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Care of Patients with Multiple Sclerosis Essay

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Multiple sclerosis (MS) is an acquired demyelinating disease of the central nervous system (CNS) that typically is diagnosed in the second or third decade of life. Normally, nerves are enclosed in myelin sheaths that help facilitate transmission of nerve impulses within the CNS and the peripheral nervous system throughout the body. In patients with MS, the myelin sheath is damaged and eventually degenerates, causing patches of scar tissue called plaques or lesions to occur anywhere randomly on the myelin sheath (Ruto, 2013). This results in impaired nerve conductivity, which interferes with message transmission between the brain and the other parts of the body. As a result, impulse transmission is altered, distorted, short-circuited,…show more content…
Pathophysiology
Multiple sclerosis is characterized by inflammation, demyelination, and axonal damage in the brain and spinal cord with a loss of myelin that covers the axons. As the myelin sheath regenerates, scar tissue forms, which looks like plaques on magnetic resonance imaging scans. Multiple sclerosis arises when immune-mediated inflammation activates T cells and causes the T cells and immune mediators to cross the blood-brain barriers into the CNS and attack oligodendrocytes (ie, a type of neuroglial cell with dendritic projections that coil around axons of neural cells). When the oligodendrocytes are attacked, the myelin sheath is replaced by scar tissue, which forms throughout the CNS. As a result of damage to the myelin sheath, the ability to transmit and conduct nerve impulses along the spinal cord and in the brain is interrupted, leading to muscle weakness, fatigue, loss of coordination, balance impairment, and cognitive and visual disturbance (DeLuca & Nocentini, 2011). This disease is characterized by unpredictable remissions that occur over several years. During periods of remission, the myelin sheath usually regenerates and symptoms may resolve, but the myelin cannot be completely repaired. As the disease progresses, the myelin sheath is destroyed and nerve impulses become much slower or absent and symptoms worsen. When degeneration exceeds self-repair ability, permanent disability results. There are four defined clinical types of
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