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Other Neurological Disorders - Coggle Diagram
Other Neurological Disorders
Guillain-Barre Syndrome
Etiology
60% have a preceeding infection (campylobacter, influenza, Epstein-Barr, cytomegalovirus)
Vaccination
Recent Surgery
Pregnancy
Autoantibodies target Schwann cells in PNS (somatic and autonomic)
Initial Symptoms
Symmetrical onset - "stoking-glove"
Rapid ascending progress (hours to days
Weakness and paresthesias in LE
loss of DTRs
Later Symptoms
Difficulty with face/eye movements
Difficulty with speaking, chewing, swallowing
Falls
MSK pain
Unsteady/ unable to walk
Rapid HR and irregular BP
Impaired B&B control
Difficulty Breathing
phases
Plateau/Static Phase
4 weeks
Recovery/Descending Phase
6-12 months. Some impairments permanent due to scarring.
Acute/Ascending Phase
hours-2 weeks
Medical Treatment
intravenous immunoglobulin
Ventilation
Plasmapheresis
Medications (pain, anti-inflammatories, blood thinners)
PT managment
Plateau: upright tolerance, AAROM, Pulmonary exercises
Recovery: strengthening (>2/5) and strentching, transfer training, gait training, adaptive devices, pain relief, MAKE SURE THEY DONT REGRESS)
Acute (prevention of 2nd complications, PROM, Positioning, Skin inspections, Pulmonary heigene)
Myasthenia Gravis
Symptoms
Dysarthria
Dysphagia/chewing problems
Ptosis (drooped eyelid)
UE/LE weakness
Blurred/double vission (1st)
chronic muslce fatigue
difficulty breathing
Medical Diagnosis
Immunologic (blood test): ACh receptor antibody, Anti-MuSK antibody)
Pharmacologics (pre/post edrophonium strength testing)
EMG
absence of sensory deficits and normal DTRs
Antibodies block/destroy ACh receptor sites at NMJ, up to 80% of sites affected, progressive weakness with each contraction
Medical Managment
Thymectomy (lessens symptoms)
Plasmapheresis (short term effect)
3F;2M, 20-30yo females, 50-60yo males
Medications
Corticosteroids
Immunosuppressants (imuran)
Antocholinesterase agents (mestinon)
Intravenous immunoglobins
Prognosis
<20% spontaneous remission >1 year
Normal Lifespan
PT managment
supportive in acute care setting
restorative in later phases (similar to MG and MS)
Huntington Disease
atrophy of BG -> entire brain, enlarged ventricles, imbalance of NTs (excess of dopamine and norepinephrine )
Symptoms
Motor
Wide BOS, slow, staggering stiff gait
Rigidity in later stages
Chorea (hallmark and 1st symptom)
Cognitive Impaiments
Judgment
Mood swings
depression
dysarthia
Delusions
Hallucinations
Other
sleep pattern reversal
urinary incontinence
Cachexia
2-80years old (30-50 years old most typical)
Prognosis
15-20 year lifespan after onset
Dominant gene defect on chromosome 4 cause abnomality in huntingtin protein
Medical Treatment
Anticonvulsants
Antipsychotics, SSRIs
PT interventions
bradykinesia/akinesia
apraxia
imbalance and poor postural stability
prevent 2nd complications
Post-Polio Syndrome
Symptoms
Pain
Cold intolerance
Fatigue
Eating and breathing may be affected
PT management
stretching
assisstive devices
balance and coordination
gait training
Non-fatiguing exercises
Supranuclear Palsy
Symptoms
Motor recklessness
Dysarthria and Dysphagia
Early falls
Loss of upward gaze, saccades, smooth pursuit eye tracking impaired
Postural instability (retropulsion)
Inhibition of eyelid opening/closing
Apathy, intellectual slowing, impaired executive function
VOR cancellation lost
psudobulbar features
Factors that differentiate from PD
axial rigidity greater than limb rigidity
early falls (retropulsion)
speech and swallowing disturbances
cognitive/behavioral changes early
vertical opthalmoplegia and oculomotor dysfunction
hypertension
poor response to levodopa
Not present: tremor, gait freezing, apraxia, autonomic symptoms