Nervous System Diseases and Disorders Practicum I 2012

1. Alzheimer’s Disease Progressive disease that begins with problems remembering Nerve endings in cortex of brain degenerate and block signals that pass between nerve cells Abnormal fibers build up creating tangles Cause – unknown Loss of sense of smell has been identified as a possible early stage symptom, although it is not definitive

Stages of Alzheimer’s 1 st stage – (2 – 4 yrs) involves confusion, short-term memory loss, anxiety, poor judgment 2 nd stage – (2 – 10 yrs) increase in memory loss, difficulty recognizing people, motor problems, logic problems, and loss of social skills 3 rd stage – (1 – 3 yrs) inability to recognize self, weight loss, seizures, mood swings, and aphasia

2. Cerebral Palsy A disturbance in voluntary muscle action Caused by brain damage: –Lack of oxygen to the brain –Birth injuries –Prenatal rubella (German measles) –Infection There is NO cure

Forms of Cerebral Palsy: –Spastic – most common form –Athetoid –Atactic

Symptoms: –Exaggerated reflexes such as head rolling, grimacing –Tense muscles –Contracture development –Seizures –Speech impairment –Spasms –Tremors –Usually, no impairment of intellect but in some cases, may cause mental retardation

Treatment: Physical and occupational therapy Speech therapy Muscle relaxants Anticonvulsants Casts Braces Orthopedic surgery for severe contractures

3. Cerebrovascular Accident (CVA) Also called a stroke. Occurs when the blood flow to the brain is impaired, resulting in lack of oxygen and a destruction of brain tissue. Causes: –Cerebral hemorrhage (from hypertension) –Aneurysm (weak blood vessel) –Occlusion/blockage (atherosclerosis) –Thrombus (blood clot)

Signs and symptoms: vary depending on the area and amount of brain tissue damaged but can include: –Loss of consciousness –Weakness or paralysis on one side of the body (hemiplegia) –Dizziness –Dysphagia (difficulty swallowing) –Visual disturbances –Mental confusion –Aphasia (speech or language impairment) –Incontinence (loss of bowel or bladder control)

The first 3 hours of a CVA are critical. Treatment with a thrombolytic agent (clot-busting drugs) can dissolve a clot and restore blood flow to the brain. CT scans can determine the area of the brain involved. Additional treatment depends on symptoms and is directed toward helping the patient recover from or adapt to the symptoms that are present.

4. Dementia Loss of 2 areas of complex behavior – such as language, memory, visual and spatial abilities, or judgment Interferes with a person’s daily life

5. Encephalitis An inflammation of the brain caused by a virus, bacteria, or chemical agent. The virus is frequently contracted by a mosquito bite. Symptoms vary but can include: fever, extreme weakness, lethargy, visual disturbances, headache, vomiting, stiff neck and back, disorientation, seizures and coma. Treatment: antiviral drugs, maintenance of fluid and electrolyte balance, anti- seizure meds, monitoring of kidney and respiratory function.

6. Epilepsy Also called seizure syndrome, characterized by recurring or excessive discharge from neurons A brain disorder associated with abnormal electrical impulses in the neurons of the brain, believed to be spontaneous and uncontrolled Causes can include: –Brain injury –Birth trauma –Tumors –Toxins (lead poisoning etc.) –Infections

Absence or Petit mal seizures are milder and characterized by a loss of consciousness lasting several seconds. Tonic-clonic or grand-mal seizures are the most severe. They are characterized by loss of consciousness lasting several minutes, convulsions accompanied by violent shaking and thrashing movements, hypersalivating (causing foaming at the mouth) and loss of body functions. Treatment : Anticonvulsant Drugs

7. Hydrocephalus An excessive accumulation of cerebrospinal fluid (CSF) in the brain. Causes: –congenital (at birth) defect –Infection –Tumor that obstructs the flow of CSF Symptoms: –Abnormally enlarged head, usually noticed at birth –Prominent forehead –Bulging eyes –Irritability –Distended scalp veins –Retardation (when pressure prevents proper development)

Treatment includes surgically implanting a shunt (bypass tube) into the brain to allow for drainage of the excessive fluid which relieves pressure.

8. Meningitis An inflammation of the meninges (lining) of the brain and/or spinal cord. Can be caused by a virus, bacteria, fungus, or toxins such as lead or arsenic. Symptoms: high fever, headache, neck and back pain, stiffness, nausea, vomiting (N/V), delirium, convulsions, and if untreated, coma and death. Treatment: antibiotics (bacterial), anticonvulsants, pain meds, and meds to treat cerebral edema.

9. Multiple Sclerosis (MS) A chronic progressive disabling (inflammatory) condition resulting from a degeneration of the myelin sheath in the central nervous system. Transmission of nerve impulses is blocked Usually occurs between the ages of 20 and 40 (mostly women) The cause is unknown. There is NO cure.

The disease progresses at different rates and has periods of remission. Early symptoms include: visual disturbances, weakness, fatigue, poor coordination, and tingling and numbness. As the disease progresses: tremors, muscle spasticity, paralysis, speech impairment, emotional swings, and incontinence. Treatment: Avonex – slows progression; physical therapy, muscle relaxants, steroids, psychological counseling are all used to maintain functioning ability as long as possible.

10. Neuralgia Nerve pain which follows the pathway of the nerve Caused by inflammation, pressure, toxins, and other disease. Treatment is directed toward eliminating the cause of the pain.

11. Neuritis Inflammation of a nerve Symptoms: –Severe pain –Hypersensitivity –Loss of sensation –Muscular atrophy –Weakness –Paresthesia (tingling, burning, crawling of skin) Causes – may be infectious, chemical, or due to other conditions Treatment – eliminate cause, take analgesics

12. Paralysis Loss of power of motion or sensation Cause: Usually results from brain or spinal cord injury that destroys the neurons and results in a loss of function and sensation below the level of the injury.

Hemiplegia- paralysis on one side of the body and is caused by a tumor, injury, or CVA. Paraplegia- paralysis in the lower extremities or lower part of the body caused by spinal cord injury. Quadriplegia-paralysis of the arms, legs, and body below the spinal cord injury. There is NO cure. Treatment: supportive, occupational and physical therapy.

13. Parkinson’s Disease A chronic progressive condition involving degeneration of brain cells. Usually occurs in persons over 50 years old. Symptoms: tremors, stiffness, muscular rigidity, a forward leaning position, shuffling gait, loss of facial expression, drooling, mood swings, frequent depression, behavioral changes. Caused by a decrease in neurotransmitter dopamine There is NO cure. Treatment: L-dopa (med. to relieve symptoms), physical therapy to limit muscle rigidity.

Parkinson’s Disease:

14. Poliomyelitis Disease of nerve pathways of the spinal cord causing paralysis Almost eliminated in US due to vaccination

15. Sciatica Form of neuritis that affects the sciatic nerve; may be from a ruptured lumbar disc or arthritic changes Symptoms – pain which radiates through the buttock, behind the knee and down to the foot Treatment – traction, physical therapy, possible surgery

16. Shingles Also called Herpes zoster An acute inflammation of nerve cells and is caused by the Herpes virus, which also causes chicken pox. It commonly shows on the thoracic area on one side of the body and follows the path of affected nerves. Symptoms: fluid filled vesicles appear on the skin, severe pain, redness, itching, fever, and abnormal skin sensations. Treatment: directed toward relieving pain and itching until the inflammation subsides, usually in 1-4 weeks.