Neuro Pathologies

Question 1

Guillain-Barre Syndrome (GBS)

Answer 1

Male dominant (2x more than females)
Progressive, sometimes has bouts of getting better
Kids and adults
Peripheral neuropathic disease

S&S:

• Symmetrical motor weakness – distal to proximal (UE and LE)
  
  • -> Rapid development
  • -> Areflexia of distal tendon response
• Mild sensory – paresthesia, hypethesia
• Autonomic dysfxn
  
  • -> tachycardia, arrhythmias
  • -> vasomotor sx
• Absence of fever –> hx of recent illness/flu sx
• Lab results:
  
  • -> elevation CSF protein
• ECG conduction testing = abnormal
• Recovery begins 2-4 wks after sx plateau

Question 2

Muscular Dystrophy (MD)

Answer 2

Male dominant, young (onset ~2-3 y.o.) (X-chrom linked)
Progressive –> w/c bound by 10-11 y.o.
Death by late teens, early adulthood
–> sig cardiomyopathy – 20-30% deaths d/t cardiac disease

S&S:

• Symmetrical mm weakness (proximal to distal)
• Pseudohypertrophy of calves by age 5
• Wide-base gait
• Gowers maneuver –> gets up from floor using arms to crawl up his legs
• Physical:
  
  • -> extreme lumbar lordosis
  • -> scap retraction
  • -> knee hyperextension
  • -> mild ankle equinus - PF contractures
• Elevated serum CK levels in female carriers

Question 3

Amyotrophic Lateral Sclerosis (ALS)

Answer 3

“Lou Gehrig disease”
Males > females, mean onset 57 y.o. (50-70)
Progressive

• UMN and LMN lesions
• Massive loss - anterior horn cells and motor cranial n nuclei in lower brain stem –> amytrophy (atrophy, weakness)
• Demyelination and gliosis of:
  
  • -> corticospinal tract
  • -> corticobulbar tract

TDP-43 proteinopathy?

Tx = Riluzole –> only one approved rn

- -> concentric exercises
- -> mod resistance
- -> focus mm that have at least antigravity strength

“Be active but don’t overdo it” –> need to encourage muscle contraction every day without pushing pt over limit –> will lose strength if contraction daily is < 20% MVC

Question 4

Multiple Sclerosis (MS)

Answer 4

Females