MND Flashcards
general definition of MNDs
progressive neurodegenerative disorder affecting motor neurons
general manifestations of MND
UMN: spasticity, hyperreflexia, weakness
LMN: atrophy, hyporefelxia/areflexia, weakness
typical MND
both UMNL and LMNL
ALS
LMN
polio and post polio syndrome
discuss ALS
most common MND
aka lou gehrig’s disease
progressive painless assymetric muscle weakness
2 forms:
- sporadic
- familial
pathophysiology of ALS
degeneration of Betz cells, ant horn cellls of SC, lower motor neuron of CN V, VII, X, XI, XII
amyotrophy - muscle wasting
lateral sclerosis - hardening of ant and lat corticospinal tracts
what are betz celss
largest layer of pyramidal cells in 5th layer of precentral gyrus
epidimiology of ALS
40-60 yo
MALE
can be sporadic or familial
clinical hallmark of ALS
UMN and LMN signs coexist
common initial findings in ALS
assymetrical hand weakness c atrophy and fasciculations
diff fine motor tasks
foot drop
shoulder weakness
discuss spinal or limb onset ALS
UMN and LMN features
discuss bulbar onset ALS
CN 5, 7, 9, 10, 11, 12
speech probs
tongue fasciculations
PBA
pathgomonic features of ALS
hyperreflexia c hoffman and babinski
weakness, atrophy and fasciculations
UMN and LMN
advanced manifestations of ALS
axial weakness and dropped head syndrome
cramps
gait impairment: foot drop and spastic gait
- sensory, autonomic, bowel and bladder, EOM prob
- basically lahat pag super sever
el scorial criteria for ALS
UMN and LMN findings in cranial, cervical, thoracic and lumbosacral
suspected: pure LMN in 2 or more
possible: UMN and LMN in one but UMN or LMN in 2 or more
lab supported: UMN and LMN in one c EMG
probable: more than 2 with UMN and LMN and some UMN or LMN
definite: UMN and LMN in 3 or more
awaji ALS criteria
for lab shit
diagnosis of ALS
EMG for denervation
transcranial magnet stim for UMN
MRI to r/o other shit
prognosis for ALS
depends on type of onset, respi function and age
bulbar: 2-3 yr survival
only 4% survive more than 10 yrs
pharmacotherapy for ALS
none that alter progression
riluzole and edaravone can only treat sx
infectious MND
poliomyelitis and post polio syndrome
discuss poliomyletis
from poliovirus via fecal-oral route
affects ant horn and brainstem
acute flaccid paralysis (bulbar or spinal) following exposure
can resolve on its own or not
clinical manifestation of polio
fever and GI tract prob muna
assymm weakness and atrophy of legs or bulbar muscles
polio gait or lurching gait
no sensory prob
no meds to treat; vaccine lang
stages of polio
prodromal: flue like sx then gagaling
pre-paralytic: babalik ule fever kasi nasa CNS na virus
paralytic: 2-5 days or 2-3 wks p magkaka paralysis na
discuss post-polio syndrome
slowly progressive assym muscle weakness in pt c history of polio
basta gumaling na from polio then balik 15-40 yrs p
