PNS Pathology Flashcards

1
Q

Acute inflammatory demyelinating polyneuropathy ; Autoimmune disease that attacks the myelin around the axon slowing or impeding nerve conduction; Lesions occur throughout PNS from spinal nerve roots to distal end of motor and sensory fibers; Characterized by motor, sensory, and autonomic dysfunction; May be related to bacterial or viral infection

A

Guillain-Barre Syndrome

- Acute inflammatory demyelinating polyneuropathy – AIDP, most common form

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2
Q

What are the S and S of GBS?

A
  1. Characterized by ascending symmetrical motor and sensory impairments and autonomic symptoms
  2. Motor: Distal weakness more than proximal, LE’s usually before UE’s, Can affect cranial nerves, May affect respiratory muscles
  3. Sensory: Absence of DTR’s, Paresthesias
  4. Autonomic: BP, HR, arrhythmia, tachycardia, fatigue
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3
Q

What are PT treatments for myasthenia gravis?

A
  1. Energy conservation techniques
  2. Isometric strength training
    * Avoid fatigue - frequent rest breaks
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4
Q

What are medical treatments for myasthenia gravis?

A
  1. AChE (acetylcholinesterase) inhibitor medication
  2. Surgical removal of thymus - Stops production of antibodies to ACh
  3. Immunosuppressives
  4. Plasmapheresis
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5
Q

What is the time course of Guillan-Barre?

A
  • Time from onset to peak impairment is 4 weeks or less followed by gradual recovery over approx. 2 years
  • 90% of cases the progression ends by 4 weeks
  • 80% ambulatory within 6 months
  • 20% have long term neurologic deficits
  • 5% mortality rate; prognosis is poorer when it reaches respiratory symptoms
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6
Q

What is the medical tx for GBS?

A
  1. Intravenous immunoglobulin (IVIg)
  2. Plasmapheresis
    - Steroids have NO benefit
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7
Q

What is the PT tx for GBS?

A
  1. # 1 focus is toward prevention of complications associated with immobilization
  2. Maintain joint ROM
  3. Monitor muscle strength - can change daily
  4. Proper skin care
  5. Coughing and deep breathing
  6. Orthotics or splinting devices
  7. Educate pt. and family
  8. Take extreme care to not over fatigue patients***
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8
Q

What are S and S for myasthenia gravis?

A
  1. Cranial muscle weakness: Ptosis of eyelids, Double vision, Difficulty holding head upright, Difficulty chewing meat, lips do not close, Difficulty swallowing
  2. Limb weakness: Proximal weakness more than distal
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9
Q

Motor endplate disorder; Acetylcholine receptors are decreased - Decreased efficiency of neuromuscular transmission; Autoimmune disease; Skeletal muscle weakness and fatiguability (Repetition of activity causes more fatigue; 85% have generalized weakness)

A

Myasthenia Gravis

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10
Q

Compensated muscle no longer have the metabolic ability to support all the fibers; New denervation results; Slowly progressive with stable periods; Those diagnosed with this will be older than 65 years old

A

Post-Polio Syndrome (PPS)

-20-50% polio survivors

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11
Q

What is the medical tx for post polio syndrome?

A
  1. Symptomatic treatment and modification of lifestyle

2. Surgery/tendon transfers

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12
Q

What is the PT tx for post polio syndrome?

A
  1. General conditioning
  2. Never exercise to point of fatigue
  3. Energy conservation techniques
  4. Orthotics
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