Neurodegenerative Disorders: Parkinson's, MS, and ALS Overview

Tremors

Involuntary shaking, most noticeable in a hand while at rest.

Bradykinesia

Slowness of movement that makes daily tasks take longer.

Akathisia

A movement disorder that causes an intense, uncontrollable inner restlessness and a compelling need to keep moving.

Rigidity

Muscle stiffness and resistance that limits movement and causes pain.

Retropulsion

Involuntary tendency to lean or fall backward, often due to a loss of balance and postural reflexes.

Dystonia

Involuntary muscle cramps or painful twisting (such as a foot turning inward).

Akinesia

The complete inability to move or initiate voluntary muscle movement.

Micrographia

Abnormally small, cramped handwriting.

Dyskinesia

Involuntary, erratic twisting movements, often related to long-term medication use.

Festinating Gait

An involuntary walking pattern where a person takes short, increasingly rapid steps while leaning forward, making it hard to stop or slow down.

Lewy Bodies

Abnormal protein deposits that impair thinking, movement, behavior, and mood.

Lewy Body Dementia

Dementia that occurs when Lewy bodies are in the cortex, characterized by visual hallucinations, mood, cognitive, and sleep disorders.

Genetics

Rare gene changes or mutations (such as in the SNCA, LRRK2, or PRKN genes) can directly cause or increase the risk for the disease.

Environmental Toxin Exposure

Agricultural toxins, Agent Orange, and other specific toxins increase the risk.

Aging

Typically develops over 60 years of age.

Carbidopa-levodopa

The most effective and widely used medication for Parkinson's disease; levodopa turns into dopamine in the brain.

Dopamine Agonists

Drugs like pramipexole and ropinirole that mimic dopamine.

MAO-B Inhibitors

Medications like rasagiline and selegiline that block the enzyme that breaks down dopamine.

COMT Inhibitors

Drugs like entacapone that help prevent the breakdown of levodopa.

Deep Brain Stimulation

A surgical treatment involving the implantation of a device to send electrical impulses to specific brain regions.

Canadian Occupational Performance Measure (COPM)

A client-centered outcome measure used to detect change in a client's self-perception of occupational performance over time.

Unified Parkinson's Disease Rating Scale (UPDRS)

A comprehensive rating scale used to follow the course of Parkinson's disease.

Montreal Cognitive Assessment (MoCA)

A rapid screening instrument for mild cognitive dysfunction, common in progressive stages of Parkinson's.

Parkinson's Disease Questionnaire (PDQ-39)

A disease-specific health status questionnaire measuring quality of life across mobility, ADLs, emotional well-being, and social support.

Box and Block Test

A quick, standardized test to measure unilateral gross manual dexterity.

Chessington Occupational Therapy Assessment (COTA)

Used to evaluate executive functioning and cognitive-based performance in daily tasks.

Plaques

Reduce the axon's ability to conduct impulses.

Myelin Sheath

Protective, fatty-protein layer wrapped around the axons of nerve cells that speeds up electrical signal transmission.

Demyelination

Loss of the protective myelin sheath.

Multifactorial model

Etiological model involving genetic, epigenetic, infections, nutrition, climate, smoking, and environmental influences.

Epstein-Barr Virus

Virus associated with multiple sclerosis, does not follow an obvious inheritance pattern.

Prevalence of MS

Most common non-traumatic neurological disorder among adults under 40 years of age, affecting 2.9 million people worldwide.

Diagnosis Age for MS

Typically diagnosed between 20-50 years old.

Gender Ratio in MS

2-3 females for every 1 male.

Clinically Isolated Syndrome (CIS)

A first single episode of neurological symptoms lasting at least 24 hours that suggests MS.

Relapsing-Remitting MS (RRMS)

The most common form of MS, marked by clear attacks or flare-ups followed by periods of remission.

Secondary Progressive MS (SPMS)

A stage that often follows RRMS, with steady worsening of disability over time.

Primary Progressive MS (PPMS)

A steady, continuous worsening of neurological function from the beginning of the disease.

Disease-Modifying Treatments

Goal to reduce new lesion growth and slow symptom development in MS.

Fatigue Severity Scale (FSS)

Evaluates the impact and severity of fatigue on daily life activities.

Amyotrophic Lateral Sclerosis (ALS)

Degenerative motor neuron disease that is fatal and progressive.

Familial ALS

Genetically determined type of ALS, accounting for 10% of cases.

Sporadic ALS

Accounts for 90% of ALS cases, with risk increasing with age.

Initial Symptoms of ALS

Weakness of the small muscles of the hand, asymmetrical foot drop, night cramps.

Course and Prognosis of ALS

Typically progressive and rapid, with a survival duration of approximately 2-5 years after diagnosis.

Riluzole

An oral medication that blocks glutamate release to reduce nerve damage in ALS.

Edaravone

An intravenous infusion designed to reduce oxidative stress in ALS patients.

ALS Functional Rating Scale Revised (ALS-FRS-R)

A 12-item scale measuring fine and gross motor skills, bulbar function, and breathing capacity.

Energy Conservation

Training patients to pace daily tasks and simplify routines to reduce exhaustion in ALS.

Assistive Equipment

Durable medical equipment such as shower chairs, raised toilet seats, and customized wheelchairs.

Home Modifications

Assessing living spaces to install grab bars and ramps for safe movement.

Joint Protection and Stretching

Guidelines for gentle range-of-motion exercises to prevent stiffness and secondary pain.

Activities of Daily Living (ADLs)

Teaching adaptive techniques for eating, dressing, bathing, and grooming.