Coppin State University Helene Fuld School of Nursing
Nurs 217 – Health Assessment
Professor Lucille Belgrave
October 7, 2014
Multiple Sclerosis mostly referred to as MS is an autoimmune disease that primarily affects the central nervous system which consists of the brain the spinal cord and optic nerve. Just about everything you do is dependent on how well the central nervous system functions, from movement of the muscles to though process throughout the day. Literally breaking down the name; multiple means many and sclerosis means scar tissue hence, many scar tissues. Before we can proceed to understanding multiple sclerosis, we have to look at the disease at the cellular level.
MS is a selective progressive inflammatory demyelinating disorder of the central nervous system. In the brain and the spinal cord, we have grey and white matter. The outside of the brain is covered with grey matter with white matter running down as fascicles. The grey matters are cell bodies of neurons that have dendrites running down a bunch of axons. The axons are electric conducting pathways that send messages through the central nervous system. The myelin sheath (grey matter) that covers the axons (white matter) is a protecting sheet that serves as insulation of the electrical pathway. These uninsulated axons thus form scar tissues and progressively hinders the transmission of nerve impulses. The selective process of this disease commonly affects the pyramidal and the cerebellar pathways, the medial longitudinal fasciculus pathway and the optic nerve and the posterior column thereby presenting symptoms associated with balance and movement, tingling and numbness, blindness to mention a few.
Multiple Sclerosis is a broad diagnosis of the disease, however, there are four types of multiple sclerosis; relapsing remitting, primary progressive, secondary progressive and progressive relapsing multiple sclerosis. The most common is the relapsing remitting multiple sclerosis, which affect about 85 percent of people who are affected by the disease.
The actual etiology of multiple sclerosis is unknown however it is evident that the immune system of the body attacks its own self. MS has no cure but it can be treated and managed. MS affects about 200 million people worldwide with typically affects more females than males, Caucasians are more affected by the disease than African Americans and Hispanics. In order to better understand the diagnosis and mechanisms of multiple sclerosis, two scholarly articles were looked at. “Differential Diagnosis of Suspected Multiple Sclerosis: A Consensus Approach” by DH Miller et al. and “Diagnostic Criteria for Multiple Sclerosis: 2010 Revisions to McDonald Criteria” by J Polman et al. Both articles analyze ways to diagnose for multiple sclerosis and which procedures and methodologies to pursue in the process of coming up with an accurate diagnosis. According to “Differential Diagnosis of suspected multiple sclerosis: a consensus approach”, MS is diagnosed by ruling out all the other possible conditions and disorders. The abstract of this article was broken down into the four parts of the paper and were briefly summarized. According to this article the guidelines for diagnosis of MS were set up by ruling out any MS mimics, and determining and excluding idiopathic inflammatory demylinating diseases. Establishing guidelines also consisted of diagnosing the common initial isolated clinical syndromes. Not being able to provide a better explanation after excluding all other factors leads clinicians to diagnose the patient as having multiple sclerosis. The McDonald criterion is used to further exclude conditions. Red flags were used as detractors, to justify deviation from a multiple sclerosis ruling. The flags are classified as major, intermediate, and minor. The ones labeled minor,...
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Polman, C., Reingold, S. Diagnostic Criteria for multiple sclerosis: 2010 Revisions to McDonald criteria. American Neurological Association (March 2011)., article first published online: 8 MAR 2011 doi:10.1002/ana.22366
Life and long-term care Insurance. Retrieved October 6, 2014 from The National Multiple Sclerosis
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Invisible Disabilities Association. (n.d.). People Living with Multiple Sclerosis. Retrieved October 7, 2014, from http://invisibledisabilities.org/about/whatpeoplearesaying/mscomments/
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