Introduction
There are several disorders within the human nervous system. The main causes of most of these disorders are not known (Wiendl & Hohlfeld, 2009). However, the majority are believed to be genetically induced while others are because of the chronic infections of the pathogens. Among the nervous system, disorders are multiple sclerosis and lupus. Though most of these disorders affect the nervous system and may be similar in terms of their causes, they differ in many ways in terms of their clinical manifestation, medical management, and their treatment.
Multiple sclerosis
Multiple sclerosis is one of the disorders of the nervous structure. In fact, multiple sclerosis can be described as the degenerative unremitting syndrome affecting the myelin sheath of the white matter of the brain and the spinal cord. The myelin sheaths are normally found on the nerve cells surrounding the axons (Wiendl & Hohlfeld, 2009). The myelin sheath is a highly conductive fatty material and its main function in the nerve cell is to increase the transmission of the nerve impulses. Myelin sheaths are essential parts of the nerve cells responsible for the regular transmission of nerve impulses. Under conditions, that there emerge to defection in the myelin sheath, the conduction nerve impulses drastically slow down.
Lupus
Lupus is another nervous system disorder manifesting in several organs. In other words, lupus is a prototypic autoimmune disorder affecting many organs and tissues (multisystem) with a wide range of clinical symptoms. The disease shows heterogeneity in terms of its effect on the body. For this reason, many argue that lupus is a syndrome instead of a single disease. Without early treatment, lupus can be chronic leading to fatalities. Like multiple sclerosis, the cause of the disease is both genetic and environmental. However, these are theoretical. The main causes of the disease are not known. Unlike multiple sclerosis, the disease affects the serous membranes of the nerve cells causing serious effects on many organs of the body (Crow, 2008).
The differences and similarities in the pathophysiology, nursing/medical management, clinical manifestation, and prognosis
Pathophysiology
In the case of multiple sclerosis, the myelin sheath becomes affected resulting in inflammation, edema, as well as demyelination, which eventually cause lesions in the nerve cell. The lesion causes a drastic reduction in the transmission of the nerve impulses. The exact cause of multiple sclerosis is still unknown up to today (Correale et al., 2006). However, some theories have been advanced to explain what the cause of the disease could. The largely acknowledged supposition is that multiple sclerosis starts on as a provocative autoimmune disorder caused by auto-reactive lymphocytes. As the disease progresses, it becomes under the control of microglial activation and the degeneration of the neurons becomes chronic.
The confirmations supporting this theory imply that an infective agent mostly viruses cause lesions in the myelin sheath causing disorders in several genes, particularly the HLA gene complex in the sixth chromosome (Correale et al., 2006). The lesion in the myelin sheath will eventually lead to the degeneration of the nerve impulses. The other accepted theories of the multiple sclerosis pathogenesis consist of the likely impervious etiology because of chronic viral infection, and non-immune or non-inflammatory etiology because of the genetically stimulated neuro-glial degenerative actions.
In lupus, either the genes associated with the immune response of the particular organ are affected by environmental factors or the genes may genetically be deformed. The disease has been proven to be highly transmitted through genes to the offspring. In other words, the offspring of patients affected by the disease are more likely to develop the disease than those not affected by the disease (Crow, 2008).
Clinical manifestations
The early manifestations of the disease depend on each individual and vary from one person to the other. However, the majority experience tingling sensations or weaknesses in most parts of the body (Correale et al., 2006). The weakness may be mild though in some cases it may be extreme. Nevertheless, the feeling of weakness and fatigue in most parts of the body are the widespread early signs of multiple sclerosis. As the disease progresses, the patient normally has difficulties with coordination and balance caused by cerebellar involvement. In most cases, the patient feels paroxysmal weaknesses, and tremors because of temperature sensations that may worsen after taking hot showers or birth, ataxia, and foot-dragging eventually leading to loss of balance.
The other sign is the loss of vision resulting from optic neuritis. Most of the patient’s experience (nystagmus) or the instinctive cadenced movements of the eyes. In addition, the patient may experience bowel and bladder dysfunction (Correale et al., 2006). The dysfunctions are caused by a lack of coordination in the spinal cord. Because of the bowel dysfunctions, the patients constipate and have urinal problems. Generally, patients suffering from multiple sclerosis are hesitant, have a sensational loss, and lack incontinence and retention.
