Differential Diagnoses Flashcards
Bell’s Palsy
Inflammation affects Facial nerve (CN VII)
Decreased control of salivation
One sided facial weakness or paralysis
Normal sensation
Decreased taste to anterior 2/3 of tongue
Use artificial tears or patching to protect cornea
E-stim
Facial muscle exercises
Functional retraining for chewing
Amyotrophic Lateral Sclerosis
Affects upper and lower motor neurons (sometimes cranial nerves) Muscle weakness Can affect muscles of respiration May appear in hands first Dysarthria Dysphagia Atrophy Cramping Fasciculations (LMN) Spasticity and hyperreflexia (UMN) Maintain respiratory function PROM Positioning Skin care Prevent deconditioning and disuse atrophy Do not overwork muscles Energy conservation Symptomatic treatment for pain, spasms, and conservation Psychological support
Guillain-Barre Syndrome
Polyneuropathy (probable immune-mediated origin)
Symmetric paralysis
Progressive muscle weakness distal to proximal
Develops quickly
LMN affects cranial and peripheral nerves
Sensory loss (stocking/glove)
Paresthesias
May produce tetraplegia with respiratory failure
Tachycardia
Abnormal cardiac rhythm
Blood pressure changes
Recovery slow
3% mortality rate
Ascending phase: respiratory function, PROM, positioning, skin care
Stabilized: avoid overuse & fatigue, gentle stretching, movement in controlled environment
Descending phase: muscle reeducation, moderate exercise, cardiovascular fitness, energy conservation
Multiple Sclerosis
Demyelinating Mild, remissions, exacerbations, or progressive Sensory disturbances Decreased coordination Spasticity Fatigue Diplopia Bowel & bladder dysfunction Communication disorders Psychosocial problems Euphoria Depression Adverse reactions to heat Improve function Prevent secondary problems Breathing exercises PNF Ambulatory or wheelchair mobility Decrease tone Keep stress levels low Avoid over vigorous activity Morning treatments best
Parkinson’s Disease
Progressive Affects basal ganglia Decrease in dopamine production &/or receptors Tremor Rigidity Fatigue Bradykinesia Festinating or shuffling gait Flexed posture Mask-like face Decreased postural reflexes Memory loss Decubitus ulcers Muscle atrophy Contractures Decreased vital capacity Falls Gait training Breathing Relaxation Mbility PNF diagonals- rhythmic initiation ROM with PNF contract-relax Inhibitory casting Orthoses Avoid excessive exercise Dopamine agonist meds- sometimes lose effectiveness Best to treat in morning after taken meds
Postpolio Syndrome
New form of muscular dystrophy Asymmetrical muscular atrophy & weakness Myalgia Joint pain Excessive fatigue Decreased endurance Low intensity exercise Never to point of fatigue Stop exercise with pain or weakness Orthotics Work on endurance & energy conservation
