Neurological Disorder Overview: Parkinson’s, MS, MG, & ALS

As a nursing student, it’s important to understand the key differences between neurological disorders like Multiple Sclerosis (MS) and Parkinson’s Disease (PD). While both conditions can cause physical and cognitive impairments, they affect the body in different ways.

You will likely encounter patients with a wide range of health conditions, including neurological disorders like MS and Parkinson’s. Understanding the differences between these conditions is crucial for improving patient outcomes.

By familiarizing yourself with the symptoms, diagnosis, and treatment options for MS and Parkinson’s, you will be better equipped to provide safe and effective patient care.

Here is a quick review of the four primary neurological disorders, mainly Parkinson’s disease (PD), multiple sclerosis (MS), myasthenia gravis (MG), and amyotrophic lateral sclerosis (ALS). We will focus on the signs and symptoms (manifestations), pathophysiology, and patient goals.

Central Nervous System vs Peripheral Nervous System

The nervous system is basically divided into two portions: the central nervous system (CNS) and the peripheral nervous system (PNS). The central nervous system consists of the brain and the spinal cord, while the peripheral nervous system includes the ganglia and the nerves mainly outside the brain and spinal cord.

Nervous system = CNS and PNS

• CNS = brain and spinal cord
• PNS = ganglia and nerves (everything outside the brain and spinal cord)

It is essential to note that MS and Parkinson’s disease primarily occurs in the central nervous system while myasthenia gravis and amyotrophic lateral sclerosis affect the peripheral nervous system. ALS is also known as Lou Gehrig’s disease.

• CNS = MS and PD
• PNS = MG and ALS

To easily remember the central nervous system diseases, think of C-M-P.

• C – CNS
• M – MS
• P – PD

Multiple Sclerosis (MS)

Remember the letters MS for multiple sclerosis, but also remember there is Myelin Sheath degradation.

MS = myelin sheath = degradation

What are myelin sheaths, and how important are they in your patient’s CNS?

Recall the anatomy and physiology of the brain, recognizing the nerve cell and it’s functions. The axon (or nerve fiber) is responsible for the conduction of motor impulses. On each neuron, are attached myelin sheaths that look like a small choo-choo train. So a neuron or nerve cell sort of resembles a palm tree.

The myelin sheath protects nerve fibers but are also responsible for electrical impulse conduction. Moving the fingers or twitching the hands happen due to normal myelin sheaths – this is referred to as an action potential.

In MS, the myelin sheaths have degraded, causing problems in the transport of impulses. Some of the notable signs and symptoms are:

• Numbness
• Cramping
• Muscle weakness

Parkinson’s Disease

In Parkinson’s disease, there is a significant decrease in the amount of dopamine in the brain.

A way to remember: decreased dope in the park.

PD = decreased dopamine

What is dopamine, and why is it important to the CNS?

Dopamine in the brain helps regulate a few key aspects of the CNS. One such regulation is blood pressure. Understanding this concept assists the student in recognizing why dopamine is given to a patient during a code or a hypotensive episode. Dopamine is a potent vasoconstrictor.

Dopamine helps increase blood flow to the brain, into the heart, and dilates the kidneys. Take note that dopamine enables a person’s ability to move.

What are the classic signs of patients with PD?

• Shuffling gait – moving slowly while having a shuffling walk
• Pill rolling – due to impaired dopamine levels the motor reflexes are affected
• Tremors in the peripherals

MS vs Parkinson’s

Multiple Sclerosis affects the central nervous system, including the brain, spinal cord, and optic nerves. It occurs when the body’s immune system attacks the protective covering around nerve fibers, causing inflammation and damage.

Symptoms can include:

• Numbness or tingling in the limbs
• Muscle weakness
• Trouble with coordination and balance
• Cognitive problems (memory loss and difficulty concentrating)

Parkinson’s Disease, on the other hand, affects movement. It occurs when the brain’s dopamine-producing cells die off, leading to a shortage of this important neurotransmitter. Symptoms can include tremors, stiffness, slowness of movement, and difficulty with balance and coordination.

Parkinson’s can also cause non-motor symptoms like depression, anxiety, and cognitive decline.

Nursing Goals for Neurological Disorders (MS, PD, MG, ALS)

Regardless of diagnosis, your nursing care plan for neurological clients will often focus on these core goals:

1. Maximize Motor Function

Encourage independence. Use assistive devices to help clients maintain control over ADLs.

2. Support ADLs (Activities of Daily Living)

Let patients do as much as possible on their own (e.g., dressing, brushing teeth) to boost confidence and slow decline.

3. Prevent Depression

Loss of function and chronic disease can lead to depression. Focus on psychosocial health, encourage social interaction, and promote autonomy.

4. Protect Airway, Breathing, and Circulation (ABCs)

Always prioritize airway—especially in conditions that affect swallowing or muscle strength. Have suction and ventilation equipment ready.

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