chapter 46 Neuro disorders

Creutzfeldt-Jakob disease

- A rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain - Chronic, progressive, fatal disease of the central nervous system caused by a prion. - initial symptoms sensory disturbance, limb pain, and behavioral changes

Copaxone (glatiramer acetate)

- Biological for multiple sclerosis - may take 6 months for evidence of any response

s/s of intercranial pressure

- Change in LOC

Intracranial pressure (IPC)

- Use cervical collar to reduce ICP

Carbidopa

- a Dopa decarboxylase inhibitor (inhibits metabolism of levodopa to dopamine) - reduces many of the side effects of levodopa in the periphery - reduces N/V, reduces postural hypotension SE: Dyskinesia

Guillain-Barré syndrome

- acute, inflammatory disease of the nerves characterized by the loss of myelin from the nerves - idiopathic polyneuritis - temporary paralysis

myasthenia gravis

- autoimmune neuromuscular disorder - decrease number of receptor sites of Acetylcholine - weakness of voluntary muscles - confirmed by - (drug) positive edrophonium (Tensilon) test, takes 30 sec to see results and last for 5 min.

edrophonium chloride

- cholinergic agent - antidote - Atropine - Curare antidote (reverse the effects of nondepolarizing blocking agents) - Binds AChE at K1 step - Works so well that it can restore function in 1 minute

meningitis

- inflammation of the meninges of the brain and spinal cord - S/S HA and nuchal rigidity

Multiple Sclerosis (MS)

- to reduce fatigue rest in a cool room - perform frequent physical activity but avoid becoming fatigued - I will stretch daily as directed by the physical therapist

cranial nerves in order

1) olfactory- sense of smell 2)optic- visual inputs 3) oculomotor- major eyeball movements 4) trochlear- activation of the superior oblique muscle 5) trigeminal- major sensory nerve of the face 6) abducens- lateral movement of the eyeball 7) facial- major motor nerve of the face 8) vestibulocochlear- sense of hearing and balance 9) glossopharyngeal- taste and swallowing 10) vagus- digestive and respiratory function 11) accessory- motor control of the neck 12) hypoglossal- motor control of the tongue

status epilepticus

A condition in which seizures recur every few minutes or last more than 30 minutes. - compliance with medications

Parkinson's disease

A disorder of the central nervous system that affects movement, often including tremors. - give a lot of time to eat

Bell's Palsy

A localized facial nerve dysfunction that causes facial droop and numbness - Facial, VII - facial distortion and pain

Antiseizure drugs

Lamictal Dilantin, Tegretol, Depakote

ALS drugs

Riluzole- neuroprotective agent, early stages extra 3 to 6 months of life Dicyclomine- anticholinergic Gabapentin Baclofen- antispasmodic Interferon

pyridostigmine bromide (Mestinon)

Treatment for myasthenia gravis; inhibits the action of cholinesterase at the cholinergic nerve endings, promotes the accumulation of acetylcholine at zcholinergic receptor sites; - adverse reactions: cholinergic crisis - antidote atropine for drug-induced bradycardia - observe for symptoms of cholinergic crisis; lifelong therapy

Kernig's sign

a diagnostic sign for meningitis marked by the person's inability to extend the leg completely when the thigh is flexed upon the abdomen and the person is sitting or lying down

Multiple sclerosis

chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of small patches of demyelination in the brain and spinal cord

amyotrophic lateral sclerosis (ALS)

condition of progressive deterioration of motor nerve cells resulting in total loss of voluntary muscle control; symptoms advance from muscle weakness in the arms and legs, to the muscles of speech, swallowing, and breathing, to total paralysis and death; also known as Lou Gehrig disease

Medical management of arthropod-borne virus (arboviral) encephalitis is aimed at

controlling seizures and increased intracranial pressure

ptosis and diplopia

drooping and double vision - 2 most common initial signs of myasthenia gravis

amyotrophic lateral sclerosis (ALS)

electromyography used to confirm the disorder

Avonex

interferon beta-1a Multiple sclerosis

ALS effects which motor neurons?

loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem

Herpes simplex virus

most common cause of acute encephalitis in the US

Dantrolene (Dantrium)

skeletal muscle relaxant