Neuro_ALL

Seen w/nn injury or transection

• Commonly manifested by the confusion of objects with their purposes
• Ideational apraxia - Person no longer gets "idea" of how to do something; Cannot perform motor task automatically or on command
• Ideomotor apraxia - Person cannot do a task on command, but can do it spontaneously

• Seen w/CP
• Damage to basal ganglia

Associated w/complex regional pain syndrome

Seen w/Hungtington's disease

• Seen w/cerebellar dysfunction
• Interventions - PNF dynamic reversals; weighted cuffs can help slow movement
• CONTRA - low resistance, fast speed isokinetic

Seen w/cerebellar disorders

• An acute, painful mononeuropathy caused by varicella zoster virus
• Last - 10 days - 5 weeks
• Inflammation to Posterior root ganglion

T-cells below 200

• Motor ataxia
• Paresis
• Pronounced gait disturbances
• Loss of fine motor coordination
• Peripheral neuropathy w/distal pain & sensory loss (distal but not widespread)

• Cells involved - CD4 (500-1,200), T-lymphocytes
• Early signs - flu-like symptoms w/rash, fever
• Meds - HAART, given when t-cell count is >500
• Test - Western blot test
• Antibodies in blood - 2 wks-6 months

• Frequency - 3-4/wk
• Intensity - 40-60%
• Resistance therex - moderate levels (8-10 times)
• Time - total: 30-60 min/day

• Autoimmune disorder that DEC ACh receptors @ end plate
• Fatigability - Muscular strength worse w/continuing contraction, improved w/rest
• Proximal mm weakness
• Chewing & swallowing problems
• Eye mm weakness, Diplopia, Ptosis
• Functionally similar to myopathies - diff w/climbing stairs/ rising from chair, lifting
• Tx: energy conservation, mild stretching, MORNING appt

• Myasthenia gravis w/respir­atory failure
• Medical emergency
• INC weakness
• Difficulty talking, swallowing, breathing

• Bizzare breathing pattern
• Period of apnea (10-60 sec) --> gradually INC then DEC depth & frequency of respirations

• Pain in limb following amputation of that limb
• Described as cramped &jQuery110103762150553088863_1483380703103?

• Pain maintained by SNS d/t traumatic injury
• Pain disproportionate to injury
• Causalgia (burning pain)
• Hypersensitivity to light touch
• Coldness
• Sweating
• CPRS II involves nn injury
• Tx - CONTRAINDICATED in early - PROM; DON’T tolerate stretching; do AROM to DEC contractures

• Nonarticular rheumatic disease of unknown origin
• Onset - 14-68, Females>males
• Axial PAIN & at least 11 of 18 tender point spots
• Symptoms > 3 months
• Sleeping disorders + Restless leg syndrome

• Occiput
• Low cervical area
• Supraspinatus
• 2nd rib
• Lateral epicondyle
• Glutes
• Greater trochanter
• Knee

• Aquatic therapy
• 3-5 min exercise sessions
• Gentle stretching
• Contraindication - Weight lifting

• Similar to fibromyalgia w/hallmark feature of FATIGUE vs pain as in fibromyalgia
• Frequent sore throat
• Tender lymph nodes
• MM pain
• Sleep that isn’t refreshing
• Multijoint pain w/o swelling
• Short-term memory impairments
• INITIAL PT - 5 MIN (progress to 40-60 min)

Velocity dependent, w/SLOWING of movement w/faster speeds

• Modified Ashworth Scale (MAS)
• 0 - No INC in tone
• 1 - Slight INC in tone w/Min resistance @ end range
• 1+ - Slight INC w/min resistance through <1/2 ROM
• 2 - Marked INC through most ROM; Part easily moved
• 3 - Considerable INC; PROM difficult; Rigid in flexion/extension

• Assesess mental status
• 11-questions - orientation, registration, attention & calculation, recall, & language
• Maximum score = 30
• Mild - 21-24

• Moderate 16-20

• Severe <15

• Asymmetrical mm weakness/atrophy/fatigue
• Excessive fatigue & DEC endurance - not related to activity levels & doesn't recover w/usual rest
• Cold intolerance, Sleep disturbances
• PT - Low intensity (NOT to fatigue); STOP w/pain/weakness

• ACUTE LMN polyneuropathy
• Sensory (stocking/glove) + Motor (distal to proximal)
• DTR - DEC/absent
• Peaks @ 4 wks
• Recovery - up to 1 yr w/mild weakness persisting
• Test - CFS w/findings of INC protein + little /no lymphocytes
• Cardiac - Tachycardia; Abnormalities in cardiac rhythm; BP changes

