degenerative neuro Flashcards
what is myasthenia gravis?
autoimmune disease that is characterized by varying degrees of the voluntary muscles causing muscle weakness
what body parts are effected?
muscles, eye muscles, throat muscles, arms, legs, and severe respiratory muscles fall
how does the thymus gland effect MG?
the thymus gland produces T cells, and then attacks them
risk factors for M.G.?
female (<40)
male (>60)
what can worsen MG?
fatigue
Illness
Stress
Extreme
signs and symptoms of MG?
diplopia
Ptosis
weakness of face, throat and general area
What type of disorder is MG?
A motor disorder
what is the tensilon test?
injection of the chemical edrophonium, which once injected may result in a sudden increase of muscle strength
what is edrophonium?
an acetylcholinesterase inhibitor, prevents the breakdown of acetylcholine.
what does the tensilion test show?
that the patient has MG
what are the adverse effects fo edrophonium?
bradycardia, systole, increased oral and bronchial secretions, and bronchoconstriction
diagnosing MG?
EMG
CT of chest to look at the Thymus
Tensilon test
treatment of MG?
supportive care
IVIG- replace antibodies
anticholinesterase medications
thymectomy- remove thymus
what is MS?
multiple sclerosis
unpredictable and disabling disease of the CNS that disrupts the flow of info within the brain and between the brain and body
causes a damaged myelin sheath
causes of MS?
idiopathic, possibly genetic
when are people diagnosed with MS?
between the ages of 20-50
symptoms of MS?
weakness tingling numbness blurred vision muscle stiffness thinking problems urinary problems
what may MS be misdiagnosed as?
a CVA
what can MS be triggered by?
a viral infection, but this is not always the case.
how is MS diagnosed?
by process of elimination,
MRI can reveal plaques in the brain and spinal cord
treatment of MS
focus is on speeding recovery from attacks, and slowing progression of disease
corticosteroids
plasmapheresis
what is the use of plasmapheresis in MS?
it is used short term for rebuilding antibodies
what is neurodegenerative disease?
disorders leading to deterioration of normal cells or function of nervous system
how fast does neurodegenerative disease onset?
slow onset of signs and symptoms
subtle changes worsening over time
what is Parkinson’s?
slow progressing neurologic movement disorder
what population does Parkinson’s more often effect?
men more than women
what age does Parkinson’s occur?
in the 50s
what are the suspected idiopathic causes?
genetics atherosclerosis viral infections head trauma chronic use of antipsychotic meds environmental exposure
patho of Parkinson’s?
decreased levels of dopamine from loss of neuronal cells in substantia nigra in the brain cells
what part of the brain is affected by Parkinson’s?
substantia nigra in basal ganglia
what does a loss in dopamine result in?
imbalance affecting voluntary movement
what are the cardinal signs of Parkinson’s?
- Tremor
- Rigidity
- Bradykinesis
- Postural instability
autonomic symptoms from Parkinson’s?
sweating, paroxysmal flushing, orthostatic hypotension, gastric and urinary retention, constipation
psych changes with Parkinson’s?
depression, dementia, delirium, hallucination
hypokinesia in parkinsons?
abnormally diminished movement, freezing phenomenon
what type of handwriting do Parkinsons patients have?
micrographia
how do people with Parkinson’s talk?
dysphonia: soft, slurred, slow, low pitched speech
how is Parkinson’s diagnosed?
2 out of 4 cardinal manifestations
what med is the go to for Parkinson’s?
levodopa
how does levodopa work?
converts to dopamine in the basal ganglia
nursing management of Parkinson’s?
improving mobility enhance self care improve nutrition enhance swallowing improve communication
what is trigeminal neuralgia also known as?
Tic Douloureux
what nerve is effected by trigeminal neuralgia?
5th cranial nerve- any of the branches, but more commonly 2nd or 3rd branches
trigeminal neuralgia causes paroxysms of __________ ____________ __________ _____.
unilateral shooting/stabbing pain
most common symptom of trigeminal neuralgia?
involuntary contraction of facial muscles with sudden closing of eye or twitching of mouth
what is thought to cause trigeminal neuralgia?
vascular compression and pressure
treatments for trigeminal neuralgia?
avoid triggers
Baclofen
Gabapentin
what are possible triggers of trigeminal neuralgia?
brushing teeth shaving face washing chewing temp changes
What is bells palsy?
unilateral inflammation of the 7th cranial nerve
what does bells palsy cause?
facial paralysis or weakness
causes of bells palsy?
vascular ischemia
viral disease
autoimmune disease
symptoms of bells palsy?
facial distortion from paralysis lacrimation painful sensation of the face, behind ear, in eye speech difficulties difficulty chewing
treatment of bells palsy?
resolves completely and rarely recurs
spontaneous recovery in 3-5 weeks
corticosteroids to reduce inflammation
