Neuro Pathologies Flashcards
CVA related disorders (-ognosia)
anosognosia: lack of awareness of dx
somatosognosia: lack of awareness of body structure
prosopagnosia: inability to recognize faces
Alzheimer’s Disease
progressive neurodegenerative disorder that results in deterioration and irreversible damage within the cerebral cortex and subcortical areas of the brain
- development of amyloid plaques and neurofibrillary tangles result in further damage to the NS
women > men, risk increases with age
change in higher cortical functions ie difficulty with new learning and subtle changes in memory
progression: loss of orientation, word finding difficulties, depression, poor judgment, rigidity, bradykinesia, shuffling gait, impaired self-care
end stage: incontinence, severe intellectual and physical destruction, inability to speak
treated with cholinergic agents
Amyotrophic Lateral Sclerosis (ALS)
both UMN and LMN, chronic degenerative disease
AHC loss which produces weakness and muscle atrophy (LMN symptoms)
demyelination of CST and CBT (UMN symptoms)
men > women, 40-70 years old
asymmetric muscle weakness, fasciculations, cramping, atrophy in hands (LMN)
*weakness spreads distal to proximal
incoordination, spasticity, clonus, (+) Babinski (UMN)
fatigue, oromotor impairment, motor paralysis, eventual respiratory paralysis
Bell’s Palsy
LMN, temporary unilateral facial paralysis 2/2 trauma with demyelination and/or axonal degeneration of the facial nerve. exact etiology is unknown, but may be 2/2 to viral infection, specifically herpes
15-45 years old
asymmetrical facial appearance with drooping of the eyelid and mouth, potential for drooling, dry eyes, inability to close eyelid due to weakness
Carpal Tunnel Syndrome
LMN, peripheral nerve entrapment injury that occurs as a result of compression of the median nerve where it passes through the carpal tunnel
- repetitive use, RA, tumor
sensory and motor disturbances in the median nerve distribution of the hand, may radiate into UE, shoulder and neck; night pain, weakness of the hand, muscle atrophy, decreased grip strength, clumsiness, decreased wrist mobility
Cerebellar Disorders
congenital: manifest early in life and are non-progressive, ataxia usually present
hereditary: most common is Friedrich’s ataxia (from gene mutation); gait unsteadiness early in life, UE ataxia, dysarthria, paresis, mental function decline, slight tremors; impaired reflexes, vibration,
Diabetic Neuropathy
direct effect of diabetes mellitus, hyperglycemia has direct effects on neurons resulting in the impairment of nerve function
- cranial neuropathies, radiculopathies, mononeuropathies, **polyneuropathy and autonomic neuropathy
weakness and sensory disturbances occur distally in a symmetrical pattern, tingling, numbness and pain, especially in the feet, OH, urinary impairments, weakness
glove and stocking distribution of sensory impairments
Epilepsy
chronic condition where there is temporary dysfunction of the brain that results in seizure activity that is typically unprovoked and unpredictable
*a seizure is a hallmark sign of epilepsy, however one seizure does not mean epilepsy
LOC, loss of awareness, disturbances of movement, sensation, mood, or mental function
antiepileptic meds
Guillain-Barre Syndrome (GBS or acute polyneuropathy)
LMN, temporary inflammation and demyelination of peripheral nerves’ myelin sheaths, potentially resulting in axonal degeneration
-peak frequencies in young adults and 50-80s
- hypothesized to be an autoimmune response to a previous infection
motor weakness in distal to proximal progression, sensory impairment, possible respiratory paralysis
*typically presents with distal symmetrical motor weakness, mild distal sensory impairments, transient parasthesias
- respiratory muscle paralysis (life-threatening), inability to speak or swallow, absence of DTR can occur
Huntington’s Disease (chorea)
UMN, neurological disorder of the CNS characterized by degeneration and atrophy of the basal ganglia and cerebral cortex within the brain; NTs become deficient and unable to modulate movement
- symptoms typically develop between 35-55
affective dysfunction, cognitive impairment, involuntary choreic movements, mild alteration in personality, grimacing, protrusion of tongue, ataxia with choreoathetosis
- late stage: mental deterioration, decrease in IQ, depression, dysphagia, incontinence, immobility, rigidity
Multiple Sclerosis
produces patches of demyelination of the myelin sheaths which decreases the efficiency of nerve impulse transmission (symptoms will vary based on the location and extent of demyelination)
-subsequent plaque development and eventual failure of impulse transmission
-exacerbations and remissions
- highest incidence between 20-35
visual problems, paresthesias and sensory changes, clumsiness, weakness, ataxia, balance dysfunction, fatigue, temperature sensitivity
Myasthenia Gravis
autoimmune disease resulting in neuromuscular junction pathology (transmission of nerve impulses to the muscles at the NMJ)
- antibodies block or destroy the receptors that are needed for ACh uptake and this prevents muscle contraction
- remissions and exacerbations
*crisis: exacerbation that includes resp. muscles
extreme muscle fatiguability and skeletal muscle weakness that can fluctuate within minutes or over an extended period
*ocular muscles are typically affected first (ptosis and diplopia are widely experienced
dysphagia, dysarthria, and cranial nerve weakness
corticosteroids, cholinergics
Parkinson’s Disease
primary degenerative disorder and is characterized by a decrease in the production of dopamine within the substanstia nigra of the basal ganglia
- dopamine is responsible for the modulation and control of voluntary movement
50-79, small % diagnosed before 40
early: resting tremor in the hands or feet that increases with stress and disappears with movement or sleep, balance disturbances, difficulty rolling over and rising from bed, impairment with fine motor skills
progression: hypokinesia, sluggish movement, difficulty with initiating and stopping movement, festinating and shuffling gait, bradykinesia, cogwheel or lead pipe rigidity, poor posture, dysphagia
*may experience freezing and also mask-like appearance
dopamine replacement agents
Post-polio Syndrome (PPS)
poliomyelitis is a viral infection resulting in neuropathy that includes focal and asymmetrical motor impairments
- PPS: LMN pathology that affects AHCs of those previously affected with polio; compensated reinnervation fails and results in ongoing muscle denervation
slow and progressive weakness, fatigue, muscle atrophy, pain, swallowing issues
Anterior Cord Syndrome
hyperflexion
loss of CST and ALS below the lesion
