Neurological Impairment Flashcards
Definition of Parkinson’s Disease
-what does this affect
-aetiology
A progressive neurodegenerative disease
-Affecting the basal ganglia with degeneration of the
dopamine receptors present in the substantia nigra.
-Idiopathic, cerebrovascular disease, head injury, drug induced eg phenothiazine, butrophenones, valproate, metoclopramide
Cardinal features of Parkinson’s
Bradykinesia
Rigidity
Mask like face
Resting tremor
Postural instability
Gradual symptom progression
Sustained response to therapy with levodopa
Dental considerations for Parkinson’s
Capacity
Access
Communication
Movement during treatment
Communication issues with those with Parkinson’s
Mask like face - loss of non verbal cues
Blankness
Hoarse voice/slow speech
Facilitating seeing a parkinson’s pt
Longer appt time - comms
Better time of day to attend
Sedation to aid tremor or pillows to help support
Dementia definition
A syndrome with chronic, progressive deterioration
of mental function characterised by impaired
cognitive state beyond which might be expected
from normal aging
What aspect of a person does Dementia affect
-Memory
-Thinking
-Orientation
-Comprehension
-Calculation and learning capacity
-Language
-Judgement.
Name some types of Dementia
-Alzheimer’s
-Vascular
-Dementia with Lewy bodies
-Fronto-temporal
-Korsakoff’s syndrome
-Parkinson’s
Early stage Dementia features
-Forgetful
-Lose track of time
-Unsure of familiar places
Middle stage dementia features
-Becoming forgetful of recent events and people’s
names
-Becoming lost at home
-Having increasing difficulty with communication
-Needing help with personal care
-Experiencing behaviour changes, including wandering and repeated questioning.
Late stage Dementia features
-Becoming unaware of the time and place
-Having difficulty recognizing relatives and friends
-Having an increasing need for assisted self-care
-Having difficulty walking
-Experiencing behaviour changes that may escalate and include aggression
Non verbal signs of pain
-Fidgeting
-Pacing
-Repetitive motions
-Refusal to eat, eating less than usual
-Refusal to cooperate in general
-Shouting
-Crying
-Groaning
Fundamental aspects of care for those with neurological impairment
PREVENTION
-disrupt biofilm
-fluoride
-pt/carer motivation
-adaptation of oral hygiene aids
Treatment adaptations for those with neurological impairment
-high volume aspiration
-dental dam??
-avoidance of GA
-capacity?
