Urgent states in neurology- retention of urine, swallowing disturbance, respiratory disturbances

Question 1

Urinary retention

Cause and symptoms:

Answer 1

Cause:

• neurogenic bladder = bladder dysfunction due to neurologic damage
• • generally related to spinal cord injury*

- symptoms: overflow incontinence, frequency, urgency, urge incontinence, retention

Question 2

Urinary retention

Complications:

Answer 2

• complications: recurrent infection, vesicoureteral reflux, autonomic dysreflexia

Question 3

Urinary retention

Diagnosis:

Answer 3

- diag:

imaging, cystoscopy, urodynamic tests

Question 4

Urinary retention

Treatment:

Answer 4

-Tx:

catheterisation, anti-cholinergics (oxybutynin, tolterodine, darifenacin, solifenacin, atropine), surgery

Question 5

Swallowing disturbances

Name and define:

Answer 5

• (Swallowing disturbances)*
• neurogenic dysphagia

= swallowing impairment resulting from neurologic disease

Question 6

neurogenic dysphagia

Symptoms and complications:

Answer 6

• symptoms: inability to swallow, coughing/choking (due to aspiration), drooling

- complications: aspiration pneumonia

Question 7

neurogenic dysphagia

Tx:

Answer 7

- Tx:

education (how to chew to reduce risk of aspiration), drugs

(Botox, Diltiazem),

feeding tubes, surgery

Question 8

Respiratory disturbances

provide examples and early signs

Answer 8

• dysfunction of breathing centres, bony ribcage, breathing muscles
• early signs: sleep disturbances, nocturnal desaturation, morning headaches, orthopnoea

-later signs: ↑RR, respiratory alternans, abdominal paradox

Question 9

Respiratory Disturbances

Complications and Tx:

Answer 9

• complications:

pneumonia, respiratory failure, death

- Tx: ventilatory support, intubation