45 Chronic Disorders of Neurological Function

Question 1

brain cerebellar disorders

Answer 1

• seizure disorder
• dementia
• parkinson disease
• cerebral palsy
• hydrocephalus
• cerebellar disorders

Question 2

Seizure Disorder

Answer 2

transient neurologic event of paroxysmal abnormal or excessive cortical electrical discharge

• -manifested by disturbances of skeletal motor function, sensation, autonomic visceral function, behavior, or consciousness
• -due to an alteration in membrane potential that makes certain neurons abnormally hyperactive + hypersensitive to changes in the environment (epileptogenic focus)

Question 3

possible triggers of seizure disorder

Answer 3

flashing lights, fever, loud noises

Question 4

GENERALIZED Seizure Disorder

Answer 4

whole brain surface is affected during the seizure

-involvmnt of thalamus + RAS sytm results in loss of consciousness

Question 5

GENERALIZED Seizure Disorder

5 types + examples

Answer 5

1 ABSENCE (PETIT MAL): occurs in kids, staring spells lasting seconds
2 ATYPICAL ABSENCE: myclonic jerks, automatism
staring spell
3 MYOCLONIC: single/several jerks
4 ATONIC (DROP ATTACK): fall down
5 TONIC-CLONIC (GRAND MAL): jerking of many muscles

Question 6

Seizure Disorder

diagnosis

Answer 6

electroencephalograms

–assess electrical patterns of brain regions

Question 7

Seizure Disorder

treatment for DURING A SEIZURE

Answer 7

• maintain airway
• protect fr injury
• document course seizure

Question 8

Seizure Disorder

treatment when not hazing an episode

Answer 8

ANTICONVULSANT MEDICATION

• contd until no sizures for atleast 2 years
• -then gradually withdrawn
• NOT A CURE

Question 9

Dementia

Answer 9

syndrome assoc w many pathologies

–characterized by progressive deterioration + continuing decline of memory + other cognitive changes

Question 10

types of Dementia

Answer 10

1 Alzheimer (most common)
2 Vascular

Question 11

Alzheimer’s Disease

Answer 11

characterized by degeneration of neurons in temporal + frontal lobes, brain atrophy, amyloid plaques, + neurofibrillary tangles

-behavioral problems progress from forgetfulness to total inability for self-care

Question 12

Vascular Dementia

Answer 12

results fr single cerebrovascular insults

-risk factors: stroke, hypertension + diabetes

Question 13

Dementia

s/s

Answer 13

• as the disease progresses, increasing difficulty w judgment, abstract thinking, problem-solving, + communication
• assistance for completing activities of daily living [ADLs]
• difficulty w eating, swallowing, weight loss, loss of bladder

Question 14

Dementia

treatment

Answer 14

• ACETYLCHOLINESTERASE INHIBITORS
• N-methyl-D-aspartate (NMDA) receptor antagonists: memantine (Namenda)
• early diagnosis + intervention is KEY
• early stage may stay at home, later in an assisted living

Question 15

ACETYLCHOLINESTERASE INHIBITORS

Answer 15

• tacrine (Cognex)
• donepezil (Aricept)
• rivastigmine (Exelon)
• galantamine (Reminyl)
• for mild-moderate Alzheimers disease + Vascular dementia
• not a cure

Question 16

N-methyl-D-aspartate (NMDA) receptor antagonists: memantine (Namenda)

Answer 16

• for moderate-severe alzheimer

- blocks stim by neuroexcitatory transmitter glutamate

Question 17

Parkinson Disease

Answer 17

• Dopamine deficiency in basal ganglia (substansia nigra) assoc w motor impairment, Lewy bodies
• difficulty initiating + controlling mvmt results in akinesia, tremor, rigidity

Question 18

Parkinson Disease

s/s

Answer 18

• general lack of mvmt
• loss of facial expression
• drooling
• propulsive shuffling gait
• absent arm swing

Question 19

Cerebral Palsy

Answer 19

diverse group of crippling syndromes that appear during childhood + involve permanent, nonaggressive damage to motor control areas of brain
-symptoms remain for life

Question 20

what area is damaged in cerebral palsy?

Answer 20

upper motor neurons that control voluntary + involuntary muscle mvmt

Question 21

Cerebral Palsy

etiology

Answer 21

• prenatal infection
• disease of mother
• mechanical trauma to head before, during, or after birth
• exposure to nerve-damaging poisons
• reduced oxygen supply to the brain

Question 22

Hydrocephalus

Answer 22

abnormal accumulation of CSF in cerebroventricular sytm

-assoc w neural tube deficit

Question 23

Obstructive Hydrocephalus

Answer 23

obstruction to the flow of CSF

-blocked aqueduct of Sylvius, fr premature closure before birth

Question 24

Obstructive Hydrocephalus

treatment

Answer 24

may be corrected surgically

• VENTRICULOPERITONEAL SHUNT
• –most effective treatment
• –CSF flows into peritoneal cavity
• ENDOSCOPIC THIRD VENTRICULOSTOMY
• –making a hole in the third ventricle to allow free flow of CSF into basal cisterns for reabsorption

Question 25

Multiple Sclerosis

Answer 25

chronic demyelinating disease of the CNS that primarily affects young adults --autoimmune disorder that results in inflammation + scarring (sclerosis) of myelin sheaths covering nerves; slowly progressive

Question 26

demyelination can occur throughout the CNS but often affects....

Answer 26

1 optic nerve 2 oculomotor nerve 3 spinal nerve tract

Question 27

Multiple Sclerosis | s/s

Answer 27

exacerbation + remission: - -exacerbated by heat, infection, trauma, stress - double/blurred vision - weakness - poor coordination - sensory deficits - bowel + bladder control may be lost - memory impairment common

Question 28

Spina Bifida

Answer 28

development anomaly characterized by defective closure of the bony encasement of the spinal cord (neural tube) thru which the spinal cord + meninges may or may not protrude

Question 29

Spina Bifida | etiology

Answer 29

environmental factors (especially lack of folate) + genetics

Question 30

Spina Bifida | treatment

Answer 30

surgery C-section ***folic acid before + during pregnancy

Question 31

Amyotrophic Lateral Sclerosis

Answer 31

aka Lou Gehrig disease - progressive disease affecting both the upper and lower motor neurons - weakness + wasting of upper extremities usually occur, followed by impaired speech, swallowing, + breathing

Question 32

Amyotrophic Lateral Sclerosis | s/s

Answer 32

``` weakness atrophy cramps stiffness irregular twitching hyperreflexia in weak atrophied extremity ```

Question 33

Spinal Cord Injury | mechanisms of injury

Answer 33

hyperflexion hyperextension compression

Question 34

types of Spinal Cord Injury

Answer 34

1 Spinal Shock | 2 Neurogenic Shock

Question 35

Spinal Cord Injury - Spinal Shock

Answer 35

occurs immediately + characterized by temporary loss of reflexes below the level of injury - -muscles flaccid; skeletal/autonomic reflex lost - -end of spinal shock: reflex return + flaccidity replace spasticity

Question 36

Spinal Cord Injury - Neurogenic Shock

Answer 36

may occur after SCI due to peripheral vasodilation --hypotension, bradycardia, + circulatory collapse can occur (life-threatening); high spinal cord injuries can affect respiratory muscles

Question 37

Guillain-Barre Syndrome

Answer 37

inflammatory demyelinating disease of the peripheral nervous system or a lower motor neuron disorder --segmental demyelination that is T-cell + B-cell mediated

Question 38

Guillain-Barre Syndrome | s/s

Answer 38

- muscle weakness that begins in the lower extremities + spreads to the proximal spinal neurons - progressive ascending weakness or paralysis, may affect respiratory muscles

Question 39

Bell Palsy

Answer 39

idiopathic neuropathy of the facial nerve | -paralysis of the muscles on one side of the face

Question 40

Bell Palsy | etiology

Answer 40

virus

Question 41

Bell Palsy | s/s

Answer 41

- develop rapidly over 24-48 hrs - unilateral facial weakness - facial droop + diminished eye blink - hyperacusis - decreased lacrimation

Question 42

Status Epilpeticus

Answer 42

continuing series of seizures, - no recovery bw episodes - life threatening

Question 43

2 types of seizures

Answer 43

Generalized | Partial

Question 44

Partial seizures

Answer 44

abnomal electrical activity on ONE brain hemisphere 3 types: simple , complex, partialw secondary generalization

Question 45

Simple Partial Seizure

Answer 45

no change in LOC | -motor, sensory, or autinomic sympt common

Question 46

Complex Partial Seizure

Answer 46

change in LOC