Neuro Differential Diagnosis & Interventions Overview

Differential Diagnosis

Process of distinguishing between diseases.

Upper Motor Neuron (UMN)

Nerve cells in the brain that control voluntary movement.

Lower Motor Neuron (LMN)

Nerve cells that directly innervate muscles.

Basal Ganglia

Group of nuclei involved in movement regulation.

Cerebellum

Brain region coordinating voluntary movements and balance.

Hypotonia

Decreased muscle tone, leading to floppiness.

Hypertonia

Increased muscle tone, often rigid.

Hyporeflexia

Decreased or absent reflex responses.

Hyperreflexia

Exaggerated reflex responses, often seen in UMN lesions.

Clonus

Involuntary muscle contractions and relaxations.

Babinski Sign

Reflex indicating UMN dysfunction when positive.

Resting Tremors

Tremors occurring when muscles are relaxed.

Bradykinesia

Slowness of movement, common in Parkinson's.

Akinesia

Inability to initiate movement.

Postural Instability

Difficulty maintaining balance and posture.

Parkinson's Disease

Progressive disorder from dopamine depletion in substantia nigra.

Hoehn and Yahr Classification

Stages of disability in Parkinson's disease.

Stage I

Minimal symptoms, unilateral involvement.

Stage II

Bilateral symptoms, balance not impaired.

Stage III

Impaired balance, some activity restrictions.

Stage IV

Severe symptoms, assistance needed for mobility.

Stage V

Confined to bed or wheelchair.

Loss of smell

Early symptom of Parkinson's disease.

Constipation

Common early symptom in Parkinson's disease.

Sleep disorders

Sleep-related issues in Parkinson's patients.

Hypophonia

Soft speech characteristic of Parkinson's disease.

Mask-like face

Reduced facial expression in Parkinson's patients.

Micrographia

Small handwriting associated with Parkinson's disease.

Orthostatic hypotension

Blood pressure drop upon standing.

Restrictive lung disease

Reduced lung expansion in Parkinson's.

Dual tasking difficulty

Cognitive challenge in Parkinson's patients.

Freezing of Gait

Sudden inability to initiate movement.

Festinating Gait

Shuffling gait with increasing speed.

En bloc turning

Turning without trunk rotation.

Levodopa/Carbidopa

Gold standard pharmacological treatment for PD.

On/off phenomenon

Fluctuations in motor performance with medication.

Dyskinesia

Involuntary smooth muscle movements during ON phase.

Dystonia

Muscle contractions causing spasms during OFF phase.

Multiple Sclerosis

Autoimmune disease causing CNS demyelination.

Nystagmus

Involuntary eye movement associated with MS.

Charcot's Triad

Combination of symptoms in Multiple Sclerosis.

Lhermitte's Sign

Electric shock sensation down the spine.

Uhthoff's Phenomenon

Worsening of symptoms with heat exposure.

Guillain Barre Syndrome

Autoimmune disorder causing rapid nerve demyelination.

Progressive Relapsing MS

Steady disability increase with superimposed attacks.

Secondary Progressive MS

Initially RR, then continuous symptom increase.

Primary Progressive MS

Continuous disability increase without attacks.

Relapse-Remitting MS

Short attacks with full or partial recovery.

Most common MS type

Relapse-Remitting MS, affecting about 80%.

MS Exercise Frequency

3-5 times per week, alternating days.

MS Exercise Intensity

Low intensity, 50-70% VO2, 3-5 METS.

MS Exercise Duration

30 minutes per session recommended.

ALS

Progressive neurological disorder affecting motor neurons.

ALS Symptoms

Muscle atrophy, spasticity, dysphagia, and dysarthria.

UMN and LMN

Upper and lower motor neuron presentations.

Pseudobulbar affect

Emotional lability seen in ALS patients.

Cervical spine extensor weakness

Common in ALS, affecting neck stability.

Respiratory muscle weakness

Can lead to death in ALS patients.

GBS Signs

Rapid motor loss, sensory loss, decreased reflexes.

GBS Recovery Time

Typically 6-12 months, possible full recovery.

GBS Intervention

Focus on respiratory care and energy conservation.

Fatigue in ALS

Patients experience easy fatigue during ADLs.

Medical Management of ALS

No effective treatment; focus on functional activities.

Energy Conservation Techniques

Recommended to avoid over-fatigue in ALS.

Cranial Nerve Involvement in GBS

Includes nerves VII, IX, X, XI, XII.

Sensory Loss Pattern in GBS

Glove and stocking distribution of numbness.

Presenting Problem

Weird sensations, frequent falls, urination difficulty.

Family History

Mother has migraines.

AROM

Active range of motion; grossly intact.

PROM

Passive range of motion; grossly intact.

Gait

Slightly wide base of support.

Tone

Increased tone in biceps, hamstrings, PF.

Cranial Nerves

Involvement of CN II, III, V, VII.

Coordination

Impaired coordination observed during evaluation.

Amyotrophic Lateral Sclerosis

Progressive neurodegenerative disease affecting motor neurons.

Guillain Barre Syndrome

Autoimmune disorder causing rapid muscle weakness.

Multiple Sclerosis

Chronic disease affecting central nervous system.

Cerebellar Tumor

Tumor affecting cerebellum, impacting coordination.

Pupillary Reflex

Response of pupils to light stimulus.

Marcus Gunn Pupil

Pupil dilates when light is shone in affected eye.

Cataract

Clouding of the lens affecting vision.

Balance Training

Exercises to improve stability and prevent falls.

Proprioceptive Training

Exercises to enhance body awareness and position.

Activity Pacing

Adjusting activity levels based on symptoms.

Pool Therapy Temperature

Recommended water temperature is 87 degrees Fahrenheit.

Neuro Stroke Class

Scheduled for March 7th at 5 pm PST.

Non-Systems Classes

Scheduled for March 9th and 12th.

APC Neuro Masterclass

Free for FLC, 50% off for bundle students.