Chronic and Degenerative Neurological Disorders

Seizures

Epilepsy

  • chronic neurological disorder

  • alternation of brain function caused by an abrupt explosive, disorderly discharge of cerebral neurons

  • motor, sensory, autonomic, and behavior manifestations

  • causes

Types of Seizures

  • focal seizures

    • simple

    • complex

  • Generalized Seizures

    • absence

    • myoclonic

    • clonic

    • tonic-clonic

    • atonic

  • Unclassified epileptic seizures

Focal Seizures

  • motor, sensory, autonomic, or psychic symptoms

  • Clonic- repetitive, flexion/extension movements

  • EEG shows spikes in region

Seizure Stages

  • Aura

  • Prodroma

  • Tonic Phase

    • contraction

  • Clonic Phase

    • relaxation

  • Postictal phase

Diagnostic tests

  • labs

  • MRI

  • CT scan

  • EEG

Emergency Seizure Care

  • the goal is to protect the patient form injury

  • Do not physically restrain the patient and do not put anything in their mouth

  • Positioning post seizure

  • Treatments

  1. do not panic

  2. turn on their side and start timing the seizure

  3. stay with person and do not restrain

  4. place something soft under head

  5. do not put anything in mouth

  6. call 911 if seizure lasts longer than 5 minutes

Other Neurological Disorders

Parkinson’s Disease

  • progressive loss of dopamine-producing cells in the basal ganglia

  • depletion of dopamine creates an imbalance

  • unopposed ACH is apparent in the tremor ad abnormal spasmodic muscle movements

  • Signs and Symptoms

    • Onset usually gradual, after age 50

      • slow progressive

    • Mask-like, blank expression

    • pill rolling tremors

    • Bradykinesia

      • loss of normal arm swing while walking

      • decreased blinking

      • loss of ability to swallow

      • black expression

      • difficulty initiating movement

    • Tremor

      • common in hands and arms

      • pill rolling motion with the fingers'

      • occurs more often at rest

      • may involve diaphragm, tongue, lips, and jaw

      • increases with stress

    • Muscle Rigidity

      • increase resistance to passive movement

      • Cog wheel, jerky slow movement

Amyotrophic Lateral Sclerosis (ALS)

  • Loss of upper and lower motor neurons

  • Signs and Symptoms

    • painless muscle weakness

    • atrophy

    • eventually results in respiratory failure

Multiple Sclerosis (MS)

  • etiology unknown

  • damage to the myelin sheath caused by autoimmune inflammation

  • both sensory and motor neurons are affected

  • Different forms/types

  • Signs and Syptoms

    • autoimmune and usually familal

    • Tinnitus

    • decreased tearing

    • nystagmus

    • blurred vision

    • dysarthria

    • dysphagia

    • weakness may progress to paralysis

    • muscle spasticity

    • atoa

    • vertigo

    • urinary retention

    • spastic bladder

    • constipation

Guillan-Barre Syndrome

  • acquire inflammatory disease-causing demyelination of the peripheral nerves with relative sparing of axons

  • acute onset, ascending motor paralysis

  • humoral and cellular immunologic reaction

  • Risk factors

    • possible autoimmune

    • association with immunizations

    • frequently preceded by mild rserum ACH espiratory or intestinal infection

  • Progresses over hours to days

  • minimal muscle atrophy

  • Symmetrical paralysis

  • Causes problems with:

    • respiration

    • talking

    • swallowing

    • bowel and bladder function

  • Begins in lower extremities and ascends bilaterally

    • weakness

    • ataxia

    • bilateral paresthesia progressing to paralysis

Myasthenia Gravis (MG)

  • autoimmune disease caused by the loss of functioning ACH receptors

  • Signs and Symptoms

    • diplopia and difficult chewing, talking, and swallowing

  • Myasthenia crisis

  • cholinergic crisis

  • Diagnosis

    • edrophonium (Tensilon) testing

    • serum Ach receptor antibodies

    • EMG