What is it?
Cause is unknown, but there is a loss of motor neurons (nerve cells controlling muscles) in the anterior horns of the spinal cord and the motor nuclei of the brain stem. Neuronal degeneration can happen to the upper and lower motor neuron systems. Has affected a famous baseball player in the past.
Amyotrophic Lateral Sclerosis (ALS)
While assessing a patient's ambulation, the nurse notices that the patient appears hunched over and is slowly shuffling.
Parkinsons Disease
What diagnostic test for MS shows lesions, multiple plaques in the CNS, and evaluates the disease progression?
MRI
What med is taken up by the dopaminergic terminal (crosses the blood brain barrier), converted into dopamine, and then released as needed?
Levodopa (Larodopa)
A patient diagnosed with MS is prescribed Baclofen PO for which symptom?
Spasticity
An autoimmune disease that affects the myelin sheath of the CNS (brain and spinal cord) which leads to inflammation and scarring of the nerve.
Multiple Sclerosis
The nurse is assessing a patient who has difficulty talking to the nurse, difficulty chewing and swallowing, some breathing difficulty, and Ptosis.
Myasthenia Gravis
Ptosis (drooping of the eyelid) is only seen in Myasthenia gravis. The other S/S are seen in a few of the neuro disorders.
Analysis of Cerebral spinal fluid to look for an increase in IgG and higher numbers of lymphocytes and monocytes can diagnose this.
What is Multiple sclerosis?
What medication is used for ALS, is a glutamate antagonist, and prolongs a person's survival with ALS for 3-6 months?
Riluzole (Rilutek)
What exercises are recommended for a patient with MS by the nurse for patient education?
yoga, swimming, ROM exercises
But don't overdo it!
A chronic progressive neurological movement disorder that affects dopamine-producing neurons in the brain. The decrease in dopamine stores leaves more acetylcholine (excitatory) neurotransmitters than dopamine (inhibitory) neurotransmitters, leading to an imbalance that affects voluntary movement.
Parkinsons Disease
A patient has fatigue, progressive muscle weakness, cramps, twitching, and a lack of coordination. The patient states they have some difficulty with talking as well. When asked about GI/GU disturbances the patient denies any problems.
Amyotrophic Lateral Sclerosis (ALS)
What test does a patient get injected with edrophonium chloride, then 30 seconds after the injection the patients' facial muscle weakness and ptosis resolve for about 5 minutes which represents a positive diagnosis for Myasthenia Gravis
Tensilon test/acetylcholinesterase inhibitor test
What med can be given to allow more Levodopa to pass through the blood brain barrier to be converted into dopamine?
Carbidopa
What treatment for a patient with Myasthenia Gravis involves pulling out plasma and plasma components, separation of blood cells and antibodies in plasma, then reinfusing the cells with a plasma substitute (but not the antibodies)?
Therapeutic Plasma Exchange (TPE)/ Plasmapheresis
Autoimmune disorder of the neuromuscular junction; when the thymus sends antibodies that block acetylcholine from attaching, which causes fewer receptors available for stimulation, and resulting in voluntary muscle weakness that escalates with continued activity.
Myasthenia Gravis
A patient presents with speech disturbances, bladder dysfunction, bowel dysfunction, anxiety, numbness in the face and hands, and lack of skin sensation.
Multiple Sclerosis
Numbness in hands and face/ lack of skin sensation are only seen in multiple sclerosis. The others are shared between neuro disorders.
Diagnosing a patient with Parkinson's disease requires their patient history and the presence of 2 out of the 4 cardinal manifestations. What are these manifestations?
Tremors, Rigidity, Bradykinesia, and Postural changes
What medication only has effect on the relapse-remitting course of MS, decreases frequency of relapse, and can give the patients flu-like symptoms as a side effect?
Interferon beta-1a (Rebif), Interferon beta-1b (Betaseron), or Interferon beta-1a (Avonex)
This medication is given to patients with ALS for their symptom of fatigue.
Modafinil (Provigil)
Orchestrated by autoreactive T-cells that migrate to the CNS causing blood-brain disruption. Also, subsequent antigen-antibody reaction leads to demyelination of axons.
Multiple Sclerosis
Upon assessment you notice the patient show signs of chorea, drooling, is constipated, does a motion with his hand as if he is rolling something in it, and the spouse of the patient states that when he is asleep, his hands and legs will be shaky.
Parkinson's Disease
What diagnostic test for ALS shows electrical potential in muscles?
Electromyography.
A patient just received a Tensilon test to confirm their suspicion of Myasthenia Gravis. Suddenly, the patient starts cramping, is diaphoretic, and has a heart rate is 40 bpm. What is the patient given?
Atropine
Atropine should be available to control potential side effects of Tensilon, which include bradycardia, asystole, bronchoconstriction, sweating, and cramping.
This procedure involves surgical implantation of an electrode into the brain in either the globus pallidus or subthalamic nucleus because stimulating these areas may increase dopamine release or block anticholinergic release, thereby improving tremor and rigidity.
Stereo Static Procedure/ Deep Brain Stimulation (DBS)