ALS, MS, Parkinson's, Huntington's Flashcards
What are some S&S for ALS?
progressive weakness, atrophy mm fasciculations in limbs and trunk hyperreflexia, spasticity (+) Babinski sign difficulty speaking (bulbar mm) difficulty swallowing respiratory failure inappropriate emotional responses
What is clinically isolated syndrome MS?
a single attack of neurological symptoms though multiple brain lesions are likely observed - may or may not go on to develop progressive MS
What is relapsing-remitting MS? (RRMS)
MS where there are clearly defined attacks and remissions
75%
What is the most common form of MS?
relapsing-remitting (or attack-remitting)
75%
What is benign MS? 10-15%
a subtype of RRMS where remission is almost complete - only minimal disability 10-15 years after onset
In most cases of benign MS, what is affected mainly?
sight and or/touch (sensory)
True or false: benign MS will always be benign MS.
false. it will no longer be MS the longer post-onset
Describe progressive MS…
disability slowly and continuously increases with or without relapses
What is primary-progressive MS? 10-15%
Who is usually affected?
nearly continuous worsening of MS from the beginning with NO clear relapses or remissions
people in their 40s - men and women equally (the only type that is equal)
People with relapsing-remitting MS tend to eventually develop….
secondary progressive MS
What does secondary-progressive MS refer to?
MS where there may or may not be relapses/remissions, but in remissions, the recovery is usually not complete - disability accumulates over time
What is the average life expectancy after the onset of MS?
25-30 years
What are the three symptom families for Huntington’s Disease?
abnormal movement, personality changes, dementia
What is the risk of a child being born if one parent has Huntington’s?
50%
Huntington’s destroys neurons mainly in the _______ and lowers levels of which neurotransmitters?
basal ganglia
GABA
ACh
Metenkephalin
Huntington’s leaves HIGHER levels of what neurotransmitters?
dopamine and NE
Huntington’s lowers levels of…
GABA, ACh, and metenkephalin
Who are the basal ganglia?
caudate nucleus, putamen, globus pallidus, substantia nigra
What causes the choreic movements in Huntington’s?
high levels of dopamine overstimulate the thalamocortical pathway
In later stages of Huntington’s, what happens as a result of the loss of inhibition of thalamocortical output?
rigidity, bradykinesia
What are some S&S of Huntington’s?
bradykinesia chorea dysarthria dysphagia cachexia sleep disorders incontinence freezing phenomenon
What is Parkinson’s?
a progressive disorder with diminishing basal ganglia function, leading to slow, difficult movement with resting tremors and muscular rigidity
True or false: Parkinson’s S&S are always BL>
false. unilateral in stage 1!
Differentiate the stages of Parkinson’s
1 - unilateral S&S
2 - bilateral S&S - moderate remor, rigidity and bradykinesia
3 - significant tremors, rigidity and bradykinesia; dystonia & freezing
4 - severe bradykinesia, impaired gait, assistance with ADLs required
5 - functional independence lost, no mobility
What is cogwheel rigidity?
muscle rigidity with pROM (ratchet-like movement)
What condition sees a pill rolling tremor?
Parkinsons
What is festinating gait?
strides become quicker and shorter than normal, which can make it look like you’re hurrying
taking jerky steps.
moving your arms less when walking.
falling frequently
What is retropulsion?
a loss of backward balance (can’t stop self from falling backward)
What is a Katharine Hepburn tremor?
tremor in people who are older, have had head trauma, but don’t have Parkinson’s
Give an example of ANS dysfunction in someone with Parkinson’s
very dry skin but very oily facial skin
ACCORDING TO RATTRAY, life expectancy after Parksinons diagnosis is…
15-20 years from onset
