ALS and Gullian Barre Syndrome Flashcards
Amyotrophic Lateral Sclerosis (ALS) is aka as _ _ disease, is a degenerative disease that affects both _ and _ and is the _ _ type of _ _ disease.
Is aka LOU GEHRIG’S DISEASE, is a degenerative disease that affects both UMN’s and LMN’s and is the MOST COMMON type of MOTOR NEURON DISEASE.
The alsa.org is a great resource for _ and _ _ for patients and caregivers.
INFORMATION and MEDICAL EQUIPMENT
Sporadic ALS accounts for %-% of cases and familial ALS accounts for -%. Affects _ more than _. Ratio? Evens out after?
Sporadic accounts for 90-95% of cases and familial ALS accounts for 5-10%.
Affects MEN more than WOMEN. Ratio of 1.7:1
Evens out after age 65
Age on onset is typically - for ALS. Mortality is typically - years, however it can be quicker. Disease usually progresses _ within a _ _.
Age of onset is typically 50-60
Mortality is typically 3-5 years from onset, however it can be quicker
Disease usually progresses RAPIDLY with a FEW MONTHS
ALS is hypothesized to occur as the result of an intersection of a _ of _ _, leading to _ degeneration and _. Research suggests an excess of _ in the synaptic cleft triggers a _ of _ that leads to _ _.
As a result of the intersection of a VARIETY OF CELLULAR INSULTS, leading to NEURON degeneration and DEATH.
Research suggests an excess of GLUTAMATE in the synaptic cleft triggers a CASCADE OF EVENTS that leads to CELLULAR DEATH.
-% develop limb onset with extremities initially involved. -% develop bulbar onset (especially in _ _ _), and is usually noticed first in _, _ or _.
70-80% develop limb onset with extremities initially involved.
20-30% develop bulbar onset (especially in MIDDLE AGED WOMEN), and is usually noticed first in SPEAKING, CHEWING, OR SWALLOWING
Pathophysiology: progressive _ _ loss in _ _, _, and _. With partial sparing of CN _, _ and _, _ spinal level, _ tract, _ and _ muscle, _ tracts and _.
Progressive MOTOR NEURON loss in SPINAL CORD, BRAINSTEM and CORTEX.
With partial sparing of CN III, IV, and VI, SACRAL spinal level (bowel/ bladder control), SPINOCEREBELLAR tract, SMOOTH and CARDIAC muscle, SENSORY tracts (eyesight), and COGNITION (aware of degeneration).
Diagnostic criteria: Objective evidence of _ and _ damage with a minimum of _ out _ regions affected. Name regions.
Objective evidence of UMN and LMN damage with a minimum of 3 out of 4 regions affected.
Regions: CBLT
Cervical, Bulbar (CN X,XI, XII), Lumbosacral, Thoracic
Diagnostic criteria scale is known as _ _ Criteria: clinically _ (/), clinically _ (/), clinically _ with _ support, and clinically _.
Scale is known as EL ESCORIAL CRITERIA: Clinically DEFINITE (3/4 regions) Clinically PROBABLE (2/4) Clinically PROBABLE with LAB support (EMG is slower) Clinically POSSIBLE
ALS affects every patient _, typically progresses in _ _ first and then _ _ to _ _ _.
Affects every patient DIFFERENTLY, typically progresses in ONE AREA first and then MOVES ON to ANOTHER MOTOR AREA.
Rilutek is a medication for ALS, increases survival rate - _ on average.
Increases survival rate 2-3 MONTHS on average
3 major stages and associated PT interventions
Early Stage- Restorative
Middle Stage: partially independent- Compensatory
Late stage: dependent- Preventative
During the early stage will get some _ due to _ _. In the late stage interventions such as a _ _, _, _ training with _ _, and _ home can be helpful.
Early stage will get some FLUCTUATION due to NERVE REGENERATION
In the late stages interventions such as HOYER LIFTS, CUSHIONING, TRANSFER training with SLIDING BOARD, and AUTOMATED home can be helpful.
Cognition, Sensation, Pain, CN integrity, ROM, Muscle performance, tone/ reflexes, motor function, postural alignment, balance, gait/ locomotion, functional status and integumentary system are all important parts of the?
Physical examination
During the examination PT may need to _ and/ or _ _ of each over _ _.
May need to PRIORITIZE and/ or SPREAD EVALUATION of each over SEVERAL VISITS
