ALS, alzheimers, huntingdon's

Amyotrophic lateral sclerosis (ALS)

also called Lou Gehrig’s disease

Amyotrophic lateral sclerosis (ALS)

most common motor neuron disease

Amyotrophic lateral sclerosis (ALS)

includes upper and lower neuron involvement

Amyotrophic lateral sclerosis (ALS)

progressive and fatal: no known cause or cure

mid to late 50s

Amyotrophic lateral sclerosis (ALS) age of onset

family history, age, gender, genetic mutations

Amyotrophic lateral sclerosis (ALS) known risk factors (4)

lifestyle, occupational factors, environmental factors, diet, trauma

Amyotrophic lateral sclerosis (ALS) possible risk factors: (5)

men

who is more affected by Amyotrophic lateral sclerosis (ALS): men or women?

Amyotrophic lateral sclerosis (ALS)

must have both UMN and LMN symptoms as well as progression of disease

Amyotrophic lateral sclerosis (ALS)

has no comprehensive diagnostic procedure

asymmetrical muscle weakness

Pt.s with ALS present with this

1

asymmetrical muscle weakness in ALS will begin in ___ UE or LE

distally

ALS unilateral/asymmetrical muscle weakness initally____

proximally

ALS unilateral/asymmetrical muscle weakness progresses___

orthopnea

inability to lay supine

orthopnea, fatigue, dyspnea, acsessory muscle use

respiratory impairments ALS (4)

PBA, executive function issues, personality changes, behavior changes, language comprehension issues

cognitive impairments ALS (5)

muscle weakness, fatigue, pain, immobility, poor posture, falls,

ALS muscloskeletal imapiarments (6)

spasticity

a common cause of pain ALS,

UMN

Is spasticity an UMN or LMN issues?

paresthesias

common sensory imapirment with ALS

• PBA

• Fatigue

• Pain

• Sensory symptoms

• cognitive impairments

• muscle weakness

• respiratory impairments

ALS s/s (7)

3-5 years

ALS life expectancy

respiratory compromise

ALS typical cause of death

aspiration pneumonia

ALS COD (cause of death) related to respiratory compromise

Alzheimer’s disease

Results in dementia

dementia

a decline in intellectual functioning

dementia

interferes with relationships and ability to perform ADLs

RISK FACTORS BOX 20.4

Alzheimer’s disease

cause is unknown: links to advanced age, genetic components, and abnormal processing of amyloid

Alzheimer’s disease

risk factors: age, family history, genetics, head injury, low TSH

THS

thyroid stimulating hormone

Alzheimer’s disease

persistent memory loss, Visuospatial deficits, Personality changes

Visuospatial deficits

issues navigating environment and drawing pictures

Alzheimer’s disease

issues handling money, solving math problems, and impaired judgement

Personality changes (alzheimers)

egocentric, impulsive, irritable, anxious, withdrawn from family

irritibale

having a short fuse: alzheimers

Alzheimer’s disease

diagnostics include clinical exam, neuroimaging and medication review

Alzheimer’s disease

unknown cause and no cure

Alzheimer’s disease

tx: manage symptoms by changing environment for saftey and taking medication

7-11 years

Alzheimer’s disease patients will live this long after diagnosis

Alzheimer’s disease

is the 4th leading cause of death

yes

Is Alzheimer’s disease progressive?

Alzheimer’s disease

PTA: keep brain active, and decrease fall risks

sundowning

increase lighting in evening to mange symptoms

BOX 20.2

BOX 20.6

Huntington’s disease

Also referred to as Huntington’s chorea

Huntington’s disease

Progressive hereditary disease

Huntington’s disease

characterized by movement abnormalities, personality disturbances, & dementia

Huntington’s disease

onset is middle aged

Huntington’s disease

usually one parent will have this

genetic

Huntington’s disease has a ___ link

basal ganglia

brain imaging can reveal Huntington’s disease through showing atrophy of this area

Huntington’s disease

atrophy of the basal ganglia

chorea

writhing movements

saccade

rapid, jerky movements

dysarthria, dysphagia

swallowing difficulties associated with Huntington’s disease

Huntington’s disease

treatment focuses on manageing movement disorders

saccade, chorea, ataxia

movement disorders associated with Huntington’s disease (3)

family history, imaging techniques

Huntington’s disease diagnostics

Cachexia

muscle wasting

• Movement abnormalities (*saccade)

• Speech and swallowing difficulties

• Cachexia

• Sleep disorders

• Bladder incontinence

Huntington’s disease s/s (5)

younger

The ____ the onset for Huntington’s disease, the more severe it will be

25%

percentage of patients who attempted suicide at least once with Huntington’s disease

slow

progression of Huntington’s disease is___

15-20

death occurs this many years after onset of Huntington’s disease

spasticity

an upper motor neuron sign

gait, transfer and mobility safety, balance training, positioning

PTA implications for Huntington’s disease

dementia

decline in intellectual functioning: changes in ADLs and relationships

symptom management, cognitive activities, functional exercise, environmental changes

Alzheimers treatment entails (4)