Common Neurological Disorders

Question 1

what are signs and symptoms of neurological disease

Answer 1

Sensory functions
Special senses: sight/smell/taste/hearing
Changes in sensation - numbness, reduced sensation, tingling pins and needles
Motor functions: power, tone, reflexes, co-ordination, tremor
Cerebral functions: speech, thought, memory

Question 2

how to test for resting tone?

Answer 2

Lift pt arm and if you feel resistance it means increased tone and limb can feel rigid
Typical sign for neurological diseases

Question 3

What are peripheral nerves -

Answer 3

nerves Not to do with brain and spinal cord

Question 4

Can peripheral or central nerves recover?

Answer 4

Axon of peripheral nerves!!! Eg: ID nerve whereas central nerves DO NOT cover

Question 5

what is trigeminal neuralgia

Answer 5

Damage to Schwann cell (insulator)

Question 6

What symptoms of trigeminal neuralgia

Answer 6

Sharp electric shock
Unilateral
Trigger points (face washing)
Lasts few seconds but very severe

Question 7

How do you diagnose trigeminal neuralgia

Answer 7

MRI scan- shows inflammation
Clinically - pt cant move / stressed

Question 8

What is TN associated with sometimes>

Answer 8

Multiple sclerosis

Question 9

treatment for TN?

Answer 9

Carbamazepine
Surgical tax: cryotherapy - incision to find nerve and then freeze that - good pain relief but division will be numb
Radiofrequency ablation - damage nerve by heating it
Radiotherapy - gamma knife- kills of trigeminal ganglion

Question 10

What is carpal tunnel syndrome

Answer 10

Median nerve is compressed at the wrist

Question 11

What impact might a patient with carpal tunnel syndrome has on a patient

Answer 11

May impact on ability to grip a toothbrush
May impact you to hold a drill safely

Question 12

What is the management for carpal tunnel syndrome

Answer 12

Rest - splints
Exercises
Drugs - NSAIDs/steroids
Surgical decompression

Question 13

What is sciatica

Answer 13

Symptom NOT a diagnosis
Pain in your leg - associated with sensory and motor dysfunction i
Caused by damage to the nerve - compression of the nerve
Can be caused by cancer or trauma

Question 14

what are the symptoms with sciatica

Answer 14

Pain numbness altered sensation in one of the dermotones of the leg
Tends to. Be l4 or l5

Question 15

What is the management of a patient with sciatica

Answer 15

NEED TO TELL THEM TO SEE THEIR DOCTOR!
CAN DETERIORATE QUITE QUICKLY

Question 16

What is multiple sclerosis?

Answer 16

Auto inflammatory disease of the CNS (brain + spinal cord)
Causes demyelination of the nerves
Can result in peripheral nerves!

Question 17

What are the symptoms of MS?

Question 18

What is the management for MS?

Answer 18

Holistic, (NEED TO ASK THEM WHAT THE IMPACT ON THEIR QUALITY OF LIFE IS) AND ADDRESS THAT ! may end up wheelchair bound
Need for carers
Pharmaceutical inflammatory mediators
Steroids

Question 19

What is Parkinson’s diseases

Answer 19

Affects very specifically a group of nerves called the basal GANGLIA

Question 20

What is the function of basal ganglia

Answer 20

Communication hub with other parts of the CNS - they have major function in control of movement ( how close, how far, stop from shaking)

Question 21

What is the cause of Parkinson’s

Answer 21

Genetic.
Environmental

Question 22

What is Parkinson’s in terms of neurones

Answer 22

Loss of dopaminergic nerourons in nigrostriatal tract = difficulty starting and stopping movements
And can get emotional changes

Question 23

What are typical features of Parkinson’s

Answer 23

Shuffling steps
Rigid
Reduced arm swings -due to basal ganglia
Tremoring
Leaning forward
Slow movement
Mask like face
Postural instability - can fall over

Question 24

What is Huntington’s disease

Answer 24

Disease of basal ganglia and purely genetic - pt can’t be still

Question 25

What are extrapyramidial tracts?

Answer 25

Excessive movements caused as a side affect of med to basal ganglia diseases such as anti-psychotics

Question 26

How would we manage a patient with a neurological disease?

Answer 26

We will ask the patient how their disease affects them and how we can make them feel more comfortable
Need to understand how their disease may affect their oral hygiene and work life
Be aware of any drug interactions with what they are already taking
Involve carers early so they have the best Quality of life possible
If they have seizures or epilepsy then make sure the instruments are removed from their mouth
These are chronic illnesses so will need to be flexible and adjust to the patients