Lecture 3 & 4: Movement Disorders (MS, MND, MD & CP) Flashcards
What is MS?
- Autoimmune disease where immune system attacks and degrades the myelin sheaths (which usually insulate and protect nerves)
- Immune system mistakes yourself as an enemy and begins to attack (like it would an infection)
What does MS cause in terms of cell signalling
- If myelin sheath (which increases signalling) decreases, it slows down signalling
- Scarring prevents movement (signalling)
Symptoms of MS
- Depression
- Pain
- Spasticity
- Fatigue
- Tremor
- Ataxia
Types of MS
- Relapsing-Remitting
- Secondary-Progressive
- Primary-Progressive
- Progressive-Relapsing
What is Relapsing-Remitting MS?
- Short duration
- May remain symptom-free for a long time
What is Secondary-Progressive MS?
- Slow, steady progression (with or without relapse)
- Relapses do not fully remit
What is Primary-Progressive MS?
- Slowly worsening symptoms with no relapses or remissions
What is Progressive-Relapsing MS?
- Steadily worsen from the onset
- Flare-ups - with or without remissions
How is MS treated and managed?
- Treat inflammation: corticosteroids
- Slow or prevent disease prevention
- Treat chronic symptoms
- Physical/psychological support
What is the most common form of MS?
- Relapsing-Remitting
What is motor neuron disease (MND)?
Group of conditions in which motor neurons die
Symptoms of MND
- Muscle wasting
- Weakness
- Respiratory failure
What happens to the neurons in MDN?
LMN: muscles gradually weaken, waste away and develop uncontrollable twitching
UMN: similar + stiffness & spasticity
What are the 2 types of muscle atrophy?
- Disuse atrophy
- Neurogenic atrophy
Which type of atrophy can be reversed?
DISUSE
Why can’t neurogenic atrophy be reversed?
There is damage to the nerve innervating the muscle
What is cell damage induced by in MND?
Reactive oxygen species (free radicals)
What causes oxidative stress?
Persistent imbalance of oxidants & antioxidants (O>A)
Riluzole MOA
Subtly blocks Na+ channels to slow down APs -> decreases glutamate that is released
What drug can control spasticity?
Baclofen
How does baclofen work?
- Injected into the spinal cord where it can bind to GABAb receptors and inhibit aspects of movement
Respiratory care in MND
- Mask ventilator system overnight
Other treatments for MND
- Assisted eating (muscle weakness in arms & hands)
- Gastrostomy insertion (feeding tube)
What is Muscular Dystrophy (MD)?
Group of disorders which involve progressive loss of muscle mass and strength
What causes MD?
Genetic mutations which interfere with the production of muscle proteins required to build and maintain muscle tissue
Why are the vast majority of MD patients boys?
- It is an X linked recessive condition
- female only has one carrier gene, therefore, female child will only likely be a carrier (as they have 2 x chromosomes)
- if male gets the carrier X gene, then he will have MD as he only has one X chromosome
Symptoms of MD
- Pain & stiffness
- Difficulty with running and jumping
- Walking on toes
- Waddling gait
How can you diagnose MD?
- Genetic testing
- Heart monitoring
- EMG
- Biopsy
Is there a cure of MD?
NO
What can medications do in MD treatment?
Slow the progression and keep the patient mobile for as long as possible
What are the 2 most commonly prescribed drugs for MD?
Corticosteroids Heart medications (e.g. beta blockers, ACE inhibitors)
What are some other forms of treatment for MD?
- General exercise
- Breathing assistance
- Mobility aids
- Braces
What is CP?
A condition that is developed when there is brain injury or malformation while the child’s brain is under development
Symptoms of CP in babies
- Low muscle tone (floppy)
- Unable to hold up their head
- Muscle spasms
- Poor muscle control
- Delayed development
Symptoms of CP in toddlers/children
- Not walking by 12-18 months
- Not speaking simple sentences by 24 months
(DEPENDING ON SEVERITY)
How is CP diagnosed?
- Look at movement
- Are their muscles floppy or stiff?
- Do they have unusual posture or favour one side?
What treatment is available/
- Medication for movement issues (diazepam & baclofen)
