Week 9 - MS and PD Flashcards
What is MS?
A chronic de-myelinating disease of the CNS characterised by an inflammatory process causing widespread degeneration of the CNS, gradually resulting in severe neurological defect
What are the 3 different types of ataxia with one potential treatment for each?
Cerebellar - core stability/ coordination exs
Sensory - sensory stimulation
Vestibular - Cooksey Cawthorne exs
What is PD?
A chronic, progressive neurodegenerative disorder resulting from the degeneration of dopamine producing neurones in the substantia nigra of the basal ganglia.
Explain the pathology of PD
Basal ganglia is part of a series of parallel loops involving thalamus and cerebral cortex.
Direct pathway - promotes movement
Indirect pathway - inhibits movement
DA excites direct and inhibits indirect pathway
Lack of DA means less excitation of direct pathway, less inhibition of indirect pathway
What are the 3 signs of PD?
Bradykinesia
Resting tremor
Rigity
What are 3 types of cueing and how does it work?
Kinesthetic, Visual, Auditory
In PD, Supplementary Motor Area (internally guided movement) is impaired but Premotor Area remains intact, involved in sensory guided movement
Describe the pathology of MS
Disruption of BBB
Leakage of inflammatory cells
Destruction of oligodendrocytes and myelin sheaths
Disruption of nerve cells, rate of conduction is slowed down
Name some initial symptoms of MS
Limb weakness Optic neuritis Parasthaesia Diplopia Vertigo Micturition Problems
Define ataxia
Disorder/ ‘confusion’ of movement
Briefly describe the vestibular system
3 semi-circular canals
Detectors of relative movement of endolymph due to inertia
Electrical signal to vestibular nucleus
Motor output via cranial nuclei of muscles of eye
Name some outcome measures for fatigue
Fatigue Severity Scale
Modified Fatigue Impact Scale
VAS for fatigue (for particular task)
Name some outcome measures for MS
Expanded Disability Status Scale
MSIS-29 (Impact of MS in daily life)
MSWS-12 (Impact of MS on walking)
Functional Reach
Briefly describe the Hoehn and Yahr Scale for PD
0
1 - UL involvement/ minimal disability
1.5 - UL involvement + neck/spine
2 - BL disease, no balance impairment
2.5 - mild BL symptoms with recovery with pull test
3 - BL mild to moderate disease, postural instability, physically indept
4 - severe disability, still able to walk/ stand unassisted
5 - need wheelchair
Describe some secondary clinical features of PD
Difficulty initiating/ terminating movement Freezing Festinating gait, slow and shuffling Difficulty with motor tasks Loss of facial expressions Monotone speech Micrographia Problem with swallow Sleep disorders Depression
Give 2 outcome measures for PD
GUAG
Unified PD rating scale
