Question

Case Study Multiple Sclerosis

You have been asked to see D.V. in the neurology clinic.  D.V., gas been referred by his internist, who thinks his patient is having symptoms of MS.  D.V. is a 25-year-old man who has experienced increasing urinary frequency and urgency over the past 2 months.  Because his female partner was treated for a Sexual transmitted disease (STD), D.V.  also underwent treatment, but the symptoms did not resolve.  D.V. has also recently had 2 brief episodes of eye “fuzziness” associated with diplopia and brightness.  He has noticed ascending numbness and weakness of the right arm with inability to hold objects over the pat few days.  Now he reports rapid progression of weakness in his legs.

1. MS is an inflammatory disorder of the nervous system causing scattered, patchy demyelination of the central nervous system (CNS).
2. MS is characterized by remissions and exacerbations.   What happens to the myelin during each of these phases?
3. Isn’t D.V. too young to get MS? What is the etiology?
4. What assessment data caused the provider to suspect a possible diagnosis of MS?
5. What are 4 common diagnostic tests that you can begin to teach D.V. about?
6. What can you teach D.V. about the treatment for MS?
7. What can you teach your patient about the exacerbations of MS?
8. List three psychosocial issues that you will follow up with D.V. regarding his case of MS.
9. List two community resources that are available to this patient. (You may use outside resources from your textbook)

Answer 1

1) In MS the body’s immune system T cells will atack myelin sheath. Myelin sheath is responsible for the protection of nerve fibres. The T cells will completely or partially strips the myelin from the fibre. Thus the nerve become uninsulated. The nerves will not able to pass information from brain to other parts. The messages are delayed or misinterpreted. Damaged areas where the sheath has been destroyed and interrupts the ability for nerves to pass message is called as plaques.

2)MS can occur at any age. But usually affects the people between 16 to 55 years.

3)Etiology: Abnormal immune response can cause inflammation and damage in CNS contributing to MS.

MS is known to occur people live in areas farther from equator.

Low vitamin D levels in the blood have found as a risk factor for MS.

Smoking and obesity plays an important role in prevelance of MS.

Many viruses and bacteria like EBV, measles have been investigated to take role in MS.

4) There are some symptoms that the patient shows which caused the health care provider to suspect a possible diagnosis for MS. They are

Urinary frequency and urgency that have been started since 2 months.

Eye fizziness associated with diplopia and brightness.

Ascending numbness and weakness of right arm with inability to hold objects.

The symptoms above arised may be due to impairment in the coordination.