Mobility Disorders PDF

‭DISORDERS OF MOBILITY‬ ‭ usculoskeletal system supports body weight, controls movements, provides stability as well as allows gross and five movements working with‬ M ‭the circulatory and nervous system. Coordinated by CNS with nerves innervating muscles.‬ ‭Conditions that limit mobility include pa...

‭DISORDERS OF MOBILITY‬ ‭ usculoskeletal system supports body weight, controls movements, provides stability as well as allows gross and five movements working with‬ M ‭the circulatory and nervous system. Coordinated by CNS with nerves innervating muscles.‬ ‭Conditions that limit mobility include pain, fatigue, respiratory disorders cardiovascular disorders, nervous system disorders, injury‬ ‭ arkinson Disease‬‭is an idiopathic, chronic, progressive‬‭degenerative disorder of the CNS that has motor, nonmotor, and neuropsychiatric‬ P ‭manifestation affecting individuals over 50. It is the second most common neurodegenerative disorder‬ ‭Some conditions that cause secondary parkinsonism include head trauma, toxins, metabolic disorders, infection, stroke‬ ‭Loss of dopamine, 90% idiopathic and 10% genetic‬ ‭Increased risk factors include increased age, male, exposure to pesticides, metals, family history, and genetic mutations‬ ‭Treatment includes pharmacological replenishment with dopaminergic drugs (dopamine agonist, amantadine, catechol o methyltransferase‬ ‭inhibitors) as well as ablation surgery, deep brain stimulation, complementary and supportive therapies‬ ‭Manifestations:‬ ‭ otor‬ M ‭Tremor‬ ‭-‬ ‭Pill rolling resting tremor of hand‬ ‭-‬ ‭Tremor of lips, chin, jaw, tongue, legs‬ ‭Rigidity‬ ‭-‬ ‭Increased muscle stiffness and tone‬ ‭-‬ ‭Cogwheeling‬ ‭Bradykinesia‬ ‭Postural instability‬ ‭ onmotor‬ N ‭Fatigue, sleep disturbances‬ ‭Olfactory dysfunction‬ ‭Pain‬ ‭Autonomic dysfunction‬ ‭Neuropsychiatric symptoms‬ ‭-‬ ‭Cognitive dysfunction, dementia, psychosis, hallucinations‬ ‭-‬ ‭Mood disorders, depression, anxiety‬ ‭Multiple Sclerosis‬ ‭Amyotrophic Lateral Sclerosis / Lou Gehring disease‬ ‭ rogressive chronic, autoimmune (theorized)‬ P ‭inflammatory, demyelinating and axonal degenerative‬ ‭disorder of CNS‬ ‭ rogressive neurodegenerative disease that causes weakness, disability and death‬ P ‭within 3 to 5 years‬ ‭Neurodegenerative‬ ‭ isk factors include age 20-50, women, more common in‬ R ‭-‬ ‭Upper motor neurons in corticospinal tract‬ ‭caucasians or northern europe descent, geography related‬ ‭-‬ ‭Lower motor neurons in anterior horn cells of spinal cord‬ ‭to latitude genetics, cause unknown‬ ‭ isk factors include age (60-69), caucasian males, family history (about 5-10%‬ ‭‬ ‭Relapsing remitting multiple sclerosis - stable for‬ R ‭of cases are inherited)‬ ‭10-20 years‬ ‭‬ ‭Secondary progressive multiple sclerosis -‬ ‭Manifestations‬ ‭gradual worsening with or without occasional‬ ‭‬ ‭Insidious onset‬ ‭relapses, minor remissions, plateaus‬ ‭‬ ‭Slowly progressive, painless weakness in one or more body parts‬ ‭‬ ‭Primary progressive multiple sclerosis -‬ ‭progressive deficits with occasional plateaus,‬ ‭‬ ‭Upper and lower motor neuron signs and symptoms‬ ‭temporary improvements or acute relapses‬ ‭‬ ‭Bulbar dysfunction‬ ‭‬ ‭Frontotemporal executive dysfunction‬ ‭Manifestations include sensory symptoms in extremities/‬ ‭face, visual loss, double vision, nystagmus, weakness‬ ‭vertigo, gait and balance disturbances, bladder problems,‬ ‭pain, dysarthria, fatigue, cognitive dysfunction‬ ‭Diagnosis‬ ‭‬ ‭Demonstration of CNS lesions disseminated in‬ ‭time and space‬ ‭‬ ‭MRI - McDonald criteria, EEG‬ ‭‬ ‭Blood test to rule of other disorders‬ ‭Diagnosis‬ ‭‬ E ‭ voked potentials recording timing of CNS‬ ‭response to various stimuli‬ ‭‬ ‭Lumbar puncture‬ ‭Treatment‬ ‭‬ ‭Immunomodulatory therapy - slows progress‬ ‭‬ ‭Education - avoid live attenuated vaccines‬ ‭‬ ‭Spasticity‬ ‭○‬ ‭Physical therapy, routine stretching‬ ‭program, medications, nerve blocks‬ ‭‬ B ‭ aked primarily on clinical manifestation‬ ‭‬ ‭Tests: MRI/ CT of brain, electromyography, nerve conduction studies,‬ ‭muscle and nerve biopsy‬ ‭Treatment‬ ‭‬ ‭Riluzole (glutamate pathway antagonist)‬ ‭‬ ‭Noninvasive ventilation‬ ‭‬ ‭Percutaneous endoscopic gastronomy tube feeding‬ ‭‬ ‭Medications to relieve symptoms and maximize remaining function‬ ‭‬ ‭Multidisciplinary approach for care‬ ‭ untington disease‬‭is a progressive, incurable, neurodegenerative‬‭disease of the brain, autosomal dominant inherited. There is a neuronal loss in‬ H ‭the cerebral cortex and varying degrees of atrophy in other areas in the midbrain and cerebellum. Causes uncontrolled involuntary movements,‬ ‭dementia, behavior changes with and onset of symptoms between 35 to 44 ears lasting a mean of 19 years‬ ‭Primary causes of death: pneumonia and cardiovascular diseases‬ ‭ anifestations:‬ M ‭Involuntary movements‬ ‭‬ ‭Chorea‬ ‭‬ ‭Parkinsonian features‬ ‭‬ ‭Akinetic rigid syndrome‬ ‭‬ ‭Dysarthria, dysphagia‬ ‭‬ ‭Abnormal eye movements‬ ‭‬ ‭Tics‬ ‭‬ ‭Myoclonus‬ ‭Cognitive impairment‬ ‭‬ ‭Short term memory loss‬ ‭‬ ‭Impaired intellectual‬ ‭function‬ ‭‬ ‭Dementia psychiatric‬ ‭manifestations‬ ‭Diagnosis:‬ ‭‬ ‭Genetically proved family history‬ ‭‬ ‭Clinical presentation‬ ‭‬ ‭MRI and CT scan to measure brain atrophy‬ ‭‬ ‭Referral to neurologist specialized in area‬ ‭Behavior changes‬ ‭‬ ‭Irritability, moodiness,‬ ‭depression, OCD‬ ‭‬ ‭Untidiness‬ ‭‬ ‭Antisocial disorder‬ ‭‬ ‭Apathy‬ ‭Treatment:‬ ‭‬ ‭Reduce symptoms and improve quality‬ ‭of life‬ ‭○‬ ‭Tetrabenazine for chorea‬ ‭○‬ ‭Antidepressant or‬ ‭antipsychotic medications‬ ‭○‬ ‭Levodopa or dopamine agonist‬ ‭medication‬ ‭ eizures disorder‬‭is an abnormal electrical discharge within rain resulting in involuntary movements the encompasses entire body or just certain‬ S ‭muscle groups and or behavior and sensory alterations. Can include changes in level of consciousness, behavior, or sensory perception‬ ‭ linical manifestations include loss of conscious awareness of environment, varying patterns of muscular rigidity and relaxation, aura‬ C ‭Generalized seizures‬ ‭ tatus epilepticus is a life threatening‬ S ‭conditions involved and enhanced and sustained‬ ‭electrical activity over 30 minutes‬ ‭There is an increase neuronal excitation with‬ ‭reduced inhibition‬ ‭Interventions‬ ‭ Establish and maintain an open airway -‬ ‭PRIORITY‬ ‭ Pad the bed frame to protect from injury.‬ ‭ Document characteristics of the seizure.‬ ‭ Administer 50% glucose‬ ‭ iagnosis:‬ D ‭Lab tests‬ ‭-‬ ‭Complete blood cells count, blood chemistry, urine culture, lumbar‬ ‭puncture‬ ‭-‬ ‭EEG, CT, MRI and angiography‬ ‭-‬ ‭Lead level, toxicology screening‬ ‭Treatment:‬ ‭-‬ ‭Anti Seizure medications‬ ‭-‬ ‭Surgical interventions‬