Walden NURS 6521 – Neurologic and Musculoskeletal Disorders Multiple Sclerosis

 

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Multiple Sclerosis

From the case study, Sabrina is a 26-year-old female patient who was diagnosed with multiple sclerosis. The patient booked an appointment with her physician for the management and treatment of the condition. Sabrina presents several questions concerning her diagnosis. As such, she calls the nurse helpline for her hospital network. She notes that multiple sclerosis affects her musculoskeletal and neurologic systems upon talking to the physicians. She learns that although the condition is an autoimmune disease, its symptoms and signs can affect other functions. Therefore, Sabrina should be aware of the specific drug therapy and other options of treatment that her physicians could decide to administer.

Symptoms of the Disorder

Signs of multiple sclerosis may vary from person to person. Typically, the symptoms affect movement functions. They include weakness or numbness in the limbs, which mostly touch one side of the patient’s body at a time. The numbness may affect the trunk and the legs of the patient (Claes et al., 2014). Another symptom of the disorder in the electric shock sensation which occurs when the neck makes specific movements. It happens especially when the neck bends forward. Also, patients of multiple sclerosis experience unsteady gait, lack of coordination, and tremors.

Decision Tree

Multiple sclerosis has no actual cure. As such, treatment aims at speeding up the recovery process from the attacks, management of the MS signs and symptoms, and slowing the progression of the disease (Claes et al., 2014). Some patients have very mild signs, so that no treatment is necessary.

Treatment Decision for MS Attacks

Medications knowns as corticosteroids, which include oral prednisone and IV methylprednisolone, are administered to minimize the effects of nerve inflammation. However, these drugs have side effects such as mood swings, fluid retention, and insomnia. Plasmapheresis (plasma exchange) is another option for the treatment of MS attacks (Spencer et al., 2015). The liquid part of the blood is removed and isolated from the blood cells. The blood cells should then be mixed with albumin and put back into the body. This decision is made when the symptoms are severe, and they have failed to respond to the corticosteroids.

Treatment Decision to Reduce Progression

The physician may also decide to give a prescription to modify MS progression. Disease-modifying therapy (DMT) is given the MS patients to slow down the rate of progress. Treatment choices for relapsing-remitting MS are composed of different intravenous medications (Spencer et al., 2015). Glatiramer acetate medication helps to block the patient’s immune system from attacking myelin. The drug is usually injected below the skin. Beta interferons are also commonly administered to reduce the severity and frequency of relapses.

Treatment Decision for Signs and Symptoms

Another treatment decision for the MS should aim at relieving the symptoms. Physical therapy can help the patients to relax the muscles through stretching and strengthening exercises (Stangel et al., 2015). Muscle relaxants such as tizanidine (Zanaflex) are useful in alleviating the uncontrollable muscle pain, spasms, and stiffness.

Sabrina’s Treatment Decision

For Sabrina’s case study, the treatment decision was aimed at the reduction of progression. Sabrina is a young patient who was diagnosed with early symptoms of MS. The DMT therapy would ensure that the disease progression would be slightly lower than the untreated cases. Also, the treatment option given to Sabrina ensures that the relapse rate and the formation of lesions are reduced.

Differences between Actual and Expected Results

The decision to treat MS attacks is expected to reduce the effects of nerve inflammation. However, the actual outcome may differ from the anticipated results due to the side effects of the drugs, which include flu-like symptoms. Also, the treatment option to reduce progression is expected to reduce the rates of relapse (Stangel et al., 2015). However, the actual results may vary due to side effects such as blurred vision and nausea.

 

References

Claes, N., Dhaeze, T., Fraussen, J., Broux, B., Van Wijmeersch, B., Stinissen, P., … & Somers, V. (2014). Compositional changes of B and T cell subtypes during fingolimod treatment in multiple sclerosis patients: a 12-month follow-up study. PLoS One, 9(10), e111115.

Spencer, C. M., Crabtree-Hartman, E. C., Lehmann-Horn, K., Cree, B. A., & Zamvil, S. S. (2015). Reduction of CD8+ T lymphocytes in multiple sclerosis patients treated with dimethyl fumarate. Neurology-Neuroimmuno

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