Question

W.H., a woman age 36, has received a diagnosis of multiple sclerosis. She has lost part of her left visual field and has weakness in her left leg. W.H.’s mother had multiple sclerosis.

1. State the factors in the history and the diagnostic tests that would indicate multiple sclerosis as a diagnosis.

2. Describe the pathophysiology of Multiple sclerosis.

3. State the possible locations of the lesions that have caused visual and motor deficits.

4.Describe the typical course of multiple sclerosis that W.H can expect in the future

5.Suggest several measures that can be used to minimize exacerbations.

6.Explain why adequate nutrition and hydration are important in patients with chronic neurologic conditions, including specific potential complications that may be avoided.

7.Explain why a program of moderate activity is important for W.H.

Answer 1

1.Factors effecting Multiple sclerosis:

1. Familial history : if the parents have multiple sclerosis sibligs are more prone
2. 60 or more aged individuals
3. certain auto immune infections
4. chronic smokers

Diagnostic tests for sclerosis:

1. Full history collection and physical and neurological examination
2. Based on symptoms blood test has to be done
3. MRI
4. CTscan
5. Xray
6. Lumbar puncture

2.Pathophysiology of multiple sclerosis

Due to genetic factors, infections in immune system and environmental factors---------T cells remians sensitized and promote the infiltration of those agents which damage the immune system---------this leads to inflammation and myelin and oligodendroglial cell destruction-----demyelination interupts the flow of nerve impulses-------plaque formation in demyelinated axons------transmission of impulses get interrupted----neurological dysfunction

3. Visual deficit is caused by the lesions in the afferent and efferent visual pathways

4.typical course of multiple sclerosis begins with relapse- remitting form with a period of increased symptoms and often followed without. further it progress in to secondary progressive,primary progresive and finally progressive relapsing and finally in worsening neurological function.

5. to minimize exacerbations:

if the neurologist identify the condition immediately begins with high dose corticosteroids to reduce inflammation and helps in quick relapse

6.Lack of sensation is one of the common problem faced by the neurological condition patients.skin integrity and pressure ulcers can be caused due to lack of sensation to prevent this good hydration and nutrition is necessary.