Immune Disorders: Multiple Sclerosis

Multiple sclerosis is a chronic, progressive, degenerative, auto immune disorder of the central nervous system characterized by the disseminated demyelination of the nerve fibres in the brain, spinal cord, and optic nerves (Lewis, 2014). The protective covering of the nerves, known as myelin, is attacked by the disease, causing inflammation and damage ("Multiple Sclerosis Society of Canada," 2015). Myelin is made up of Schwann cells, and facilitates the transmission of nerve impulses. According to Canadian Medical Surgical Nursing there are 5 different types of multiple sclerosis, relapsing-remitting, benign, primary-progressive, secondary progressive and progressive relapsing (Lewis, 2014). Relapsing-remitting is the most common type of Multiple
These stages include assessment, diagnosing, planning, implementation and evaluation. When assessing a patient with multiple sclerosis a nurse should take into account the, “physical, cognitive, sensory, bowel and bladder function... [which is the] baseline functional assessment [that] can be used to compare [against] future neurological examinations” ("National Guideline Clearinghouse", 2015). Subjective data is collected through past health history and current medication information. Objective data may be assessed by neurological and muscular skeletal examinations which includes scanning for speech, tremors, decreased hearing, spasticity, hyperreflexia, muscular weakness, paralysis, spasms, foot dragging, dysarthria, and decreased bowel and bladder function (Lewis, 2014). The assessment of multiple sclerosis is systematic and ongoing. The signs and symptoms of multiple sclerosis affect how a nurse would assess and manage the disease
Diet, exercise and stress management are important factors in the overall management of the disease. There are many diets that have been recommended for patients with multiple sclerosis such as being gluten free, eating reduced fat diet, and cutting out processed foods, and reducing sodium intake. Doctor Pavan Bhargava has suggested that “metabolism plays an important role in the function of several types of immune cells… thus [the] intake of certain types of fats has been linked to greater inflammation while [the] intake of polyunsaturated fatty acids has the opposite effect.” Exercise has been shown to improve mobility, fatigue and quality of life. Dr. Amy Latimer-Cheung has researched the effects of exercise in patients and has developed the Canadian physical activity guidelines for people living with multiple sclerosis ("Multiple Sclerosis Society of Canada," 2015). Frederick Foley, PHD, has done extensive research on managing stress and the effects of stress on multiple sclerosis. Many patients with multiple sclerosis acknowledge that stress can increase the severity of their symptoms and feel as though stress management is beneficial to their treatment. Foley, has found that, “common signs of stress include changes in breathing, tight muscles, cold sweaty hands, and clenched teeth…in people with MS, some of the common signs of