Alzheimer’s Disease and Aphasia Overview

Alzheimer’s disease

• Most common form of dementia
• Cause: Idiopathic (unknown)
• Common in elderly (average onset at 50 years old)
• Risk factors: advancing age, family history, women
• Characterized by gradual onset of recent memory loss (anterograde amnesia)
• Hallmark manifestation: neurofibrillary tangles in the brain, high levels of Tau proteins in nerve tissue
• Symptoms: anterograde amnesia, agnosia, apraxia, aphasia, ataxia, cognitive changes, aggressive behavior, apathy, wandering behavior, muscle atrophy, incontinence
• Diagnosis: confirmed via autopsy
• Management: medications like Donepezil to slow progression, reminiscence therapy for mental stimulation, focus on safety (well-lit environment, avoid clutter)
• Complications: pneumonia, death from secondary complications

Aphasia

• Absence of the ability to communicate properly and coherently
• Broca’s Aphasia (Expressive Aphasia): difficulty in speaking and writing, confusion, slurring and stuttering
• Wernicke’s Aphasia (Receptive Aphasia): difficulty in understanding spoken and written language, confusion, limited ability to comprehend instructions
• Global or Mixed Aphasia: Both Broca's and Wernicke's Aphasia

Guillain-Barré Syndrome (GBS)

• Temporary neurologic deficit from an autoimmune response, characterized by polyradiculoneuropathy
• Mechanism: Autoimmune response that attacks nerves and spinal tissue, damaging myelin sheath and axons
• Types of GBS:
  • Acute Inflammatory Demyelinating Polyneuropathy (AIDP): most common variety, characterized by ascending paralysis, motor deficits (weakness, atrophy), and sensory deficits
  • Acute Motor Axonal Neuropathy (AMAN): most common in East Asia, retains sensation, associated with Campylobacter jejuni infection
  • Miller-Fisher Syndrome (MFS): associated with Zika virus infection, mainly affects eye muscles with ataxia and areflexia
• Symptoms: temporary loss of function such as movement, bladder and bowel elimination, respiratory failure
• Progression: self-limiting, complete recovery expected within weeks, as long as the client survives
• Diagnosis: CT, MRI, PET scan, CSF analysis to confirm inflammation
• Risk factors: recent viral illnesses (influenza, mononucleosis, COVID-19), bacterial infections (Campylobacter jejuni), vaccine components (influenza, HiB)

Parkinson’s Disease

• Progressive degeneration of the substantia nigra
• Cause: idiopathic, though risk factors include advancing age, viral illness (especially in elders), family history, toxins and pesticides
• Characterized by the presence and progression of 5 Cardinal Signs:
  • Unintentional tremors: resting tremors, “pill rolling” tremors
  • Rigidity: stiffness, unilateral or bilateral
  • Bradykinesia: slow movement with unsteady gait, shuffling gait
  • Postural changes: hunched back, shuffling gait, generalized stiffness
  • Loss of automatic movements: inability to blink, frown, grimace, or swing arms while walking, resulting in masked face
• Management: focus on safety, mild to moderate exercise, soft diet, respiratory function, preventing atrophy
• Medical management: medication like Dopar/Levodopa (most effective)
• Complications: pneumonia, death from secondary complications

This quiz explores key aspects of Alzheimer's disease, including its symptoms, risk factors, and management strategies. Additionally, it covers aphasia, particularly Broca’s aphasia, detailing its impact on communication. Test your knowledge and understanding of these critical neurological conditions.