Nursing Assessment, Management and Treatment of Autoimmune Diseases
230
Signs and symptoms Assessment of signs and symptoms can be challenging because they are both un- predictable and hard for the patients to describe. Signs and symptoms may be transient or may last for hours or weeks. Typically, there are two general catego- ries of initial symptoms: vision problems (because of optic neuritis) and sensory impairment such as paresthesia (Rebar et al., 2019). Patients experience a variety of signs and symptoms including the following (Rebar et al., 2019): ● Vision issues such as blurred vision, scotoma, ophthalmoplegia. ● Emotional lability. ● Dysphagia. ● Poorly articulated speech. ● Urinary problems. ● Intention tremors. ● Ataxia. ● Bowel problems. ● Cognitive dysfunction. ● Fatigue. ● Varying degrees of paralysis. Figure 5 provides an overview of the main symptoms of MS. ● Muscle weakness. ● Muscle spasticity. ● Hyperreflexia.
Blood and imaging tests The following tests, while not definitive, can help to make the diagnosis of MS (Mayo Clinic, 2020b; Rebar et al., 2019): ● MRI : MRI is the most sensitive method to identify areas of MS lesions on the brain and spinal cord. It is also used to evaluate the progression of the disease. ● Lumbar puncture : A sample of cerebrospinal fluid can show elevated immunoglobulin G levels, but normal protein levels. This is significant only when serum gamma O levels are normal, and it reflects immune system hyperactivity because of chronic demyelination. The WBC count may be slightly elevated. Results of a lumbar puncture can help to rule out infections and other disorders with signs and symptoms similar to MS. ● Evoked potential tests : These tests record electrical activity produced by the CNS. CNS damage may cause slowing of electrical conduction. ● Blood tests : Blood tests help to rule out other disorders with signs and symptoms similar to those of MS. Blood tests may also be used to check for specific biomarkers associated with MS.
Powered by FlippingBook