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NPTE: Neuro Disorder

Diff Diagnosis of Neuro Disorders

QuestionAnswer
Definition of Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig's disease) A degenerative disease that involves both upper & lower motor neurons
Signs & Symptoms of ALS Progressive muscle weakness, can affect muscles of respiration. Weakness may appear in hands first. Dysarthria, Dysphagia. Muscle atrophy, fasciculations, cramping(LMN signs). Spasticity, hyperreflexia (UMN signs). Often no sensory changes.
Definition of Bell's Palsy An inflammatory response affecting Facial N. (CN VII) resulting in paralysis of muscles of facial expression.
Signs & Symptoms of Bell's Palsy Depends on branch involved. May have difficulty wrinkling forehead, closing eye tightly, smiling. Loss of control salivation, uni facial weakness/paralysis, normal sensation. Mouth droop, decreased sensation ant 2/3 of tongue
Definition of Guillain-Barre Syndrome A polyneuropathy of probable immune-mediated viral origin, results in symmetrical motor paralysis & progressive weakness that develops quickly (LMN disease)
Signs & Symptoms of Guillain-Barre Syndrome some sensory loss (stocking-glove) & paresthesias, ascending muscle weakness (distal to proximal), may produce full tetraplegia with respiratory failure, Tachycardia, abnormal cardiac rhythm & BP changes, slow recovery
Definition of Multiple Sclerosis Demyelinating disease more prevalent in colder climates. Can be mild, have bouts of remissions and exacerbations or get progressively worse
Signs & Symptoms of MS Sensory, including tingling, numbness, pain. Coordination problems & spasticity, fatigue (esp in afternoon), diplopia, B&B problems, communication disorders, psychosocial problems (euphoria, depression), adverse reactions to heat
Definition of Parkinson's Disease Progressive disease affecting basal ganglia with decrease in dopamine production and/or receptors in brain
Signs & Symptoms of Parkinson's Disease Tremor, Rigidity, fatigue, Difficulty initiating movement, bradykinesia, abnormal gait (festination), flexed posture, mask-like face, decreased postural reflexes, Behavioral changes such as memory loss
Behavioral changes in Parkinson's such as memory loss or apathy can result in what secondary effects? Decubitus ulcers, muscle atrophy, contractures, decreased vital capacity, and falls
Definition of Post-polio Syndrome Muscular dystrophy that occurs decades after the initial polio episode. New denervation occurs with asymmetrical muscle weakness.
Signs & Symptoms of Post-polio Syndrome Myalgia, joint pain, variable asymmetrical muscle atrophy with decreased strength, excessive fatigue & decreased endurance contribute to loss of function
General treatment focus for ALS patients Maintain respiratory function & activity levels, PROM exercise, positioning & skin care, prevent further deconditioning, avoid overworking muscles, teach energy conservation, symptomatic tx of pain, psychological support & reassurance
General treatment focus for patients with Bell's Palsy Artificial tears or temp patch to protect eye, E-stim to maintain tone & support function of facial muscles, teach facial muscle exercises, provide functional retraining (chewing gum on opposite side)
General treatment focus for patients with Guillain-Barre Syndrome Ascending phase: respiratory function, PROM to tolerance, positioning, skin care. Stabilized: prevent injury to denervated muscle, avoid overuse/fatigue, gentle stretching initiate movement in controlled environment. Descending: muscle re-ed, energy cons
General treatment focus for patients with Multiple Sclerosis Improve function, Prevent secondary problems (Skin care), Morning tx sessions preferable, Breathing exercises, PNF to tolerance, Amb or WC mobility, decrease tone, positive approach, fatigue could increase symptoms
General treatment focus for patients with Parkinson's Disease Gait: increase stride width & length, breathing exercises, relaxation techniques, PNF diagonals, ROM including PNF contract-relax, inhibitory casting, orthoses, Best to tx in morning following dopamine agonist administration
General treatment focus for patients with Post-polio Syndrome Low-intensity exercise NEVER to fatigue, Stop exercise with pain or weakness, Orthotics as needed, focus on endurance & energy conservation techniques
Referred pain to Right Subscapular region with no musculoskeletal findings possibly indicates... Gallbladder problems
Referred pain to Medial Left arm & Jaw with no muscuskeletal findings possibly indicates... A Heart Attack
Referred pain to Thoracic region or flank pain with no musculoskeletal findings possibly indicates... Kidney problems
Referred pain to Left Upper Quadrant and shoulder pain with no musculoskeletal findings possibly indicates... Spleen Damage
Referred pain to Right Upper Quadrant with no musculoskeletal possibly indicates... Liver Problems
Created by: zimrizzle on 2010-10-06



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