45 Chronic Disorders of Neurological Function Flashcards
brain cerebellar disorders
- seizure disorder
- dementia
- parkinson disease
- cerebral palsy
- hydrocephalus
- cerebellar disorders
Seizure Disorder
transient neurologic event of paroxysmal abnormal or excessive cortical electrical discharge
- -manifested by disturbances of skeletal motor function, sensation, autonomic visceral function, behavior, or consciousness
- -due to an alteration in membrane potential that makes certain neurons abnormally hyperactive + hypersensitive to changes in the environment (epileptogenic focus)
possible triggers of seizure disorder
flashing lights, fever, loud noises
GENERALIZED Seizure Disorder
whole brain surface is affected during the seizure
-involvmnt of thalamus + RAS sytm results in loss of consciousness
GENERALIZED Seizure Disorder
5 types + examples
1 ABSENCE (PETIT MAL): occurs in kids, staring spells lasting seconds
2 ATYPICAL ABSENCE: myclonic jerks, automatism
staring spell
3 MYOCLONIC: single/several jerks
4 ATONIC (DROP ATTACK): fall down
5 TONIC-CLONIC (GRAND MAL): jerking of many muscles
Seizure Disorder
diagnosis
electroencephalograms
–assess electrical patterns of brain regions
Seizure Disorder
treatment for DURING A SEIZURE
- maintain airway
- protect fr injury
- document course seizure
Seizure Disorder
treatment when not hazing an episode
ANTICONVULSANT MEDICATION
- contd until no sizures for atleast 2 years
- -then gradually withdrawn
- NOT A CURE
Dementia
syndrome assoc w many pathologies
–characterized by progressive deterioration + continuing decline of memory + other cognitive changes
types of Dementia
1 Alzheimer (most common) 2 Vascular
Alzheimer’s Disease
characterized by degeneration of neurons in temporal + frontal lobes, brain atrophy, amyloid plaques, + neurofibrillary tangles
-behavioral problems progress from forgetfulness to total inability for self-care
Vascular Dementia
results fr single cerebrovascular insults
-risk factors: stroke, hypertension + diabetes
Dementia
s/s
- as the disease progresses, increasing difficulty w judgment, abstract thinking, problem-solving, + communication
- assistance for completing activities of daily living [ADLs]
- difficulty w eating, swallowing, weight loss, loss of bladder
Dementia
treatment
- ACETYLCHOLINESTERASE INHIBITORS
- N-methyl-D-aspartate (NMDA) receptor antagonists: memantine (Namenda)
- early diagnosis + intervention is KEY
- early stage may stay at home, later in an assisted living
ACETYLCHOLINESTERASE INHIBITORS
- tacrine (Cognex)
- donepezil (Aricept)
- rivastigmine (Exelon)
- galantamine (Reminyl)
- for mild-moderate Alzheimers disease + Vascular dementia
- not a cure
N-methyl-D-aspartate (NMDA) receptor antagonists: memantine (Namenda)
- for moderate-severe alzheimer
- blocks stim by neuroexcitatory transmitter glutamate
Parkinson Disease
- Dopamine deficiency in basal ganglia (substansia nigra) assoc w motor impairment, Lewy bodies
- difficulty initiating + controlling mvmt results in akinesia, tremor, rigidity
Parkinson Disease
s/s
- general lack of mvmt
- loss of facial expression
- drooling
- propulsive shuffling gait
- absent arm swing
Cerebral Palsy
diverse group of crippling syndromes that appear during childhood + involve permanent, nonaggressive damage to motor control areas of brain
-symptoms remain for life
what area is damaged in cerebral palsy?
upper motor neurons that control voluntary + involuntary muscle mvmt
Cerebral Palsy
etiology
- prenatal infection
- disease of mother
- mechanical trauma to head before, during, or after birth
- exposure to nerve-damaging poisons
- reduced oxygen supply to the brain
Hydrocephalus
abnormal accumulation of CSF in cerebroventricular sytm
-assoc w neural tube deficit
Obstructive Hydrocephalus
obstruction to the flow of CSF
-blocked aqueduct of Sylvius, fr premature closure before birth
Obstructive Hydrocephalus
treatment
may be corrected surgically
- VENTRICULOPERITONEAL SHUNT
- –most effective treatment
- –CSF flows into peritoneal cavity
- ENDOSCOPIC THIRD VENTRICULOSTOMY
- –making a hole in the third ventricle to allow free flow of CSF into basal cisterns for reabsorption
Multiple Sclerosis
chronic demyelinating disease of the CNS that primarily affects young adults
–autoimmune disorder that results in inflammation + scarring (sclerosis) of myelin sheaths covering nerves; slowly progressive
demyelination can occur throughout the CNS but often affects….
1 optic nerve
2 oculomotor nerve
3 spinal nerve tract
Multiple Sclerosis
s/s
exacerbation + remission:
- -exacerbated by heat, infection, trauma, stress
- double/blurred vision
- weakness
- poor coordination
- sensory deficits
- bowel + bladder control may be lost
- memory impairment common
Spina Bifida
development anomaly characterized by defective closure of the bony encasement of the spinal cord (neural tube) thru which the spinal cord + meninges may or may not protrude
Spina Bifida
etiology
environmental factors (especially lack of folate) + genetics
Spina Bifida
treatment
surgery
C-section
***folic acid before + during pregnancy
Amyotrophic Lateral Sclerosis
aka Lou Gehrig disease
- progressive disease affecting both the upper and lower motor neurons
- weakness + wasting of upper extremities usually occur, followed by impaired speech, swallowing, + breathing
Amyotrophic Lateral Sclerosis
s/s
weakness atrophy cramps stiffness irregular twitching hyperreflexia in weak atrophied extremity
Spinal Cord Injury
mechanisms of injury
hyperflexion
hyperextension
compression
types of Spinal Cord Injury
1 Spinal Shock
2 Neurogenic Shock
Spinal Cord Injury - Spinal Shock
occurs immediately + characterized by temporary loss of reflexes below the level of injury
- -muscles flaccid; skeletal/autonomic reflex lost
- -end of spinal shock: reflex return + flaccidity replace spasticity
Spinal Cord Injury - Neurogenic Shock
may occur after SCI due to peripheral vasodilation
–hypotension, bradycardia, + circulatory collapse can occur (life-threatening); high spinal cord injuries can affect respiratory muscles
Guillain-Barre Syndrome
inflammatory demyelinating disease of the peripheral nervous system or a lower motor neuron disorder
–segmental demyelination that is T-cell + B-cell mediated
Guillain-Barre Syndrome
s/s
- muscle weakness that begins in the lower extremities + spreads to the proximal spinal neurons
- progressive ascending weakness or paralysis, may affect respiratory muscles
Bell Palsy
idiopathic neuropathy of the facial nerve
-paralysis of the muscles on one side of the face
Bell Palsy
etiology
virus
Bell Palsy
s/s
- develop rapidly over 24-48 hrs
- unilateral facial weakness
- facial droop + diminished eye blink
- hyperacusis
- decreased lacrimation
Status Epilpeticus
continuing series of seizures,
- no recovery bw episodes
- life threatening
2 types of seizures
Generalized
Partial
Partial seizures
abnomal electrical activity on ONE brain hemisphere
3 types: simple , complex, partialw secondary generalization
Simple Partial Seizure
no change in LOC
-motor, sensory, or autinomic sympt common
Complex Partial Seizure
change in LOC
