Neuro Diagnoses Flashcards
Alzheimer’s Disease
- Irreversible degeneration of acetylcholine transmitters within cerebral cortex
- progressive
- amyloid plaques
Alzheimer’s Disease - etiology
Unknown
-Maybe: lower levels of neurotransmitters, higher levels of aluminum in brain, genetics, autoimmune, abn amyloid processing, virus
Alzheimer’s Disease - risk
Older women
Alzheimer’s Disease - sxs (early, middle, late)
-early on: difficulty w/ new learning, subtle changes to memory and concentration
- word finding difficulties, no orientation, depression, poor judgement
- rigidity, bradykinesia, shuffling gait, unable to self-care
-end stage: severe intellectual/physical destruction, incontinence, funct dep, inability to speak
Alzheimer’s Disease - tx
No cure
-treat sxs w/ rx
Alzheimer’s Disease - rx
- Rx: block acetylcholinesterase, Alleviate cog sxs, control behavior
- Tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon)
Amyotrophic Lateral Sclerosis
- chronic degenerative
- muscle denervation and atrophy, weakness
- upper AND lower motor neuron impairment
Amyotrophic Lateral Sclerosis - UMN/LMN
- UMN: Coritcospinal/bulbar demye
- LMN: loss of ant horn cells in spinal cord, loss of motor cranial nerve nuclei in brainstem
Amyotrophic Lateral Sclerosis - risk
40-70 y.o. men
Amyotrophic Lateral Sclerosis - etiology
Unknown
-Maybe: genetics, virus, metabolic disturbances, toxicity of lead/aluminum
Amyotrophic Lateral Sclerosis - sxs
- Distal to proximal ASYMM muscle weakness
- fatigue, oral motor deficits, motor and resp paralysis
-fasciculations, cramping, hand atrophy, incoordination, spasticity, clonus, +Babinski
Amyotrophic Lateral Sclerosis - tx
-tx: PT, OT, SLP, RT, Nutritional Therapy
Amyotrophic Lateral Sclerosis - rx
riluzole (Rilutek)
Carpal Tunnel Syndrome
- median nerve entrapment
- normal pressure 2 to 10 mmHg, CTS > 30mmHg
- nerve ischemia
Carpal Tunnel Syndrome - etiology
Unclear
-associated: repetitive use, RA, pregnancy, DM, cumulative trauma disorders, tumor, hypothyroidism, wrist sprain or fx
Carpal Tunnel Syndrome - sxs
- Median sensory changes and paresthesia
- May radiate up
- Night pain, weakness, muscle atrophy, clumsy, dec mobility
Guillain-Barre Syndrome - risks
Young adults; adults 5th-8th decade
Guillain-Barre Syndrome
- autoimmune “acute polyneuropathy”
- temp inflammation and demye of peripheral nerve myelin sheath
- axonal degeneration
Guillain-Barre Syndrome - etiology
Unknown
-possible response from previous resp infection, flu, immunization, sx
-associations: viral infection, Epstein-Barr syndrome, cytomegalovirus, bacterial infection, sx, and vaccinations
Guillain-Barre Syndrome - sxs
- distal to proximal and symm
- sensory impairment
-sometimes: absent DTR, can’t speak, or swallow, respiratory paralysis
Guillain-Barre Syndrome - progression
2-4 weeks: peak impairment
Guillain-Barre Syndrome - tx
- hospitalization
- PT, OT, SLP
Guillain-Barre Syndrome - rx
- immunosuppressive, analgesics, narcotic
- cardiac monitoring, plasmapheresis, mechanical vent
Guillain-Barre Syndrome - PT
Pulmonary rehab, strength/mobility, WC/orthotics, AD
Huntington’s Disease
basal ganglia and cerebral cortex degeneration/atrophy
Huntington’s Disease - etiology
Autosomal dominant
35-55 y.o.
Huntington’s Disease - sxs
- affective dysfunction, personality changes
- cog impairment
- chorea, choreoathetoid, ataxia
- grimacing, tongue protrusion
Huntington’s Disease - Late stage
-mental deterioration, dec IQ, depression, dysphagia, incontinence, immobility, rigidity
Huntington’s Disease - tx
Family counseling, rx
Huntington’s Disease - PT
Endurance, strength, balance, postural control, funct mobility
Multiple Sclerosis
- autoimmune demyelination patches in brain and spinal cord
- plaque development
Multiple Sclerosis - types (best to worst)
Relapse and remitting
Secondary progressive
Primary progressive
Progressive relapse remitting - worst prognosis
Multiple Sclerosis - etiology
Unknown
- maybe: slow acting virus initiates autoimmune response
- associations: genetics, viral inf, enviro
Multiple Sclerosis - risks
20-35 y.o.
Multiple Sclerosis - initial sxs
- visual problems, clumsiness, fatigue
- paresthesias, sensory changes, weakness, ataxia, balance dysfunct,
Multiple Sclerosis - tx and goals
Tx: rx, medical intervention, PT, OT, SLP,
Goal: dec length of exaccerbation
Multiple Sclerosis - PT
Energy conservation, normalization of tone, balance and gait, core, AD and adaptive devices
CVA Types (5)
Transient Ischemic Attack Completed Stroke - total sxs at onset Stroke in Evolution - thrombus usu, gradual onset of sxs Ischemic (embolus/thrombus) Hemorrhagic
CVA Transient Ischemic Attack
Usu atherosclerotic thrombus
Sxs resolve quickly (24-48h)
Carotid and vertebrobasilar arteries
CVA Ischemic
Embolus (20% of ischemic CVAs) or thrombus
-loss of perfusion w/i seconds
Irreversible infarct w/ surrounding ischemia
