Progressive Neurodegenerative Diseases Flashcards
Disorders effecting cortical function
Schizophrenia
Depression
Alzheimer’s disease
Alzheimer’s disease
Different types: late or early onset
Stage I (1-3 years)
- memory, depression, mild language effects
- motor is normal
Confusion II (2-10 years)
- memory is worse with confusion, indifference, and apathy
- language is impacted
Terminal III (8-10 years)
- cognition is severely impaired
- motor control is rigid with flexion posture
- incontinence
Multiple sclerosis
Demyelization disorder - progression of 30 years
Myelin of the CNS is broken down (PNS is not involved)
Onset 20-30 years, more in women, all races
May be triggered by pregnancy, trauma, or infection
Relapsing and remitting - acute attack with full or near full recovery
Primary progressive - steady progression, only minor recovery (somewhat rare)
Secondary progressive - starts as relapsing, 2/3 of patients have this type, eventually begins to progress with less recovery, ?stair step?
Progressive relapsing - rare
Treatment for MS
Acute management
Manage symptoms
- fatigue
- weakness
- ataxia
- vertigo
- tremors
- heat intolerance
- pain
- psychosocial issues
Parkinson’s Disease
May demonstrate akinesia hyperkinesia, or bradykinesia
Difference between syndrome and disease
- we know what causes syndrome
Effect of basal ganglia
Cause is idiopathic
Hits around 50-62 years old, men more than women
Loss of dopamine
Resting and intention tremors, rigidity, stooped posture, foot shuffle, freezing
Depression is common (50%)
Dementia (30%)
Treatment: Levadopa, therapy, surgery, deep stimulators
Stages of Parkinson’s
Stage 1
- Slight tremors on one side of the body
- symptoms are often mild and include changes in walking, posture, and facial expressions
Stage 2
- symptoms worsen and affect both sides of the body
- changes in walking and moving make daily tasks more difficult
Stage 3
- loss of balance and slowness of movement make falls more common
- symptoms significantly impair ADLs
Stage 4
- symptoms are severe and limit the ability to live alone
- walkers or other aides are used daily to help support limited mobility
Stage 5
- confined to wheelchair or bed
- a 24 hour caregiver is required
- many experience hallucinations and other non-motor symptoms
Amyotrophic lateral sclerosis (ALS)
Lou Gehrig Disease
Worldwide degenerative disease of upper and lower motor neurons
Progressive weakness, leading to respiratory failure
2-5 year time frame
DON’T PUSH THEM
ALS stages
Early
- muscle weakness, fasciculation (twitch), and atrophy often limited to one region of the body
- fatigue, poor balance, slurred words, tripping, weak grip
Middle
- symptoms from early stage are more widespread and affect more than one region of the body
- muscles become paralyzed and fasciculations continue
- muscle contractures, weakness in breathing and swallowing causing difficulty eating, drinking, and breathing
Late
- most voluntary muscles are paralyzed and breathing muscles are very weak
- very limited mobility, poor respiration causing fatigue, and increased susceptibility to pneumonia
- loss of speech and limited eating/drinking via mouth
Huntington’s Disease
Also called Huntington Chorea
Hereditary and degenerative
Onset around 30-50 years (often had kids before they know they have it)
Occurs in all races
Abnormal movement with progressive dementia
Guillian-Barre Syndrome
Polyneuritis (a bunch of inflammed nerves)
Idiopathic
Acute inflammatory condition
Acute motor paralysis
- they often think they’re having a stroke
Occurs worldwide, in children and adults, of all races
Often precipitated by a mild viral or bacterial infection
2-3% die, usually from respiratory distress
5-10% have permanent disability
Different degrees
Many make a full recovery
Types of abnormal movement
Hypokinesia - decreased movement
Akinesia - absence of movement, related to extrapyramidal system
Bradykinesia - slowness of movement
- difficulty initiating movement
- difficulty with smoothness
- difficulty with synchronizing movement
- client may “freeze”
Myasthenia gravis
Chronic autoimmune disease that effects the neuromuscular junctions
Fatigue and weakness that worsens with excessive activity
Can be onset from neonate up
Generalized (mild to severe-respiratory failure) or ocular
Treated with meds and therapy
DON’T PUSH THEM
Bell’s Palsy
Idiopathic inflammation of the 7th cranial nerve (facial nerve)
Sudden onset paralysis of 7th cranial nerve distribution
- gets all of it; if only part then it’s not bell’s
Effects children to adults, more common in diabetics
Aging and the nervous system
Structures change in size and weight
Number of neurons decrease
- may or may not effect intelligence
Deposits of senile plaque may be common
Slowing of neurological function
- especially the special senses
Neurological patients age
Slowed reflexes
