Neurological Testing, Diseases, and Disorders Nervous System Neurological Testing, Diseases, and Disorders

Standard 27 Define key terms associated with vision disorders, ear disorders, nose disorders, and mouth disorders. Write a case study based on one of these disorders using appropriate medical terminology, describing the typical profile of a person suffering from the selected disorder. ©2006 by Thomson Delmar Learning, a part of the Thomson Corporation. ALL RIGHTS RESERVED.

Neurologic Testing Typical neurologic examination State of consciousness Reflex activity Speech patterns Motor patterns

Neurologic Testing: Diagnostic Procedures Lumbar puncture Magnetic resonance imaging (MRI) Positron emission tomography (PET) scan Cerebral angiography Computerized tomography (CT) scan Electroencephalogram (EEG) X-ray

Neurologic Testing – Cranial Nerve Tests Olfactory nerves (Cranial nerve I) Have patient smell various substances Cranial nerves III, IV, and VI Have patient track movement of finger Cranial nerve V Have patient clench teeth, feel jaw muscles

Neurologic Testing – Cranial Nerve Tests (cont.) Cranial nerve VII Check patient’s facial expression Cranial nerve XII Have patient extend his tongue and move it from side to side

Neurologic Testing- Cranial Nerve Tests (cont)

Neurologic Testing: Reflex Testing Areflexia Absence of a reflex Hyporeflexia Decreased reflex Hyperreflexia Stronger-than-normal reflex

Neurologic Testing: Reflex Testing Biceps reflex Absence indicates spinal cord damage in the cervical region Knee reflex Absence may indicate damage to lumbar or femoral nerves Abdominal reflexes Used to evaluate damage to thoracic spinal nerves

Common Diseases and Disorders Disease/Disorder Description Alzheimer’s disease Progressive, degenerative disease of the brain Amyotrophic lateral sclerosis (ALS) Lou Gehrig’s disease Degeneration of neurons in the spinal cord and brain Bell’s palsy Weak or paralyzed facial muscles

Common Diseases and Disorders (cont.) Disease/Disorder Description Brain tumors and cancers Abnormal growths Can be primary or secondary tumors Most common – gliomas Epilepsy and seizures Occurs as a result of bursts of electrical signals that disrupt normal brain functioning Guillain-Barré Syndrome Body’s immune system attacks the PNS

Common Diseases and Disorders (cont.) Disease/Disorder Description Headaches Tension Migraines Cluster Episodic or chronic With aura/without aura Form of migraines; occurs in groups Meningitis Inflammation of meninges Multiple sclerosis (MS) Chronic disease of CNS Myelin is destroyed

Common Diseases and Disorders (cont.) Disease/Disorder Description Neuralgias Disorders causing nerve pain Parkinson’s disease Progressive and degenerative motor system disorder Sciatica Damage to sciatic nerve Stroke Brain cells die because of an inadequate blood flow; “brain attack”

Diseases/disorders Traumatic disorders – caused by injury: Concussion. Brain contusion. Congenital disorders – present at birth: Spina bifida. Hydrocephalus. Cerebral palsy. Cerebrovascular accident (CVA). Encephalitis. Epilepsy. Meningitis. Multiple sclerosis (MS) Neuralgia. Paralysis. Parkinson’s disease. Dementia. Alzheimer’s disease.

Spina Bifida Opening in the spinal column At delivery, spinal cord and nerves are exposed causing nerve damage Results in paralysis

Cerebral Palsy Caused by brain damage at birth Lack of oxygen, birth injuries, infection, etc. Symptoms: Tense muscles leading to contractures Tremors Mental retardation Treatment: Therapy, anticonvulsants, braces, surgery

Cerebrovascular accident (CVA) a.k.a. stroke Blood flow to the brain is impaired resulting in brain tissue damage Causes Cerebral hemorrhage Aneurysm Weak blood vessels Blood clot Treatment depends on cause

Encephalitis Inflammation of the brain resulting in weakness, visual disturbances, vomiting, stiff neck and back, coma Caused Virus Chemical Bacteria Treatment is supportive including medications and monitoring

Epilepsy Seizure syndrome Disorder associated with abnormal electrical impulses in the neurons of the brain Causes Trauma Toxins Idiopathic (spontaneous) Treated with medications

Hydrocephalus Excessive accumulation of cerebrospinal fluid in the ventricles Symptoms include abnormally large head, prominent forehead, irritability, retardation Treated with surgical shunt between ventricles

Meningitis Inflammation of the meninges of the brain and/or spinal cord Caused by bacteria or virus High fever, headaches, back and neck pain, n/v, delirium, convulsions and death Treatment includes medications and anticonvulsants

Multiple sclerosis Chronic, progressive disabling condition resulting from degeneration of the myelin sheath Occurs between 20 and 40 y.o. Cause is unknown Progresses at different rates depending on the person No cure

Neuralgia Nerve pain Caused by inflammation, pressure, toxins and other disease Treatment directed at eliminating the cause of the pain

Paralysis Usually results from brain or spinal cord injury Hemiplegia Paralysis on one side Quadriplegia Paralysis of the arms, legs, and body below the spinal cord injury No cure, treatment is supportive

Parkinson’s disease Chronic, progressive degeneration of brain cells usually in people over 50 y.o. Tremors, stiffness, muscular rigidity, forward leaning position, shuffling gait, mood swings, etc. Treatment is supportive and symptomatic

Shingles Herpes zoster Inflammation of nerve cells caused by herpes virus Same virus that causes chicken pox Occurs in thoracic area on one side of the body and follow path of affected nerves Itching, fever, increased skin sensitivity Treatment is to relieve pain and itching until inflammation subsides

Dementia General term defining a loss in at least two areas of complex behavior such as language, memory, visual/spatial abilities or judgment Does not mean that everyone that is forgetful has dementia

Alzheimer’s disease Progressive disease where initial symptom is usually a problem with remembering recently learning information Nerve endings in the cortex of the brain degenerate and block signals Cause is unknown and has 3 stages: 1st stage lasts 2-4 years and involves short-term memory loss, anxiety and poor judgment 2nd stage lasts 2-10 years and increases memory loss, difficulty recognizing people, motor problems, loss of social skills 3rd stage lasts 1-3 years and includes inability to recognize self, weight loss, seizures, mood swings, and aphasia (loss of speech).