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Multiple Sclerosis
Chronic degenerative disease that affects the Mylin sheath of the neurons in the CNS.
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S/S of MS
Muscle weakness, tingling sensations and numbness. Visual distubances, usually in one eye at a time. With or without pain.
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Testing for MS
Cerebrospinal fluid/ MRI may be helpful in diagnosis of sclerotic plaques can be detected
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Therapeutic Measures in MS
- Cholinesterase Inhibitors/ increase acetylcholine at synapses.
- neostigmine(Prostigmin)
- pyridostigmine(Mestinon)
- Glucocoticoids/ reduce inflammation
- prednisone, prednisolone, prednisolone acetate or sodium phosphate
- Immunosuppressants/suppress immunity and antibody formation.
- azathioprine(Imuran), cyclophosphamide (Cytoxan)
- Antispasmodies/muscle relaxants
- dantrolene(Dantrium), baclofen(Lioresal), diazepam(Valium),tizanidine(Zanaflex)
- Anticonvulsants/treat nerve pain
- phenytoin (Dilantine),carvamazepine(Tegretol), gabapentin(Neurontin)
- Glutamate antagonist/delays progression of ALS(Amyotrophic Lateral Sclerosis)
- riluzole(Rilutek)
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Plasmapheresis:
plasma exchange therapy to supress immune response and inflammation
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Prostprocedure
Hypovolemia, dizziness and hypotension. Compare preprocedure and postprocedure labs CBC, plateletcount, and clotting time.
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Myasthenia Gravis
- Grave muscle weakness or weakness of the voluntary or skeletal muscles of the body. The disease affects the neuromuscular junction. This causes the muscle contraction not to have connection therefore no complete muscle movement is made,making patients muscle fatigue rather easy.
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S/S Myasthenia Gravis
extreme muscle weakness, during activity and improvement in muscle strength after rest. Pt will present with drooping of the eyelides(ptosis)
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Exacerbations Myasthenia Gravis
Emotional or physical stress, such as pregnancy, menses, illness, trauma, extremes in temperature, electrolyte imbalance, surgery, and drugs that block actions at the neuromuscular junction.
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Testing for Myasthenia Gravis
- Pt looking upward for 2 to 3 minutes. Increased droop of the eyelids (ptosis) occurs MG is present
- other test is EMG to rule out other conditions.
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Therapeutic Measures for Myasthenia Gravis
- Removal of the thymus gland (thymectomy) can decrease productin of ACH receptor antibodyies and decrease symptoms in most patient.
- Anticholinesterase/ Prostigmin) pyridostigmine(Mestinon)
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Amyotrophic Lateral Sclerosis (ALS)
AKA Lou Gehrig's disease
Degenerative condition that affects motor neurons responsive for the control of voluntary muscles. In the brain spinal cord, upper and lower motor neurons begin to degenerate and form scar tissue or die, blocking trasmission of the nerve impulses.
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