Slowly increase the level of exercise and activity Overexertion can lead to relapse › Can take 2 years for maximal improvement! 80-90% have little residual deficit
Huntington’s Disease (HD) Genetically transmitted progressive degenerative neurologic disorder › Autosomal dominant, 50% chance child will inherit › If child doesn’t inherit, the gene is not passed on Characterized by abnormal movements › Chorea : jerky, involuntary muscle movements › Voluntary movement deteriorates until patient no longer capable of independent movement Decline in intellectual capacity and emotional disturbances Usually diagnosed in 40s – 50s No known treatment
Myasthenia Gravis (MG) literally means grave muscle weakness Etiology and pathophysiology: › Chronic disorder manifested by fatigue and exhaustion Skeletal, respiratory, muscles and muscles enervated by cranial nerves affected › Most cases caused by auto-immune disease › Aggravated by activity › Relieved by rest › Autoimmune disease
Myasthenia Gravis (MG) Signs and symptoms: › Severe muscle weakness that improves with rest › Ocular myasthenia usually occurs first demonstrated by: Diplopia : double vision Ptosis : Drooping upper eyelid = early sign › Does not affect the level of consciousness Diagnosis: › History and physical examination › Tensilon test : marked increase in muscle strength 1 minute after second injection
Myasthenia Gravis (MG) Treatment: › May manage by dealing with specific symptoms › Plasmapheresis Removes circulating antibodies from pt’s blood › Anticholinesterase therapy › Delicate balance between too much and too little acetylcholine at the neuromuscular junction › Thymus gland removal › IV immune globulin (IVIG)
Nursing Management of Myasthenia Gravis Assess fatigue, affected areas of body, and severity. Determine patient’s knowledge and coping abilities. Assess muscle strength of the face, swallowing, speech volume and clarity, and cough and gag reflexes. Check strength of the shoulder muscles and of the limbs.
Restless Leg Syndrome (RLS) Affects 15% of population, more women Uncontrollable urge to move legs, especially in evening Unknown cause, but leaning toward genetic Primary : Occurring before the age of 40 Secondary : Occurring after the age of 40 Treatment › 3 medications approved: Mirapex and requip are dopamine agonists and Horizant which is an anti-seizure medication
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- Fall '19
- Neurology, Myasthenia gravis