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Degenerative Neurological Disorders

Parkinson's Disease . 4th most common neurodegenerative diseaseMost often idiopathicOften presents in 5th decadeWidespread degeneration of the substantia nigra. Review. What are some of the suggested causes?What neurotransmitter is affected?What are the early signs?What are the cardinal sympto

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Degenerative Neurological Disorders

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    1. Degenerative Neurological Disorders

    2. Parkinson’s Disease 4th most common neurodegenerative disease Most often idiopathic Often presents in 5th decade Widespread degeneration of the substantia nigra

    3. Review What are some of the suggested causes? What neurotransmitter is affected? What are the early signs? What are the cardinal symptoms? What will the individual manifest as the disease progresses? How is the disease diagnosed?

    4. Pharmacologic Therapy Actions ? dopaminergic activity in corpus striatum ? excessive influence of cholinergic neurons on extrapyramidal tracts Acts on neurotransmitter pathways Drug classes Dopaminergic Anticholinergic Dopamine agonista MAOIs Antiviral COMTs Antidepressants Antihistamines

    5. Surgical Management Stereotactic Procedures Thalamotomy pallidotomy Neural transplantation Deep brain stimulation

    6. Nursing Interventions Improving mobility Enhancing self-care activities Improving bowel elimination Improving nutrition Enhancing swallowing Encouraging use of assistive devices Improving communication Supporting coping abilities

    7. Amyotropic Lateral Sclerosis (ALS) Degenerative disease of unknown cause Loss of motor neurons in anterior horns of spinal cord and the motor nuclei of the lower brain stem Atropic changes seen in muscle fibers supplied by dying motor neuron cells Can occur in both upper and lower motor neuron systems

    8. Clinical Manifestations What will manifestations depend upon? Chief symptoms: Fatigue Progressive muscle weakness cramps Fasciculations Incoordination

    9. Assessments and Diagnostics How is ALS diagnosed? What diagnostic tests would you expect?

    10. Management Supportive therapy Symptomatic Rehabilitative What would be the goal of supportive therapy? Durg Therapy: riluzole (Rilutek)

    11. Questions Give some examples of medications for spasticity. What is the expected outcome of this disease? What care measures would you anticipate?

    12. Degenerative Disk Disease Herniated (Ruptured) intervertebral disk: “rupture of the soft tissue that separates two vertebral bones into the spinal canal or adjacent spinal nerve roots. Herniation of intervertebral disks can cause back pain and, occasionally, loss of neurological function in the distribution of the affected nerves” (Taber’s, p. 618)

    13. Questions What do these terms mean? Radiculopthy Sciatica Spondylosis What diagnostics would you expect?

    14. Management Medical– conservative treatment Surgical— Discectomy Laminectomy Hemilaminectormy Partial laminectomy or laminotomy Discectomy with fusion Foraminotomy

    15. Nursing Management What are the associated collaborative problems? Care goals: Relieving pain Improve mobility Monitoring and managing potential complications

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