Chapter 17

Guillain-Barre syndrome

- GBS - acquired inflammatory disease causing demyelination of the peripheral nerves w/ relative sparing of axons - acute onset, ascending motor paralysis - humoral & cellular immunologic reaction - considered to be an autoimmune disease triggered by a preceding bacterial or viral infection

Amyotrophic Lateral Sclerois

- ALS- Lou Gehrig's disease - diffusely affects upper & lower motor neurons of the cerebral cortex, brainstem & spinal cord (corticospinal tracts & anterior roots) - progressive weakness leading to respiratory failure & death - person has normal intellectual & sensory function until death

Myasthenia Gravis

- MG - chronic autoimmune disease - IgG antibody produced against acetylcholine receptors (anti-acetylcholine receptor antibodies) at the acetylcholine-binding site of the postsynaptic membrane - weakness & fatigue of muscles of the eyes & the throat, causing diplopia, difficulty chewing, talking, swallowing - characterized by exertional fatigue & weakness that worsens with activity, improves with rest & recurs w/ resumption of activity

Subarachnoid Hemorrhage

- blood escapes from defective or injured vasculature into the subarachnoid space - manifestations: meningeal irritation & inflammation causing neck stiffness (nuchal rigidity); photophobia, blurred vision, irritability, restlessness & low-gradefever *positive Kernig sigh: straightening the knee w/ the hip & knee in a flexed position produces pain in the back & neck regions *Brudzinksi sign: passive flexion of the neck produces neck pain & increased rigidity may appear

Migraine

- chronic headache - trigger factors -aura

Chronic paroxysmal hemicrania

- cluster-type headache that occurs w/ more daily frequency but w/ shorter duration

Embolic Stroke

- fragments that break from a thrombus formed outside of the brain - high-risk sources for the onset of embolic stroke are atrial fibrillation (15 to 25% of strokes, left ventricular aneurysm or thrombus, left atrial thrombus, recent myocardial infarction, rheumatic valvular disease, mechanical prosthetic valve, nonbacterial thrombotic endocarditis, patent foramen ovale & primary intracardiac tumors - moving from another area of body; like DVT - arterial defibrillation = irregular contraction of atria; many Ps before QRS

Tension-type headache

- mild to moderate bilateral headache w/ a sensation of a tight band or pressure around the head

Multiple Sclerosis

- progressive, inflammatory, demyelinating, autoimmune disorder of the CNS - degeneration of the myelin sheath in CNS neuron & loss of axons

Cluster Headache

- several attacks can occur during the day for days followed by a long period of spontaneous remission - pain mainly in temporal lobe that last 2-4 hours - chronic - usually begin with warning & is characterized by severe, unilateral tearing, burning, periorbital & retorbulbar or temporal pain lasting 30 min to 2 hours

Thrombotic Stroke

- type of ischemic stroke - arterial occlusions caused by thrombi formed in arteries supplying the brain or in intracranial vessels - transient ischemic attacks (for short period of time; decrease blood supply) - blockage in brain

Hemorrhagic stroke

-ICH - lacunar stroke: a microinfarct smaller than 1 cm in diameter; b/c of the subcortical location & small area of infarction, these strokes may have pure motor & sensory deficits - cerebral infarction -cerebral hemorrhage