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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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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