Neuro Disorders Flashcards
What is Multiple Sclerosis?
A chronic, inflammatory autoimmune disorder of the Central Nervous System caused by degeneration of the myelin sheath and loss of axons
What are the three principal parts of MS?
- brain and spinal inflammation
- Demyelination
- Scar development (gliosis)
What are the risk factors for the development of Multiple sclerosis?
20-40-year-old women who live in a cooler climate, are Caucasian, have smoked in the past, are Vitamin D deficient, obese, or have had EBV before
Define Benign MS:
no disability with a return to normal between attacks
define Primary-progressive MS:
steady increase of disability with no remissions
define Relaxing-Remitting MS:
most common - unpredictable attacks with periods of remissions and possible disabilities
define Secondary-Progressive MS:
initial relapsing-remitting pattern that suddenly declines with steady disability increase and no remissions
define Progressive-Relapsing MS:
steady disability decline with occasional SUPER-imposed attacks
How would an individual with Multiple Sclerosis present to the clinic?
The 1st sign would consist of trunk, limb, and face paresthesias, cog fog, vision problems, bowel and bladder problems, depression, fatigue, weakness, sexual issues, muscle stiffness and spasms, and vertigo
How would you treat a relapse of multiple sclerosis?
high-dose IV glucocorticoid, IV gamma globulin, ACTH
What is Guillain-Barre Syndrome (GBS)?
An autoimmune disorder where the myelin sheath is damaged by antibodies of the Peripheral Nervous System
What is the cause of GBS?
GBS is thought to be caused by viral infections and bacterial infections and occur days to weeks after these events
How many people survive GBS?
95%
How many people completely recover from GBS?
75%
How does GBS present?
presents in an ascending pattern starting with decreased sensation in the feet that moves upwards and the severity of symptoms increases over hours or weeks
What is the range of disabilities with GBS?
numbness to complete paralysis
Why can GBS become life-threatening?
If the respiratory muscles become affected
What are common clinical manifestations of GBS?
decreased sensation, decreased bowel and bladder control, blurry vision, difficulty breathing, swallowing, and chewing
What is ALS (Lou Gehrig)?
ALS is a rare, progressive neuro disorder characterized by the loss of motor neurons in both the upper and lower extremities caused by excessive levels of glutamate
What is the life expectancy of those with ALS?
3 years after diagnosis
Who is at risk of developing ALS?
males in their 40-70s who have a family history and have smoked in the past
How do motor neurons degenerate in ALS?
The “Excitotoxicity hypothesis” says that excessive glutamate production leads to a cascade of events that causes neuron death, causing motor neuron degeneration and electrical/chemical messages not making it from the brain to the muscles.
What is the most common cause of death in those with ALS?
respiratory failure due to respiratory muscles not working
How would an individual with ALS present to the clinic?
upper extremity weakness with muscle wasting and spasticity, dysarthria, dysphagia, drooling, and cognitive and behavioral changes, constipation, sleep problems, and breathing issues
What is Parkinson’s Disease?
A progressive and degenerative disorder of basal ganglia function leading to faulty substantial nigra and decreased dopamine production causing loss of smooth muscle movement
What are the three factors that characterize Parkinson’s Disease?
- Tremor
- Rigidity
- Bradykinesia
What does an excess of acetylcholine in relation to dopamine cause?
loss of controlled muscle movement
What does the destruction of the substantia nigra in the basal ganglia cause?
decreased dopamine levels
What causes of Parkinson’s Disease are acquired?
infection, intoxication, trauma (head), and drug-induced
Who is at risk of developing Parkinson’s Disease?
Men in their 70s who have a history of head trauma, family history, andxiety and depression, or a hysterctomy if female
What is a protective factor for PD?
drinking coffee
What is dopamine?
an INHIBITory neurotransmitter that controls balance, movement, message transmission, and smooth muscle movement
What is Acetylcholine?
an EXCITATory neurotransmitter that works in conjunction with dopamine
When is an essential tremor seen?
with activity/movement
When is a PD tremor seen?
with rest
A patient presents with a masked expression, shuffling gait, postural instability, pill-rolling tremor at rest, toe tap, and cogwheel rigidity; what is the diagnosis?
Parkinson’s disease
What is the 1st sign seen in someone with PD?
A tremor that affects handwriting, occurs at rest and is exacerbated by stress and concentration
What is cogwheel rigidity look like in someone with PD?
a resistance to passive movements that presents as slow, jerky movements, sustained muscle contractions, and muscle soreness/pain
What is Bradykinesia looks like in someone with PD?
A loss of automatic movements including blinking, arm swinging, swallowing saliva, self-expression, and spontaneous movements
What is the goal of Pharmacology in Neuro disorders?
Alleviate signs and symptoms and slow down disability
What are complications that often appear as a result of Parkinson’s Disease
dementia, depression, anxiety, malnutrition, aspiration, pneumonia, UTIs, and skin breakdown
What is Myasthenia Gravis (MG)?
An autoimmune disorder and type 2 hypersensitivity reaction characterized by fluctuating muscle weakness of certain muscle groups
Who is at risk of developing myasthenia gravis?
women between 10 and 65 years old
How do antibodies cause Myasthenia Gravis?
Antibodies attack Acetylcholine receptors which causes a decrease in acetylcholine sites and less Acetylcholine initiating muscl contraction
How would an individual with Myasthenia Gravis present?
They would present with fluctuating skeletal muscle weakness, increased strength after rest, and trouble controlling muscle movements of the eyes, eyelids, face, throat, and respiratory system
What is a major complication of Myasthenia Gravis?
breathing muscle weakness
What is a Myasthenic Crisis?
An acute muscle exacerbation triggered by a stressor such as infection, surgery, emotional distress, pregnancy, menses, or not enough neostigmine
