Neuro

Nota:

• progressive neurodegenerative movement disorder....due to decreased dopamine 

1. Meds
   1. Levodopa
   2. benztropine

      Nota:

      • Anticholinergics 
      1. reduce tremor
   3. pramipexole

      Nota:

      • dopamine receptor agonists 
      1. treat tremor, rigidity
   4. amantadine

      Nota:

      • anticholinergic & dopaminergic 
      1. bradykenesia and tremor
2. Exericse
   1. effect on
      1. altered gait/ posture
      2. bradykenesia
      3. reduced stamina
   2. benefits
      1. usual
      2. reduced tremor
      3. improve mobility
   3. usual functional testing
   4. Px
      1. avoid pain
      2. mobility and flex
         1. trunk, head movement
      3. low resistance
      4. walking
         1. large steps
      5. supervision needed
      6. freezing
      7. avoid dual tasking
3. Classification
   1. 1

      Nota:

      • not disabling, unilateral symptoms
   2. 2

      Nota:

      • bilateral involvement without impaired balance. light kyphotic posture, sloweness and speech problems
   3. 3

      Nota:

      • significant slowing of body movement...mod/severe symotoms....postural instability...impaired walking but possible with help...indepdenent ADLs
   4. 4

      Nota:

      • Severe symptoms...rigidity and bradykenesia....partly disabled...cant walk or stand unassisted
   5. 5

      Nota:

      • fully disabled..cant walk stand without help...bidridden/ wheelchair.
4. signs
   1. rigitidy
   2. bradykenesia
   3. tremor
   4. shuffling gait

1. Seizures
   1. Generalised
      1. Absences
      2. Atonic
      3. Tonic
      4. Myoclonic
      5. Tonic-clonic
   2. Partial
      1. Simple
      2. Complex
2. Meds
   1. Luminal
   2. Tegretol
   3. Dilantin
3. Dx
   1. seizure history
   2. neuro exam
   3. EEG
4. Considerations
5. Exercise
   1. Max intenstiy may cause seizure

1. Meds
   1. acute
      1. methylprednisolone

         Nota:

         • anti-inflammatories 
      2. immunosupressants
         1. avonex
         2. rebif
         3. copaxone
   2. long term
      1. azathioprine
      2. mitoxantrone
      3. cyclophosphamide
2. Exericse
   1. benefits
      1. usual
      2. pain relief
      3. mobility
   2. tesing
      1. meds, fatigue, heat
      2. usual functional
   3. usual
      1. mindful of progression
      2. enjoyable
   4. temp
   5. stop during flare up
3. progressive
4. relapse/ remitting
5. signs
   1. fatigue
   2. numbness
   3. muscle weakness/spas
   4. impaired coordination
   5. reduced concentration/mem
   6. heat sensitivity