NEURO
AUTOIMMUNE &
NEUROMUSCULAR
1-Multiple sclerosis
2-Myasthenia Gravis
3-Parkinsons
# 1 MULTIPLE SCLEROSIS
-AUTOIMMINE
-EXASERBATION &
REMISSION
-disease that affects CNS, vision,
muscles, coordination, fall risk,
over time total loss.
-immune system attacks myelin
sheath between spinal chord
and muscle. Nerve impulses are
unable to get to muscle and
person looses function
-more exacerbations leads to
worse MS
-affects women
MS ASSESSMENT
-can progress slowly with remission
or rapidly with lots of exacerbation
-MUSCLES: fatigue, depression,
weakness, numbness, loss of
coordination, balance, spasticity
-EYES: optic nerves affected, blurry
vision, diploplia, scotoma (patchy
blindness), blindness
-PAIN- from lesions on sheath
-FATIGUE- depression, loss of
function, meds
-SPASTICITY: ataxia, loss of bladder ,
bowel, sexual function
AT FIRST:
VISUAL CHANGES (diplopia)
FATIGUE: pt. can’t hold arms up,
can’t do their hair or regular
ADL’s are exhausting
COORDINATION ISSUES: pt.
states they are off balance,
clumsy
SPEECH: messing up words,
dysarthria
INCONTINENCE: suddenly out of
nowhere they pee themselves,
the bed bowel and bladder
issues
DIAGNOSTIC TESTS
-Scans looking for scarring on
myelin sheath
-rule out other things with
blood testing
-spinal tap for biomarkers
MS TREATMENT
MEDS
MTHOTREXATE: DMARD,
immunosuppressant
-kills all cells
-can kill baby in pregnancy
BIRTH CONTROL
CORTICOSTEROIDS: for acute
exacerbations
EDUCATION
-you need to be on birth control
to not conceive
-conserve energy, use assistive
devices
-nutrition, exercise, get cleared
to dirve, visual testsing
GRIEF
-deal with depression
-anticipatory grieving over not
being able to get pregnant/
have kids
MS VS MG (both nervous system)
MS= whole body + extremities
(eyes, speech, B&B, extremities)
