3.1 Transverse Myelitis Flashcards
PT treatment for someone on a vent
- PROM
- positioning
- education of family, nursing
PT for someone awake on a vent
- early mobilization
- getting them to a chair and sitting on the edge of the bed if they’re too weak to walk
- prevention of skin breakdown
PT for someone on a vent: What should you remember if they’re below a 3/5?
don’t push them too hard
- could create additional problems
- can’t go against gravity
- do AAROM exercises or isometrics
What type of injury is transverse myelitis?
- SCI
- typically have better outcome than SCI pts
What is inflamed with TM?
spinal cord
causes of TM
- don’t really know why it happens
- once you have it once, higher likelihood of getting it again
- viruses (epstein barr)
- autoimmune
- could be virus/bacteria that causes autoimmune, etc.
diagnosing TM
- MRI, CT will show inflammation
- ASIA scale will show the point of most inflammation
- spinal tap
purpose of spinal tap
- pull fluid out and see what’s going on with CSF
- start ruling out
TM onset
- some pts have gradual onset
- some have rapid onset
TM age range
- teens to 40s, 50s
- 1500 new cases per year
progression of healing of TM
- period of weakness, get better over time
- the sooner we get things back initially, gives us an idea that they’re going to get better
- window for healing gets smaller if there’s long periods at beginning with no change
treatment for TM
steroids to deal with inflammation
spinal tap process
laid on the side, flexed to open space, big needle shoved in to suck out fluid
What can happen as a result of spinal tap?
sometimes get a CSF leak because of the hole
- may have some yellowish leakage
- severe headache, worst sitting up (CSF pools down)
treatment for CSF leak
blood patch: to fill up the hole that was made
CIDP
chronic inflammatory demyelinating polyneuropathy
What is CIDP?
long term version of GBS
- not a constant chronic, waxing and waning presentation
- demyelination of nerves and get weakness, just like GBS
treatment for CIDP
plasmapheresis
How is CIDP most commonly diagnosed?
most are dx with GBS and get symptoms again
CIDP plateau phase
plateau phase isn’t as long as with GBS
- more rapid recovery
- may or may not get back to where they were before
- slow tapering and loss
Does CIDP ever go away?
no
critical illness polyneuropathy
- changes in nerves in people who are laid up in an ICU bed beyond atrophy
- pts in ICU bed more than 7 days are having changes at the nerves
What is the cause of critical illness polyneuropathy?
- muscles have been denervated
- smaller motor units
critical illness polyneuropathy recovery
most people recover fully, but it takes a long time
PT for critical illness polyneuropathy
- typically do functional activities, not one muscle at a time
- there’s a lot to work on, get the most out of a session