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Neurological Disorders

Disorder Definition
Risk
Factors/Etiology
Manifestations Treatment/Medications
Huntingtons Disease Autosomal dominant
neurologic disease
Decrease in GABA and
acetylcholine
Abnormal movements
Progressive dementia
Fidgeting/Restlessness
Jerky movements of distal
arms/legs
Rhythmic, lurching gait
Affects chewing,
swallowing and speaking
muscles
Genetic Testing
Amyotrophic Lateral
Sclerosis (ALS or Lou
Gehrigs)
Rapidly progressive, fatal
degenerative neurologic
disease.
Degeneration of both
upper and lower motor
neurons.
40-60 years of age
Males
Familial
Weakness & paralysis
locked in syndrome
Eventual inability to
communicate.
Riluzole
Guillan-Barre Syndrome Acute inflammatory
demyelinating disorder of
the PNS
Autoimmune
Associated with
immunizations
Preceded by resp. or
intestinal infections 1-3
weeks prior.
Muscle, sensory, and CN
weakness.
Symmetric muscle
weakness in lower
extremities.
Ascending in nature
Cognition and LOC not
affected.
Focus on ventilation
Preventing complications of
immobility
Nutritional support
Creutzfeldt-Jakob
Disease (CJD,
spongiform
encephalopathy, mad
cow)
Transmissible and fatal
disease that causes brain
degeneration without
inflammation
Caused by a prion protein
Direct contamination with
infected neural tissue
Memory impairment &
behavior changes
Mental deterioration
Involuntary movements
Weakness in the limbs
Blindness
Coma
No treatment available and
must be reported to the CDC
Postpoliomyelitis
Syndrome
Complication of a
previous infection by the
Previous infections of
polio
Mild to severe flaccid
paralysis and atrophy
Manage S/S, rehabilitation,
encourage independent self-
poliomyelitis virus that
destroys motor cells
care
Multiple Sclerosis (MS) Demyelinating neuro
disorder of the CNS
Associated with abnormal
immune response to and
environmental factor
Ages 20-50, peak 30
Female

Fatigue
Remissions and
exacerbations
Glucocorticoids
ImmunosuppresantsImuran,
Cytoxan
Interferon and glatiramer
acetate (Copaxone)
Anticholinergics
Antidepressants
Parkinsons Disease (PD) Disturbed balance
between excitatory and
inhibitory
neurotransmitters.
Failure to inhibit
acetylcholine.
White
Male

Tremor at rest
Motor and postural
effectsrigidity,
bradykinesia, cogwheel
rigidity
Slowed/delayed
movements that effect the
eyes, mouth, and voice
mask-like face and
soft/muffled voice
Others: constipation,
urinary hesitancy & freq.,
ortho hypo, eczema, sleep
disturbances
MAOIs
Dopaminergics
Dopamine agonists
Anticholinergics
Levodopa
COMT inhibitors
Antidepressants
Propranolol
Botulism toxin
Myasthenia Gravis (MG) Antibodies destroy/block
neuromuscular junction
receptor sitesdecreased
number of acetylcholine
receptors
Decrease in the muscles
ability to contract.
Women
Ages 20-30
Autoimmune
Double vision, ptosis,
blurred vision, problems
with chewing and
swallowing
Myasthenia crisis
Cholinergic crisisSLUD
Anticholinesterases
neostigmine
Glucocorticoids
Trigeminal Neuralgia (tic
douloureux)
Chronic disease of CN
Vtrigeminal
Irritation from flu-like
illness, trauma, jaw/teeth
infection
Pressure on the nerve
Arteriosclerotic changes
Middle and older adults
Brief, repetitive episodes
of severe unilateral facial
pain
Tegretol
Dilantin
Neuronin
Baclofen
Women
Bells Palsy (facial palsy) Disorder of CN VII
Facial
Inflammation of the nerve
Relationship to the herpes
simplex virus
Adults ages 20-60
Unilateral paralysis of the
facial muscles
Forehead on one side not
wrinkled
Eyeball rolls up
Eyelid does not close
Flat nasolabial fold
Corticosteroids
Antivirals
Eye carewarm moist heat
Rabies Rhabdovirus infection of
the CNS transmitted by
infected saliva through an
open wound; fatal if
untreated
Open wound
Bite from an animal with
virus
Prodromalwound site
pain, anxiety, irritability,
S/S of infection, increased
sensitivity to light and
sounds

Excitement
laryngospasms, thick large
amounts of mucus,
convulsions, death usually
in 7 days due to
respiratory failure
Prevention=immunization
Maintain airway
Seizure safety
Standard precautions to avoid
transmission
Tetanus (lockjaw) Disorder caused by a
neurotoxin elaborated by
Clostridium tetani that
enters the body through
open wounds
Wound causes: puncture,
scratches, abrasions, bee
stings, abortions, surgery,
trauma, burns, IV drug
use
Difficulty swallowing
Tonic spasms
Profuse sweating
Facial muscle spasms
Sore throat
Prevention=childhood
immunization
Botulism Food poisoning Consuming food
containing Clostridium
botulinum found in soil
Respiratory paralysis 12-
36 hours after ingestion of
contaminated food
Cathartics
Enemas
Gastric lavage
Mechanical ventilation or
tracheostomy
TPN for nutrition
IV fluids
Report to the CDC
Meningitis Viral, fungal, or parasitic
infection of the meninges
in the brain
Bacteria, viruses, fungi,
protozoan, and toxins
entering the brain
Bacterialfever, chills,
severe HA, nuchal
rigidity, positive
Antibiotic for bacterial
Viral causesherpes
simplex, herpes zoster,
Epstein Barr, CMV, West
Nile
Brudzinskis and Kernigs
signs, petechial rash, S/S
or IICP

Viralmilder/less severe
Encephalitis Generalized infection of
brain and spinal cord
Viral, bacterial, fungal Viraledema,
disorientation,
agitation/restlessness,
decline in LOC, coma

Arboviruswidespread
degeneration of nerve
cells; exaggerated deep
tendon reflexes, altered
LOC, fever, stiff neck,
paralysis of extremities

Brain abscesschills,
fever, S/S of IICP, altered
LOC
Bacterial
antibioticspenicillin,
cephalosporin, vancomycin

Viral and encephalitis
symptomatic treatment

Brain abscessantibiotics,
drainage, surgery