Neurodegenerative Diseases

Question 1

multiple sclerosis

Answer 1

CNS disease caused by genetic, immunologic, and/or infectious processes/ Oligodendrocytes that produce myelin are destroyed, and the myelin sheath degrades

Question 2

MS risk factors

Answer 2

20-50 yr olds
northern European descent
colder climates
women 2-3x more likely
1st degree relative with MS

Question 3

s/s MS

Answer 3

• ataxia (decreased motor coordination)
• parestesia (numbness, tingling)
• nystagmus (involuntary eye movements)
• muscle weakness
• hypoalgesia (decreased pain sensitivity)
• scotomas (impaired peripheral vision)
• fatigue
• dysarthria (speech difficulty/slurring)
• tinnitus or vertigo
• temp sensitivity
• dysphagia
• decreased auditory acuity
• intention tremor (when performing activity)
• diplopia (double vision)
• bowel/bladder dysfunction
• cognitive changes
• depression

Question 4

diagnosis of MS

Answer 4

• thorough history of symptoms
• physical exam
• lumbar puncture (CSF will have elevated proteins and WBCs. CSF electrophoresis may show increased IgG)
• brain MRI/spinal cord: plaques in the white matter - created from scar tissue over areas of demyelination
• Evoked potential testing: non-invasive test measures time it takes for nerve to respond to stimulus and the strength of the response

Question 5

Dawson’s fingers

Answer 5

hallmark sign of MS on brain MRI - white marking (plaque) in at least 2 areas of white matter

Question 6

nursing care for MS pt

Answer 6

• fall risk precautions
• promote least restrictive methods of performing ADLs (OT/PT)
• alternate activity with rest to optimize physical function

Question 7

Guillaine-Barre Syndrome (GBS)

Answer 7

acute autoimmune ….

Question 8

s/s GBS

Answer 8

• muscle weakness
• paresthesia
• ascending paralysis - starts in feet

Question 9

GBS complications

Answer 9

SNS:
- muscle weakness, severe deconditioning
- pressure injury, VTE d/t immobility
- contracture (muscles shorten d/t immobility)
ANS:
- respiratory failure
- HR/BP irregularity 
- bowel/bladder incontinence

Question 10

GBS interventions

Answer 10

• hospitalization for supportive care through trajectory of illness
• close monitoring of airway
• VTE prophylaxis (heparin)
• frequent turning, dolphin bed
• aggressive PT/OT to combat deconditioning

Question 11

GBS tx

Answer 11

• immunoglobulins (IVIG) - contains healthy antibodies to combat the antibodies against the glycolipids/nerves
• plasmapheresis: machine “cleans” the plasma and removes the bad antibodies
• PLEX

Question 12

ALS diagnosis

Answer 12

• rule out other diseases - mimics many other neuro diseases
• no single test can confirm
• detailed hx of sx
• physical
• MRI of brain and spine
• EMG: uses small needles w/ electrodes in muscle to test electrical activity
• lumbar puncture
• muscle biopsy: rule out of muscular dystrophy
• blood tests to rule out heavy metal toxicity

Question 13

ALS tx

Answer 13

• no cure

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