Unlike in multiple sclerosis, a manifestation of lupus varies depending on the organ and individual. The signs and symptoms also differ with the severity and duration of remissions. The clinical manifestation of the disease depends on the acute relapses and chronic nature of the disease (Crow, 2008). Patients diagnosed with Lupus show diverse manifestations, an inflammatory connection that can affect many organs. The highly anticipated symptoms include immunologic abnormalities, musculoskeletal together with serologic involvement. However, hematologic, renal manifestations are observed in some patients (Crow, 2008). These symptoms are similar to that of multiple sclerosis.
Prognosis
Multiple sclerosis does not kill except in severe conditions. In most cases, patients diagnosed with multiple sclerosis live their normal lives and fully have their life span. Generally, these people are affected and are killed by any other diseases that normally affect the broad spectrum of people such as cancer and heart disease (Correale et al., 2006). However, the prevalence rate of these diseases among patients diagnosed with multiple sclerosis is high. In addition, symptoms of multiple sclerosis seriously affect the patients leading to an increased suicide rate among such patients. In lupus, many organs are affected and in such a case leading to the death of individuals.
Like lupus, the severity of the disease depends on the individual and as the disease progresses the result becomes unpredictable. Unlike patients diagnosed with lupus, multiple sclerosis patients remain asymptomatic or may become slightly asymptomatic after the initial diagnosis (Correale et al., 2006). Researches indicate that only twenty percent of those diagnosed with multiple sclerosis experience express progressive condition while in lupus the percentage is higher. The reason is that lupus affects many organs and therefore has a greater degree of disease progression. In both conditions, women are highly affected than men.
Nursing management of the diseases
To care effectively for both diseases, nurses are advised to be updated with the current trends of the diseases and advanced knowledge of the disease. This applies mostly to lupus, which affects many organs in the body, and the symptoms vary depending on the affected individual body system. Lupus also manifests differently in varying conditions, its unpredictability, as well as changing patterns (Crow, 2008). Therefore, the management of the condition is specific to the individual concerned and depends on whether the patient is hospitalized or not. However, nurses are advised to constantly keep evaluating the patient’s condition from time to time. Most importantly, nurses caring for patients diagnosed with lupus are advised to take into consideration the needs of the patients in their daily routines in the planned care.
Nurses are advised to promote physical mobility for patients suffering from multiple sclerosis. Physical mobility can be improved through exercises and taking part in everyday activities. However, the exercises should not be vigorous. The patients should rest in between the activities and exercises (Correale et al., 2006). The patients should also be advised to avoid injuries. Patients suffering from multiple sclerosis should walk with their legs wide apart. They should also be aware of their environment to avoid encounters with dangerous objects.
Nurses are also advised to promote the patient’s bowel and bladder control with urinal or bedpan, increasing the fibers in their food, making use of fluids intake schedules as well as the intermittent self-catheterization (Correale et al., 2006). The nurses should also improve the patients’ sensory and cognitive functions. These include the patients’ vision, speech cognitive, and emotional responses. In addition, the coping strengths, self-care, as well as adaptive sexual dysfunction of the patients should be improved.
Conclusion
Both lupus and multiple sclerosis are diseases of the nervous system affecting the membranes and the myelin sheath of the nerve cells respectively. Since lupus affects the membranes, the disease manifests itself in many organs of the body. The result is the complexity in the management of the disease. However, both diseases manifest in the inflation of the nerves. The treatment and prognosis of multiple sclerosis and lupus are almost similar.
References
Correale, J., Fiol, M. & Gilmore, W. (2006). The risk of relapses in multiple sclerosis during systemic infections. Neurology. 67(4), 652-659.
Crow, MK. (2008). Collaboration, genetic associations, and lupus erythematosus. Journal of Medicine, 358(9), 956-961.
Wiendl, H. & Hohlfeld, R. (2009). Multiple sclerosis therapeutics: unexpected outcomes clouding undisputed successes. Neurology. 72(11), 1008-15.