Nervous System Disorders PDF

Nervous system disorders Dr. Mona Elsheikh Lecturer at department of Physical Therapy for Neurological Disorders and its Surgery Faculty of Physical Therapy, MUST univ. Mission and Vision of the Colle...

Nervous system disorders Dr. Mona Elsheikh Lecturer at department of Physical Therapy for Neurological Disorders and its Surgery Faculty of Physical Therapy, MUST univ. Mission and Vision of the College of Physical Therapy – Misr University for Science and Technology (MUST)  Intended learning outcomes of course (ILOs) A- knowledge and understanding: - Recognize the integrated role of various body systems in health and disease. - Describes the pathomechanical aspects in relation to different pathological conditions. - Describe pathophysiology of the disease - Discuss determinants and patterns of health, illness and disability, and the social, cultural, and global factors that influence these. - Describe the pathological process and presentation of common diseases of the musculoskeletal, respiratory, cardiovascular and endocrine systems relevant to physiotherapy clinical practice.  Intended learning outcomes of course (ILOs) B- Intellectual skills: Analyze pathophysiological problems of various disorders of the human body. D- General and transferable skills: Demonstrate competence in the use of computer-based information.  Depression Depression is classified as a mood disorder  Subgroups of depression Major depression, Bipolar disorder Depression due to exogenous or unipolar disorder involves alternating periods or reactive episode of depression and mania (is a It is endogenous, state of abnormally elevated, and a precise diagnosis is It is a response to a life event, or expansive, or irritable mood secondarily to based on biologic factors and abnormally and or personal many systemic disorders, including persistently increased cancer, diabetes, characteristics. Etiologic activity or energy level). heart failure, and systemic lupus factors include genetic, developmental, erythematosus. and psychosocial Depression is a common problem, and stressors. many patients with milder forms may be misdiagnosed and not receive treatment.  Pathophysiology  Depression is classified as an affective or mood disorder on the basis of characteristic disorganized emotions.  It results from decreased activity by the excitatory neurotransmitters, norepinephrine and serotonin, in the brain.  The exact mechanism has not yet been established, but twin studies do suggest a genetic component.  The depressed client often has a history of major psychosocial trauma, which may contribute to the development of the disorder.  Signs and Symptoms  A prolonged period of profound sadness marked by hopelessness and an inability to find pleasure in any activity.  Lack of energy and loss of self-esteem and motivation interfere with daily activity.  Some individuals may be irritable and agitated. The individual has difficulty in concentrating and solving problems.  Sleep disorders, such as insomnia or, occasionally, excessive sleep, usually accompany depression.  Loss of appetite and libido (sex drive) is common.  The degree to which the individual is affected varies over time and among individuals. In some cases disability results as the individual is unable to meet the demands of daily life.  Treatment Antidepressant drugs that increase norepinephrine activity are effective in treating many cases of depression. There is concern about the increased risk of suicide in children and adolescents taking antidepressant medications without concurrent psychiatric counseling. Antidepressant drugs + psychiatric counseling. Another treatment of severe depression involves electroconvulsive therapy (ECT, shock treatments), which increases norepinephrine activity but may result in some memory loss.  Panic Disorders Panic disorder Panic attack It is an anxiety Refers to a sudden brief disorder, develops when episode of discomfort panic attacks are frequent or and anxiety. prolonged. These attacks occur in situations that most individuals would not find threatening.  Pathophysiology  A genetic factor has been implicated. An increased discharge of neurons may occur in the temporal lobes.  Biochemical abnormalities involving the neurotransmitters norepinephrine, serotonin, and GABA may also be involved.  Patients are fearful of having another panic attack, leading to increased irritability of the limbic system.  Signs and Symptoms  Repeated episodes of intense fear without provocation, which may last for minutes or hours, characterize this disorder.  Palpitations or tachycardia.  Hyperventilation.  Sweating.  Sensations of choking or smothering (feel of tightness).  Nausea accompany the feeling of terror.  Patients who anticipate attacks may develop a fear of open spaces (agoraphobia) or a fear of being in a place where no help is available and may refuse to leave their homes.  Treatment Treatment consists of psychotherapy + drug therapy (antianxiety agents)