CHAPTER 5 Nervous System^237
- Explain to the patient:
- Why restrictions (bed rest) are necessary.
- Vaccine available for meningococcal meningitis—the 2 different types
are meningococcal polysaccharide vaccine (MPSV4) and conjugate vac-
cine (MCV4).
Multiple Sclerosis (MS)
WHAT WENT WRONG?
This is an autoimmune disease that results in demyelination of the white matter of
the nervous system. Nerve impulses travel along the myelin coating on the outside
of the nerve cells. With the disruption in the myelin on the outside of the nerve
cells, the transmission of information from cell to cell within the nervous system is
altered. The patient’s sensations, movements, or mental function may be affected.
A patient with relapsing-remitting disease will have episodes of exacerbation when
symptoms occur and then months or years of symptom-free episodes. A portion of
these patients will progress to enter a disease state that has a steady pattern of dete-
rioration without relation to the periodic exacerbations; this is referred to as a sec-
ondary progressive disease. Other patients have a primary progressive disease and
develop the steady deterioration from the onset of the disease.
PROGNOSIS
The actual cause of the disease is unknown, although it is thought to be autoim-
mune. The disease is progressive. Stress may be noted to aggravate symptoms.
When damage is done to the nerve cells, it is not repairable, even when symptoms
resolve in between periods of exacerbation. The pattern of symptoms will vary
from one patient to the next. The time frame between exacerbations will also vary.
As the disease progresses, the patient will lose more functional ability and will
ultimately need assistance with basic self-care needs.
HALLMARK SIGNS AND SYMPTOMS
Symptoms have periods of exacerbation and remission. Symptoms typically
resolve completely in between exacerbations early in the disease process.
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