Adult Neuro Disorders

CNS (Central Nervous System) disorders

leading to involuntary movements, cognitive decline, and motor dysfunction

Multiple Sclerosis (MS), Parkinson’s, and Huntington’s

Peripheral nervous system (PNS) disorders

involve damage to nerves outside the brain and spinal cord, causing pain, numbness, muscle weakness, and autonomic dysfunction

• ALS, Myasthenia Gravis, Guillain-Barré

Neurotransmitter Dopamine ↓

Parkinson’s

Neurotransmitter Acetylcholine ↓ 

Alzheimer’s

ACh receptor issue

Myasthenia Gravis

BELL’S PALSY

CN VII inflammation → facial nerve ischemia/paralysis

Manifestations

• Unilateral facial paralysis

• Drooping face

• Increased tearing

• Speech & eating difficulty

TRIGEMINAL NEURALGIA

CN V irritation → severe neuropathic pain

• Sudden “electric shock” facial pain

• Triggered by touch, eating, and cold air

carbamazepine

Antiepileptics

• Action: stabilize nerve firing

• Side effects: dizziness, sedation

for TRIGEMINAL NEURALGIA

AMYOTROPHIC LATERAL SCLEROSIS (ALS)

• Degeneration of upper + lower motor neurons

• Possible glutamate toxicity

No cure (3–5 yrs survival)

Clinical Manifestations

• Progressive weakness

• Muscle atrophy

• Dysphagia, dysarthria

• Respiratory failure (MOST IMPORTANT)

MYASTHENIA GRAVIS

a chronic autoimmune disorder causing fluctuating weakness of voluntary muscles, particularly those controlling eye movement, eyelids, chewing, swallowing, and speaking

• Autoimmune → blocks ACh receptors

• ↓ muscle contraction

 Clinical Manifestations

• Weakness WORSE with activity

• Ptosis (HALLMARK) (drooping of the upper eyelid)

• Diplopia

• Dysphagia

• Respiratory weakness

• Small frequent meals

Myasthenic Crisis

Too little ACh → respiratory failure

Cholinergic Crisis

• Too much ACh → SLUDGE symptoms

• Treat with atropine

SLUDGE symptoms

Salivation/Sweating, Lacrimation, Urination, Defecation/Diarrhea, Gastrointestinal distress, and Emesis (vomiting)

Cholinergic Crisis

Medications for MYASTHENIA GRAVIS

Pyridostigmine / Neostigmine

• Action: inhibit ACh breakdown

• Side effects: diarrhea, sweating

Atropine

• Action: blocks ACh (for cholinergic crisis)

Take meds BEFORE meals

PARKINSON’S DISEASE

• ↓ dopamine, ↑ ACh imbalance

• Tremor (resting)

• Rigidity

• Akinesia/bradykinesia

• Postural instability

Medications for PARKINSON’S DISEASE

Levodopa-Carbidopa (Sinemet)

• Action: ↑ dopamine

• Side effects: dyskinesia, nausea

• Teaching: No high protein meals / No MAOIs (hypertensive crisis)

MULTIPLE SCLEROSIS (MS)

a chronic autoimmune disease where the immune system attacks the protective myelin sheath covering nerve fibers in the brain and spinal cord, causing communication issues between the brain and body.

Uhthoff’s sign

a temporary worsening of neurological symptoms in people with multiple sclerosis (MS) caused by increased body temperature

HUNTINGTON’S DISEASE

fatal genetic neurodegenerative disorder causing the progressive breakdown of nerve cells in the brain

Elevated dopamine directly triggers involuntary, jerky movements known as chorea

GUILLAIN-BARRÉ SYNDROME (GBS)

An acute autoimmune disorder where the immune system attacks peripheral nerves (attacks the myelin sheath), often triggered by a previous bacterial or viral infection

Clinical Manifestations

• Ascending paralysis

• Loss of reflexes

• Respiratory failure risk

RISK FACTOR: Recent infection (Campylobacter)

• Usually reversible

• Recovery may take months–years