• UMN + LMN + Cranial nn
• Also known as Lou Gehrig's disease
• Onset - over 50; Males 2:1
• Motor impairment (ASYMETRICAL)/ SENSORY INTACT
• Weakness appears in hands first - CLAW hand
• UMN signs - regular + Hoffman's sign + Bulbar sign
• PT - low level resistance (Swimming, Walking, Stationary bike @ submax levels); PNF w/o resistance
• PT Contraindication — only 1/2 motor units are left

• Weakness in mms of speech, chewing, swallowing
• Tongue fasciculations

• Gradual asymmetrical distal to proximal weakness > in extensor mms
• MM atrophy
• Cramping
• Fasciculations
• Claw hand

Normal, similar to locked-in syndrome in CVA

• Inflammatory response of facial nn (CN VII)
• One-sided paralysis of mms of facial expression
• Sensory - NORMAL
• S/S - inability to close eye; mouth droops; loss of control of salivation; DEC taste to anterior 2/3 of tongue

• ALS
• Postpolio
• Bell’s palsy

Myasthenia Gravis

Guillain-Barre

• Activate postural extensors of neck, trunk & proximal jts
• Soothing effect for sympathetic responses

Fast spinning

MEDICAL EMERGENCY when unresponsive

• EMRGENCY
• Vomiting
• Irritable
• Lethargic

• Weakness
• Unsteady gait
• DEC proprioception

• Neurapraxia (Class 1)
• Axonotmesis (Class 2)
• Neurotmesis (Class 3)

• LOCALIZED injury to nn causes a transient loss of function
• Recovery - Rapid & complete (4-6 wks)
• Ex: P injuries, Conduc­tion block ischemia

• REVERSIBLE injury to axon of nn 
• Loss of function & wallerian degeneration distal to lesion 
• Spontaneous recovery - NN regeneration distal to site @ 1mm/day
• Surgery may be required
• Ex: Traction, Compression, Crush injury

• IRREVERSIBLE complete transaction of nn trunk w/complete loss of function
• Flaccid paralysis, wasting of mm, total loss of sensation supplied by nn
• Surgery needed - proximal 1st - 1mm/day
• First to recover is SENSORY

• Sensory - intact
• Motor - Weakness, Atrophy, Fasciculations
• DTR - DEC
• Ex: ALS, Poliomyelitis

• Sensory - Intact
• Motor - Fatigue > weakness
• DTR - Normal
• Ex: Myasthenia Gravis

• Abnormal growth of cells
• D/t Vasculitis, AIDs, Amyloidosis

• Symmetrical involvement
• 2/t pathology, not trauma
• Distal segments earlier & more involved than proximal

• Myopathy - proximal weakness
• Neuropathy - distal weakness

• Involvement of multiple, random nns (Ex: 1 UE, 1 LE, etc.) - NO PATTERN
• D/t VASCULAR

• Position in side-lying/turn head to side - to avoid aspiration
• Check for an open airway
• Call emergency services
• Wait for tonic/clonic activity to subside before starting artificial ventilation

• INC tone
• Hyperreflexia
• MM spasms
• (+) Babinski
• Dyssynergia
• Timing deficits

• DEC tone (hypotonia) or flaccidity
• Hyporeflexia or absent reflexes
• MM weakness
• Fasciculations
• Neurogenic atrophy

Involuntary oscillatory movements - occur during VOLUNTARY movement

• Below level of L1-L2
• Purpose - Withdraw CSF for Chemical analysis + Measure intracranial P

• Complications:
• Severe HA caused by CSF leakage (relieved by lying down)
• Infection
• Epidural hematoma
• Uncal herniation

• Leakage of CSF
• Severe dehydration

• DEC consciousness
• Slowing of pulse
• Cheyne-stokes respirations

CNII (papilledema) & CNIII (dilation of pupils)

• CT (computed tomography)
• Detects cerebral edema within 30 min after occlusion & infarction within 2-6 hrs

MRA = Magnetic resonance angiography

X-rays of spine after injection of air or dye into subarachnoid space

Delineates abnormalities impinging on subarachnoid space

Complication - meningeal irritation from dye

X-rays of skull after injection of air into lateral ventricles

• Useful for:
• Localizing tumors
• INC intracranial P

• Vibration
• Acceleration

Jt compression

Jt stretching

Pain