Neuro new pathologies Flashcards
Define Cerebral Palsy
Permanent impairment of movement and posture resulting from a non-progressive brain disorder due to hereditary factors or events during pregnancy, delivery, neonatal or first 5 years of life
Classification ways of Cerebral Palsy (2)
- part of body
- type of tone
Part of body classification (3)
Hemiplegia (one side of body e.g. left)
Diplegia (only lets affected’)
Quadriplegia (all 4 limbs affected)
Type of tone classifications (4)
Hypertonic: spastic and dystonic
Hypotonic: athetoid and ataxic
Outcome measure - who is Gross Motor Function Measure suitable for (3)
Suitable for: cerebral palsy, Down syndrome and developmental delay
Levels of Gross Motor Function Measure
1- walk without assistance
2- walk without devices but limitations in community
3- walk with devices, limitations in community
4- self mobile with limitations, use power mobility in community
5- mobility severely affected even with power devices
Describe the 4 types of cerebral palsy, classified by tone
Hypertonic spastic: exaggerated reflexes, jerky movements
Hypertonic dystonic: repetitive and involuntary movements, not functional. Twisting and abnormal posture
Hypotonic athetoid: slow unpredictable riding movements
Hypotonic ataxic: uncoordinated jerky movements
Define spina bifida & cause
Congenital abnormality with the formation of the spinal vertebrae, can lead to neural tubing protruding through the gap
Cause: lack of folic acid
3 types of spina bifida
Occulta - one or more spinal vertebrae don’t form, only leave small gap
Cystica meningocele- membrane of neural tubing protrudes
Cystica myelomeningocele- membrane and spinal cord protrude
Define hydrocephalus
Cerebrospinal fluid build up in the brain, causing pressure resulting in balance and walking difficulties (depends where pressure is)
Hydrocephalus treatment
Shunt/ stent into brain, drains fluid off into thoracic cavity or stomach
Duchenne Muscular Dystrophy
Progressive genetic condition causing muscular weakness. More common in boys, life expectancy 20-30
Can be seen doing Gowers Manoeuvre, locking knees into standing
Limb girdle is a type of diagnosis
Physio interventions for all
24hr postural management: encourage symmetry, prevent abnormalities developing, encourage independence
Primary impairments and secondary impairments
Primary: spasticity, tone, etc
Secondary: muscle contracture, weakness
Key drugs: Diazepam, Botulinum toxin A, intrathecal Baclofen
Diazepam- spasms and pain control
Botox- focussed spasticity e.g. one muscle
Baclofen- widespread spasticity, affecting posture, function
Selective dorsal rhizotomy (cerebral palsy)
Treat and ‘reset’ spasticity by cutting the dorsal nerve root innovating the muscle causing the spasticity
Lumbar spine
Age 3-12
Gross motor function classification 2 or 3
Guillain barre syndrome definition
A disease consisting of demyelination of the peripheral nervous system, with secondary atonal degeneration.
characterised by rapidly progressing, symmetrical limb weakness, loss of tendon reflexes, absent sensation and some autonomic dysfunction.
GBS causes
No known cause but has autoimmune link, usually comes on after a viral infection
GBS diagnosis
Bilateral symptoms
Blood tests
Nerve conduction tests (electromyograms)
Lumbar puncture
Types of GBS
AIDP- acute inflammatory demyelinating polyradiculoneuropathy
MFS- Miller Fischer syndrome
AMAN and AMSAN - acute motor axonal neuropathy
Acute motor-sensory axonal neuropathy
AIDP- acute inflammatory demyelinating polyradiculoneuropathy
Signs and progression
Limb weakness begins lower and ascends up to arms. Weakness can evolve into paralysis
Symptoms: sensory changes -p&n, bilateral weakness that spreads, facial movement and eye problems
Stages of GBS
Worsening- Nadir: maximum signs reached within 2-4 weeks
Plateau: can last 4-6 weeks up to a year
Recovery: begins after 4 weeks to a year
GBS more common in?
Men
Elderly
GBS treatments
Medical management: plasma exchange
Physio therapy: treat symptoms
