Chronic Degenerative Disorders

Multiple Sclerosis (4 manifestations)

Cause - autoimmune, idiopathic

Risk - Caucasian, women age 20-40

What - progressive, irreversible demyelination of brain, spinal cord, neurons —stops, slows nerve impulses

Manifestations - exacerbations and remissions

1. weakness - sclerosis in spinal cord

2. lack of coordination - sclerosis in cerebellum

3. paresthesia - sclerosis in spinal cord

4. vision issues - diplopia, vision loss (1 eye at a time) - sclerosis in optic n.

*No respiratory issues

Treatment - no cure

• avoid triggers (fever, hot baths, sun, stress) - when myelin is lost, nerve’s ability to transmit signals becomes temperature-sensitive

• medication - decrease exacerbations

Parkinson’s Disease (5 manifestations? treatment?)

Cause - unknown

Risk - men, rural areas

What - progressive destruction of substantia niagra, loss of dopamine

Manifestations

1. Dysphagia

2. Drooling

3. Shuffling Gait

4. Difficulty initiating movement

5. Rest Tremors - increase with purposeful movement

Treatment - no cure

• Levodopa & Dopamine agonists

Amyotrophic Lateral Sclerosis (ALS)/Lou Gehrig’s Disease - what functions does it affect (3)? early manifestations (3)?

Cause - unknown

Risk - men, 40-70

What - damage to upper neurons of cerebral cortex and lower motor neurons of brainstem & spinal cords

Manifestations

• CN 3 (oculomotor), 4 (trochlear), & 6 (abducens) unaffected

• affects chewing, swallowing, breathing

• Early: foot drop, slurred speech, & hand weakness

• Symptoms worsen w/ further motor neuron damage

Treatment - no cure

• death within 5 years

Myasthenia Gravis (3 manifestations? 4 Treatments?)

Cause - autoimmune, thymus may play a role

Risk

What - Acetylcholine receptors impaired/destroyed by IgG autoantibodies

Manifestations

1. hoarse/changing voice

2. ptosis

3. difficulty rising from chair

Treatment - no cure

• Medications

• Rest

• Nutrition

• Assistive Devices

Huntington’s Disease (Chorea) - cause? risk? 6 manifestations? 3 complications?)

Cause - autosomal dominant mutation in IT15 gene (worsens with each generation)

Risk - 30-40 years

What - degeneration of neurons, brain atrophies

Manifestations

1. Uncontrolled rapid, jerky, movements of fingers, feet, trunk (chorea) intensify w/ anxiety

2. Psychosis

3. Depression

4. Hallucinations

5. Antisocial

6. Mood Swings

Treatment - no cure

Complications

• Death from infection (pneumonia)

• Injuries from falls

• Suicide

• Earlier Onset = faster progression

Alzheimer’s Disease (3 risks? 4 manifestations? 3 characteristics? 3 stages?)

Risk - increased age, women, less education

What - brain tissue degenerates & atrophies leading to decline in mental abilities & memory (most common form of dementia)

Manifestations - insidious onset

1. Memory Loss

2. Problems w/ abstract thinking

3. Difficulty reading, writing, & word finding 

4. Disoriented even in familiar surroundings

3 Characteristics

1. Amyloid Plaques

2. Neurofibrillary Tangles

3. Lost connections between neurons responsible for memory & learning

3 Stages

1. Forgetfulness

2. Confusion

3. Dementia

Treatment