Neuro new pathologies

Question 1

Define Cerebral Palsy

Answer 1

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

Question 2

Classification ways of Cerebral Palsy (2)

Answer 2

• part of body

- type of tone

Question 3

Part of body classification (3)

Answer 3

Hemiplegia (one side of body e.g. left)
Diplegia (only lets affected’)
Quadriplegia (all 4 limbs affected)

Question 4

Type of tone classifications (4)

Answer 4

Hypertonic: spastic and dystonic
Hypotonic: athetoid and ataxic

Question 5

Outcome measure - who is Gross Motor Function Measure suitable for (3)

Answer 5

Suitable for: cerebral palsy, Down syndrome and developmental delay

Question 6

Levels of Gross Motor Function Measure

Answer 6

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

Question 7

Describe the 4 types of cerebral palsy, classified by tone

Answer 7

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

Question 8

Define spina bifida & cause

Answer 8

Congenital abnormality with the formation of the spinal vertebrae, can lead to neural tubing protruding through the gap
Cause: lack of folic acid

Question 9

3 types of spina bifida

Answer 9

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

Question 10

Define hydrocephalus

Answer 10

Cerebrospinal fluid build up in the brain, causing pressure resulting in balance and walking difficulties (depends where pressure is)

Question 11

Hydrocephalus treatment

Answer 11

Shunt/ stent into brain, drains fluid off into thoracic cavity or stomach

Question 12

Duchenne Muscular Dystrophy

Answer 12

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

Question 13

Physio interventions for all

Answer 13

24hr postural management: encourage symmetry, prevent abnormalities developing, encourage independence

Question 14

Primary impairments and secondary impairments

Answer 14

Primary: spasticity, tone, etc
Secondary: muscle contracture, weakness

Question 15

Key drugs: Diazepam, Botulinum toxin A, intrathecal Baclofen

Answer 15

Diazepam- spasms and pain control
Botox- focussed spasticity e.g. one muscle
Baclofen- widespread spasticity, affecting posture, function

Question 16

Selective dorsal rhizotomy (cerebral palsy)

Answer 16

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

Question 17

Guillain barre syndrome definition

Answer 17

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.

Question 18

GBS causes

Answer 18

No known cause but has autoimmune link, usually comes on after a viral infection

Question 19

GBS diagnosis

Answer 19

Bilateral symptoms
Blood tests
Nerve conduction tests (electromyograms)
Lumbar puncture

Question 20

Types of GBS

Answer 20

AIDP- acute inflammatory demyelinating polyradiculoneuropathy
MFS- Miller Fischer syndrome
AMAN and AMSAN - acute motor axonal neuropathy
Acute motor-sensory axonal neuropathy

Question 21

AIDP- acute inflammatory demyelinating polyradiculoneuropathy
Signs and progression

Answer 21

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

Question 22

Stages of GBS

Answer 22

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

Question 23

GBS more common in?

Answer 23

Men

Elderly

Question 24

GBS treatments

Answer 24

Medical management: plasma exchange

Physio therapy: treat symptoms