (demyelination) and the flow of nerve impulses is disrupted.
The damage may happen in ‘multiply’ locations along the nerve fibres and scars
or plaques can form over these areas. ‘Sclerosis’ refers to these hardened
patches or scars.
Photo credit: http://health.howstuffworks.com/diseases-conditions/musculoskeletal/multiple-sclerosis1.htm
The severity of damage varies and the disease process may
differ from person to person. A person with MS may experience periods of
relapse and remission, where symptoms of the disease are present and then
subside. This relapse-remitting type of MS is the most common with
approximately 85% being diagnosed with this form. About half of these will go
on to develop to a progressive form with increasing levels of disability within
the following 10-20 years. MS is not a fatal disease and while the levels of
disability differ, those with MS “can expect to live 95% of their normal life
expectancy” (MS Society of Canada, 2014).
Who gets MS and why?
MS typically develops in young adults age 20-40 years but
may also affect children and older adults. MS occurs in one in every 500-1000
people and women are affected more frequently than men. An estimated 100,000
Canadians have MS (MS Society of Canada, 2014). Although MS occurs in warmer climates, it seems to be more common in geographical locations like Canada and the northern USA where cold, damp climates prevail.
Photo credit: https://sofija.wordpress.com/2007/01/12/multiple-sclerosis-world-map/
MS is not an inherited disease, nor is it contagious. Why
someone is affected is not completed understood. It is believed that genetic
and the environmental factors may contribute to making the body more
susceptible to triggering the autoimmune response activated in MS (Day et al.,
2010).
How is MS diagnosed?
Diagnosis of MS may take time since there is no single test.
A detailed health history of symptoms, neurological testing of reflexes, eye
movements and assessment of coordination and walking (gait) may be done.
Computerized tomography (CT) and magnetic resonance imaging (MRI) scans may
detect areas of demyelination. A lumbar puncture (spinal tap) may be done to
draw a sample of cerebrospinal fluid for analysis. The speed of nerve impulses
along the nerve fibres may be measured to detect abnormalities of conduction.
Treatment
Treatment of MS includes medications. Some of these may include:
Steroids- decrease inflammation and increase periods of remission
Immunomodulators- slow progression and reduce number of relapses
Analgesics- treat pain symptoms
Baclofen, tizanidine, dantrolene and/or benzodiazepines- treat spasticity (muscle stiffness)
Acute infections require prompt treatment and other medications may be prescribed according to an individual's unique needs.
Other treatments:
Physiotherapy and exercise help maintain mobility and reduce spasticity. Occupational therapy can assist with special devices to help with daily work and reduce fatigue. Rehabilitation may help with maintaining bladder and bowel continence, and promoting speech and swallowing.
Diet alone is not a treatment for MS, but a well-balanced diet does provide energy and strengths the immune system (Burke, LeMone, & Mohn-Brown, 2007). Calcium, vitamin D, and weight-bearing exercise counteract bone loss.
Treatment
Treatment of MS includes medications. Some of these may include:
Steroids- decrease inflammation and increase periods of remission
Immunomodulators- slow progression and reduce number of relapses
Analgesics- treat pain symptoms
Baclofen, tizanidine, dantrolene and/or benzodiazepines- treat spasticity (muscle stiffness)
Acute infections require prompt treatment and other medications may be prescribed according to an individual's unique needs.
Photo credit: www.animatedmspatient.com
Other treatments:
Physiotherapy and exercise help maintain mobility and reduce spasticity. Occupational therapy can assist with special devices to help with daily work and reduce fatigue. Rehabilitation may help with maintaining bladder and bowel continence, and promoting speech and swallowing.
Diet alone is not a treatment for MS, but a well-balanced diet does provide energy and strengths the immune system (Burke, LeMone, & Mohn-Brown, 2007). Calcium, vitamin D, and weight-bearing exercise counteract bone loss.
Symptoms and symptom management
The specific areas along the nerve fibres that are affected by demyelination determine the symptoms that will be experienced. Blurring of vision and weakness of the legs are early signs. Double vision, blind spots in the visual field, numbness, burning and tingling in certain areas may occur. Chronic fatigue is common. Some people experience dizziness, difficulty in speech, and changes in mood. With progressive symptoms, loss of coordination, bladder, bowel and sexual dysfunctions may occur. These may be temporary and treatable. However, it is important to work with a health care provider or team, and to seek treatment early in the course of the illness. The diagram below indicates the body systems which MS can affect. It is important to note that not everyone will be affected in the same manner.
Photo credit: http://www.amsvans.com/blog/stem-cell-clinical-trial-for-multiple-sclerosis-approved-by-fda/
There are strategies for managing symptoms as they arise. Getting to know one's limits for activity helps offset fatigue. Extreme fatigue may contribute to symptom relapses and frequent rest periods are encouraged. Caution is advised against injuries and burns that may occur as a result of diminished nerve sensation or as a result of vision disturbances.
Education regarding medications, symptom management, and home care can assist the person with MS to maintain optimal independent function. Additional informative patient videos about MS can be found at www.animatedmspatient.com.
Many areas have established support groups where an individual may meet others to share experiences and learn self-help strategies. Publications and information regarding services available for people with MS and their families, may be found at the Multiple Sclerosis Society of Canada (www.mssociety.ca).
Education regarding medications, symptom management, and home care can assist the person with MS to maintain optimal independent function. Additional informative patient videos about MS can be found at www.animatedmspatient.com.
Many areas have established support groups where an individual may meet others to share experiences and learn self-help strategies. Publications and information regarding services available for people with MS and their families, may be found at the Multiple Sclerosis Society of Canada (www.mssociety.ca).
The preceding information was complied for those seeking information about Multiple Sclerosis by P Trevors as a partial requirement for the course ED6108.
References
Burke, K., LeMone, P., & Mohn-Brown, E. (2007). Caring for clients with degenerative neurologic and spinal cord disorders. Medical-sugical nursing care. Upper Saddle River, NJ: Pearson Education. pp. 949-52.
Day, R., Paul, P., Williams, B., Smeltzer, S., & Bare, B. (2010). Brunner & Suddartha’s textbook of Canadian medical-
surgical nursing, 2nd Canadian ed. Philadelphia, PA: Wolters Kluwer Health. pp. 2161-69.
Multiple Sclerosis Society of Canada. (2014). Multiple Sclerosis: Its effects on you and those you love. Pickering, ON: Author.
www.animatedmspatient.com
www.animatedmspatient.com
Photo credits as indicated.
