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Degenerative Neurologic Disorders

Degenerative neurological disorders like Parkinson's disease are progressive conditions characterized by nerve damage that affect movement, coordination, speech, and other functions. Parkinson's disease specifically results from the death of dopamine-producing neurons in the brain and causes symptoms like tremors, rigidity, slow movement, and impaired balance. While the exact causes are unknown, genetic and environmental factors may play a role. Current treatment focuses on managing symptoms through medications and potentially surgery, but there is no cure for the underlying neurodegeneration.

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295 views29 pages

Degenerative Neurologic Disorders

Degenerative neurological disorders like Parkinson's disease are progressive conditions characterized by nerve damage that affect movement, coordination, speech, and other functions. Parkinson's disease specifically results from the death of dopamine-producing neurons in the brain and causes symptoms like tremors, rigidity, slow movement, and impaired balance. While the exact causes are unknown, genetic and environmental factors may play a role. Current treatment focuses on managing symptoms through medications and potentially surgery, but there is no cure for the underlying neurodegeneration.

Uploaded by

VIDYA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd

 Degenerative neurologic disorders leads to nerve damage

 Progressive disorders
 These diseases affects mainly
• Balance

• Coordination

• Movement

• Speech

• Respiration

• Heart functions
 More than 200 degenerative disorders
 The exact cause is not known
 Mostly genetic transmission
 It can’t be completely cured
 Treatment focuses on symptoms and to maintain
the functional level
 Patients have problems related to safety, self
care, mobility and coping
 Degenerative neurological diseases
include
• Alzheimer's disease
• Amyotrophic lateral sclerosis
• Friedreich's ataxia
• Huntington's disease
• Lewy body disease
• Parkinson's disease
• Spinal muscular atrophy
 Basically affects movement and balance.
 It is a form of parkinsonism
 PD is more common in men [3:2]
 Incidence of PD in India is
• 1% of adult above 65years

• 5% of adults above 85 years

• More than 1 million cases per year

• 7 million people living in India with PD.


Parkinson’s disease [PD] is a chronic,
progressive, neuro-degenerative disorder
characterized by slowness in the initiation
and execution of movement [bradykinesia],
increased muscle tone [rigidity], tremor at
rest, and gait disturbance.
 Idiopathic

 Genetic [10-15% of reported PD have


family history]
 Environmental triggers [exposure to toxins]
 Male gender
 Age above 65 years
 Lewy bodies
• These are clumps of protein found in the brain of

patients with PD.


• Results in abnormal functioning of brain

• Why it is formed is not known so far.


 It has a gradual onset and slow progress
 The classical symptoms are [TRAP]
• Tremors

• Rigidity

• Akinesia or Bradykinesia

• Postural instability
 Uncontrolled sweating
 Orthostatic hypotension
 Depression, anxiety, dementia
 Delirium, hallucination
 Insomnia
 Micrographia [small handwriting]
 Dysphonia [altered voice production]
 Side effects of medication
 History collection
 Physical examination
 Neurological examination
 Movement and coordination test
 Genetic testing
 MRI
 PET and SPECT scan
 Positive response to levodopa
 Medical management
• It is the mainstay treatment

• Goals of treatment
 No complete cure
 Symptom control
 Maintain functional independence
 Treatment plan is individualized
• Anti parkinson’s medication action
 Increase striatal dopaminergic activity
 Reduce the effect of acetylcholine
 Acting on the neurotransmitter pathway

• Anti parkinson’s drug


 Levodopa [convert as dopamine in basal ganglia]
 Levodopa + Carbidopa [prevent metabolism of
levodopa before reaching brain].
 Examples are ropinirole, pramipexole, rotigotine.
 Can be monotherapy in early disease; need l-dopa in
mid to late disease
 Can add to l-dopa to reduce OFF time
 Frequent side effects! Nausea, sleep attacks,
hypotension, compulsive behaviors, LE edema
 More prone than l-dopa to causing hallucinations and
confusion. Caution in older or demented patients!
 Amantadine and apomorphine
 It blocks reuptake of dopamine into
presynaptic neurons
 Blocks cholinergic receptors
 Helps in balancing cholinergic and
dopaminergic activity.
 Eg: trihexyphenidyl
 It
has anticholinergic effect
 Eg: diphenhydramine
 It
blocks the breakdown of dopamine
 Eg: selegiline
 To relieve symptoms of PD.
 Patients with unresponsiveness to
medical management.
 Surgeries includes
• