Degenerative diseases of the CNS Flashcards
How can you optimize the quality of life?
By providing AE, task strategies, etc
Probable decline in performance of an occupation.
Inconsistent preformance throughout the day.
Impact on the family is related to role change, caregiving needs, and potential loss.
Limited medical intervention.
Psych issues
Fairs that influence progressive neurological patients
Pneumonia, blood clots, or pressure ulcers/bedsores
Preventative secondary complications
Damage or lesions in neural pathway above the anterior born cell of the spinal cord
Upper motor neuron dysfunction
Muscle weakness Incoordination, slow movements spasticity Babinski sign increased deep tendon Reflex (DTR) Pronator drift
Symptoms of UMN deficits
Lesion that affects nerve fibers traveling from the anterior horn of the spinal cord to muscles
Lower motor neuron dysfunction
Muscle weakness Fasciculations (shaking, tremors, jerkiness) Hypotonia decreased deep tendon Reflex absent Babinski
Symptoms of LMN deficits
An autoimmune disease that affects the CNS.
The immune system attacks myelin, causing demyelination in multiple areas
Multiple sclerosis
Leaves scars known as sclerosis, plaques or lesions
Demylenation
The protective coating that goes around the nerve
Myelin
Acute attacks with full or partial recovery; 85% of initial diagnosis
Relapsing and remitting
Starts with relapsing and remitting course followed by progression at a variable rate; 50% develop in 10 years and 90% within 25 years
Secondary progressive
Progressive without remission; 10% of initial diagnosis
Primary progressive
Progressive with acute relapses; 5% of initial diagnosis
Progressive relapsing
Most common symptom of MS caused by demyelination
Fatigue
Avoid fatigue, cooler room it normally better, use heart modalities with caution, levels of Independence may fluctuate throughout the day, gaurd against soft tissue injury, monitor for safety issues, be aware of the combined effects of cognitive and physical dysfunction
The OT management of MS
Due to disease process
Primary fatigue
More controllable, due to deconditioning and respiratory muscle weakness and pain
Secondary fatigue
Control of tremors and movement disorders, cognitive compensation, managing sensory deficits
Some OT interventions for MS
One method to help with Diplopia
Cover one eye
A contagious vital disease
Poliomyelitis (polio)
Bedrest, positioning, and warm packs
Medial treatment for polio
Impairment occurring years after having polio with satisfactory function in the interim
Post-polio syndrome
Evaluate how strenght, ROM, and endurance affects ADLS, occupational performance, and psychosocial status. Assessment of psychosocial status is needed.
Overwork of muscles should be avoided.
Manage pain with body mechanics, support of weak muscles, and lifestyle modification
OT interventions for treating post polio syndrome
Acute inflammatory condition of the spinal nerve roots, peripheral nerve, and in some cases, selected cranial nerve
Guillain-Barre syndrome
Rehab is initiated when the patient is stable.
Initial focus on PROM, positioning, and splinting to prevent contracture.
Graded activities as the patient progresses.
Always gaurd against fatigue and irritation of the inflamed nerve.
Use AE and energy conservation techniques as needed.
Progress with upright positioning and activities.
Provide psychosocial support
OT treatment for Guillain-Barre syndrome
