PHTY 3070 VIVA Neurological Conditions

What is Post Polio Syndrome (PPS)?

A condition occurring most often in individuals who contracted severe cases of polio before age 10

What are some symptoms of Post Polio Syndrome?

Characterized by fatigue, exhaustion, muscle weakness, painful joints, and occasionally difficult breathing.

What are some positive Attributes of Post Polio Syndrome?

Remaining cells increase the area they innervate: axonal sprouting, Myofibre hypertrophy, Motor relearning, A period of functional and neurological stability

What are some Theories about what causes PPS?

Aging, Overuse/Disuse/Misuse, Immune/Inflammatory factors

What are some signs & symptoms of PPS?

Fatigue, Pain, mm weakness

What are some signs & symptoms of PPS?

Respiratory impairment, mm cramping/fasciculation, Autonomic dysfunction

How might a Physio treat a patient with PPS?

Aim to retain patient's independence and slow disease progression through Energy conservation, Strengthening/stretching

How might a Physio treat a patient with PPS?

Orthopaedic support, Education, Psychosocial support

What is Huntington's Disease (HD)?

Progressive neuro-degenerative disease causing uncontrolled physical movements and mental deterioration.

What causes Huntington's Disease (HD)?

Caused by a defect in the Inherited HD gene, which is located on the short arm of chromosome 4

What are the Neurotransmitters that are affected in HD?

GABA, Acetylcholine, Dopamine

What are some signs and symptoms in Movement with HD?

Chorea,

Clumsiness,

Stumbling,

Gait deviations,

Saccadic eye movement

Akinesia,

Hypokinesia,

Facial grimacing,

Rigidity

What are some signs and symptoms of Cognitive function in HD?

Lack of concentration,

Poor judgement,

Dementia,

Inflexibility of thought

What are some signs and symptoms of Emotion changes in HD?

Mood changes,

Depression,

Frustration,

Apathy,

Paranoia,

Psychosis

What are some of the treatment methods used for HD?

Medications,

Auditory/Visual cueing,

Attention strategies

What is the main goal of treatment for Huntington's disease

Aims to maintain function and delay deterioration

What are some of the treatment methods used for HD?

Muscle Strengthening/Flexibility,

Improve Balance/Posture,

Assistive devices,

Modify environment

What is Myasthenia Gravis (MG)?

Autoimmune disease that causes muscle weakness.

What causes Myasthenia Gravis (MG)?

The body's own immune system attacks a receptor on the surface of muscle cells interrupting the communication between nerve and muscle

What are some signs and symptoms of MG?

Fluctuating fatigable weakness of voluntary mms,

initially occular mms,

Generalized weakness UL > LL, Proximal > distal, Improves with rest

What are some signs and symptoms of MG?

Ptosis,

Diplopia,

Dysphagia,

Aspiration,

Dysarthria,

Paraesthesia reported but not accompanied by sensory loss

What is the role of the Physio in treating a patient with MG?

Aim to optimize performance & prevent disability, Must include multiple rest breaks

What is Myotonic Dystrophy (DM)?

A progressive disease in which the muscles are weak and are slow to relax after contraction.

What causes DM?

Autosomal dominant inheritance, Almost always maternally inherited

What are some signs and symptoms of DM?

Hatchet-faced appearance,

Frontal blindness,

Progressive mm weakness,

Hypotonia

Myotonia,

Mental retardation,

Occular Cataracts,

Cardiac, respiratory, GI, & endocrine dysfunction

What are some Medical management methods for DM?

Cardiac pacemaker, Ocular: ptosis surgery, cataract management, Pain: regular meds, Drowsiness: meds, BiPAP

What is the overall goal of the Physio when dealing with DM?

Minimize disability and Maximize QOL

What is the role of the Physio in treatment of DM?

Muscle Strengthening/Stretching, Respiratory function, Assistive devices, Manage pain, Education

What is Fibromyalgia?

Medical condition characterised by chronic widespread pain and a heightened and painful response to pressure.

What are some signs and symptoms of Fibromyalgia?

Widespread Chronic Pain,

Pressure points,

Fatigue,

Sleep disturbances

Joint stiffness,

Numbness & Tingling,

mm spasms,

Bowel dysfunction,

Anxiety & Depression

Are men or women more likely to be affected with Fibromyalgia?

More Females (9:1 ratio)

How do you go about treating patients with Fibromyalgia?

Symptom Management: Reduce stress, Education, Low impact aerobic exercise

What is Progressive Supranuclear Palsy (PSP)?

A degenerative disease involving the gradual deterioration and death of Neurons & glial cells

What are some signs and symptoms of PSP?

Parkinsonism

Disordered Gait & Balance,

Frequent falls,

Speech & Swallowing deficits,

Mood / Behavior / Cognitive changes,

Contratures of facial mms,

Sleep disturbances,

Incontinence,

Vertical gaze disorder

How is one medically diagnosed with PSP?

Purely clinical, Vertical gaze disorder most distinctive feature, Insidious onset

What is PSP sometimes misdiagnosed as?

Often misdiagnosed as PD or Alzheimer's

What are some possible treatment methods for PSP?

Medications: Levadopa or Anticholinergics, Prozac (depression),

Weighted walking frame to counteract tendency to fall backwards

What is the downside to treating someone with PSP?

No proven benefits of formal therapy - symptom management