Diff Diagnosis of Neuro Disorders
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| Definition of Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig's disease) | A degenerative disease that involves both upper & lower motor neurons
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| 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.
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| Definition of Bell's Palsy | An inflammatory response affecting Facial N. (CN VII) resulting in paralysis of muscles of facial expression.
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| 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
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| 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)
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| 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
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| Definition of Multiple Sclerosis | Demyelinating disease more prevalent in colder climates. Can be mild, have bouts of remissions and exacerbations or get progressively worse
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| 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
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| Definition of Parkinson's Disease | Progressive disease affecting basal ganglia with decrease in dopamine production and/or receptors in brain
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| 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
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| 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
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| Definition of Post-polio Syndrome | Muscular dystrophy that occurs decades after the initial polio episode. New denervation occurs with asymmetrical muscle weakness.
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| 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
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| 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
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| 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)
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| 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
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| 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
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| 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
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| 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
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| Referred pain to Right Subscapular region with no musculoskeletal findings possibly indicates... | Gallbladder problems
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| Referred pain to Medial Left arm & Jaw with no muscuskeletal findings possibly indicates... | A Heart Attack
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| Referred pain to Thoracic region or flank pain with no musculoskeletal findings possibly indicates... | Kidney problems
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| Referred pain to Left Upper Quadrant and shoulder pain with no musculoskeletal findings possibly indicates... | Spleen Damage
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| Referred pain to Right Upper Quadrant with no musculoskeletal possibly indicates... | Liver Problems
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