Motor Unit Disorders

Question 1

Motor Unit Disorders

Answer 1

Disorders of the motor unit generally cause muscle weakness and atrophy of skeletal muscle that may of neurogenic, neuromuscular, or myopathic origin

Question 2

Guillain Barre Syndrome

Answer 2

An acute inflammatory condition involving the spinal nerve roots, peripheral nerves and in some cases selected cranial roots, (neurogenic).
Autoimmune disease with no know cause or cure.

Question 3

Guillain Barre Syndrome what does theImmune system destroy

Answer 3

the myelin sheath that surrounds the axons of peripheral nerves or the axons.

Question 4

When does Guillain Barre Syndrome typically appear

Answer 4

Often follows a viral illness, immunizations, or surgery.

Question 5

Guillain Barre Syndrome Symptoms

Answer 5

Initial symptoms weakness and sensory changes in LE’s.
Rapid progressive weakness from distal to proximal
Inability to feel textures, heat, pain.
Complaints of tingling, crawling skin, or painful sensations
May progress to problems with breathing, speaking, swallowing, BP, heart rate, or total paralysis.

Question 6

Guillain Barre Syndrome Treatment

Answer 6

ROM
Positioning
Splinting
Energy Conservation/Work simplification/AE
Avoid over fatigue 
ADLs/IADLs
Mobile arm supports

Question 7

Poliomyelitis:

.

Answer 7

A highly contagious viral disease that is transmitted via fecal-oral (primarily spread through unsanitary conditions and or through poor handwashing).

Question 8

Why don’t all people know they have polio

Answer 8

People acquiring the disease can be asymptomatic but still spread the disease.

Question 9

Is flaccid paralysis typical?

Answer 9

no results in less than 1% of all polio infections, usually followed by a full recovery. (if paralysis lasts longer than 12 months usually permanent).

Question 10

3 Types polio

Answer 10

Spinal polio: .
Bulbar polio:
Bulbospinal polio:

Question 11

Six criteria for Postpolio syndrome:

Answer 11

1. Prior paralytic poliomyelitis
2. Period of complete or partial recovery
3. Gradual or sudden onset of progressive and persistent; muscle weakness, abnormal muscle fatigue.
4. New difficulties with breathing/swallowing.
5. Symptoms last for at least a year
6. Other cause of symptoms ruled out

Question 12

Postpolio syndrome (PPS).

Answer 12

25 -40%These adults are currently dealing with new muscle pain and increasing weakness or developing new weakness /paralysis that is diagnosed as Postpolio syndrome (PPS).

Question 13

Postpolio syndrome (PPS) Pathogenesis

Answer 13

Failure of oversized motor units created during the recovery process of paralytic poliomyelitis (not contagious).

Question 14

Additional PPS disabling problems:

Answer 14

Muscle atrophy
Scoliosis
Osteoporosis
Fractures
Contractures (prolonged shortening of muscle joint)
Depression
Increased difficulty with ADLs/IADLs, ambulation, transfers, stairs, home management, driving, eating/swallowing and bowel/bladder control

Question 15

Polio Treatment

Answer 15

Energy conservation/Work Simplification/Pacing
Purse lip breathing
Address psychosocial and emotional aspects
ADLs, IADLs, transfers, home management, driving, bowel & bladder
Address fatigue/pain
ROM exercises (conservative)
Family training, AE

Question 16

Myastensis Gravis

Answer 16

The most common chronic disease involving a disorder of chemical transmission at the nerve-muscle synapse, or neuromuscular junction (neuromuscular disorder)

Question 17

Myastensis Gravis Caused by

Answer 17

an autoimmune response in which antibodies are produced that block, alter, or destroy the nicotinic acetylcholine receptors on the post synaptic membrane and interfere with synaptic transmission at the nerve muscle junction.

Question 18

Myastensis Gravis defective neurotransmissions causes

Answer 18

skeletal (voluntary) muscles typically cranial muscles become weak (eye, eyelids, chewing, swallowing, coughing and facial expression).
Eyelid drooping(pytosis), double vision (diplopia), 

oropharyngeal muscle weakness causing difficulty with chewing, swallowing, and speaking

Question 19

Myastensis Gravis Medical Management

Answer 19

Thymectomy (secondary to abnormalities of the thymus)
Corticosteroids
High dose immune globulin
Plasma exchange

Question 20

Myastensis Gravis Treatment

Answer 20

Energy conservation/work simplification/pacing
Assess dysphagia and risk for aspiration
Family education/training
Address psychosocial issues
Address vision deficits and adapt/grade environment accordingly (lighting, furniture, etc).