Neurogenic pathologies

Neurogenic - Differential Gillian-Barre Syndrome Etiology The virulence of C jejuni presence of specific antigens in its capsule that are shared

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Differential Etiology Patholophysiology Pain Weakness Sensory DTRs Prognosis Treatment Gillian-Barre Syndrome The virulence of C jejuni - presence of specific antigens in its capsule that are shared with nerves Ganglioside GM1 cross-react with C jejuni lipopolysaccharide antigens, leading to immunologic damage to the peripheral nervous system + + LEs/UEs ascending, symmetric normal ↓ or loss Recovery with RX medical emergency, constant monitoring and support of vital functions in an ICU. Plasmapheresis, γ-globulin 400 mg/kg IV once/day for 5 d. Amyotrophic Lateral Sclerosis - 5 to 10% of cases are familial (fALS), mostly autosomal dominant; Familial cases develop symptoms earlier than most sporadic cases, but clinical course is comparable. - 25% of fALS cases are caused by mutations in gene encoding copper-zinc superoxide dismutase ( SOD1 ) on chromosome 21. still not understood, numerous genetic associations. Studies suggest that a ↓ capacity to detoxify free radicals may account for neuronal death in ALS, however, this has not been proved, & currently a more accepted idea is that the mutated SOD1 protein triggers an injurious response spasm + UEs/LEs asymmetric normal ↑ or ↓ Death in 2-3 yrs PT early, supportive care: feeding tube, oxygen/ventilation, home health/hospice Botulism Clostridium botulinum anaerobic, gram+ spore forming rod, survives in soil Exotoxins irreversibly bind to presynaptic membranes of neuromuscular & autonomic nerve GI + general normal ↓ or normal Good with RX or Death with resp. arrest hospitalization and close monitoring, heptavalent botulism anti-toxin on wound.
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junctions; block acetylcholine release Cauda Equina Syndrome any lesion that compresses CE nerve roots, they are susceptible to injury due to a poorly developed epineurium. narrowing of the spinal canal compresses nerve roots from lumbar and sacral levels and reduces the motor and sensory signals resulting in paralysis, pain, numbness + + LEs ↓ or loss Bad if chronic Surgical emergency to decompress nerves Cervical Spondylosis trauma, arthritis, DDD/DJD narrowing of disc spaces for nerve root passage compresses peripheral nerves causing pain, numbness, weakness + + UEs Good with RX PT (traction, exercise, ultrasound, electrical stimulation), NSAIDs, Surgery for severe cases Myasthenia Gravis idiopathic t he body’s antibodies are directed toward the acetylcholine receptor (AChR) at the neuromuscular junction (NMJ) of skeletal muscles - + proximal, symmetric normal normal Good with RX plasmapheresis or plasma exchange (PE) surgery- thymectomy especially if a thymoma is present Multiple Sclerosis unknown, autoimmune disorder Myelin specific antibodies are present, demyelinate nerves by stimulating macrophages and microglial cells . These cells scavenge
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This note was uploaded on 02/18/2012 for the course PAS 600 - 601 taught by Professor Garrubba during the Fall '10 term at Chatham University.

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Neurogenic - Differential Gillian-Barre Syndrome Etiology The virulence of C jejuni presence of specific antigens in its capsule that are shared

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