Neurological Disorders

Question 1

Cerebral palsy

Answer 1

Umbrella term encompassing a wide spectrum of non progressive neurological (motor control) and physical disabilities
Can be developmental or as a result of peri-natal insult such as hypoxia, trauma, infection
It is the most common congenital cause of physical impairment

Four types of cerebral palsy:
1. Spastic- most common; affected muscles are stiffer and tighter
2. Dyskinetic- muscle tone changes suddenly from tight to floppy causing uncontrolled movements or spasms
3. Ataxic- least common; shaky movements, poor balance, difficulties in fine motor skills, tremor, low muscle tone
4. Mixed- mix of more than one type

Can cause :
Monoplegia- one limb only
Hemiplegia - one side of the body
Paraplegia - both lower limbs
Quadriplegia- all four limbs

Diagnosis usually made from clinical signs
Can have other impairments: visual, hearing, speech impairment, epilepsy, drooling, learning disabilities

Question 2

Cerebral palsy- oral and dental features

Answer 2

Higher level of untreated disease
Developmental abnormalities
Malocclusion
Uncontrolled movement
Bruxism
Drooling
Perio disease and caries

Question 3

Multiple sclerosis

Answer 3

Complex autoimmune neurological condition which occurs as the results of damage to the myelin sheaths of the nervous system (myelin sheath allows impulses to transmit quickly and effectively along nerve cells, if damaged, the impulses slow down and cause communication problems between the brain and the resto of the body)
Affects both motor and sensory nerve transmission
Can be relapsing or progressive

Question 4

Symptoms and signs in MS

Answer 4

Vision problems
Numbness or weakness
Facial pain/trigeminal neuralgia
Speech, swallowing and hearing problems
Fatigue
Depression
Tremors, spasms…

Question 5

MS and dental management

Answer 5

Shorter appointments
Rigours prevention
Dysphagia
Dizziness, vertigo

Nitrous oxide should be avoided as may theoretically cause further demyelination

Question 6

Huntington’s disease

Answer 6

Inherited, progressive, degenerative neurological disorder
Autosomal dominant
Onset commonly between 30 and 50
15-20 years of life after onset- commonly due to pneumonia

Signs and symptoms:
Physical ( uncontrolled movements, clumsiness, lack of coordination-chorea)
Cognitive ( lack of concentration, short term memory loss, lack of interest, lack of organizational skills)
Emotional/psychological ( depression, mood swings, antisocial behavior, frustration)

Question 7

Common neurological terms

Answer 7

Aphasia-difficulty with sleech
Ataxia- poor muscle control causing clumpsy voluntary movements
Bradykinesia- slow movements
Chorea- sudden, unintended jerky movements of the arms legs, facial muscles
Dysarthria- difficulties controlling muscles for speech, slurred speech
Dysphagia- swallowing difficulty
Dysphasia- language disorder- understanding it and speaking it
Parasthesia- abnormal sensation
Paraplegia- paralysis of legs but not arms
Spasticity - abnormal increase in muscle tone causing stiffness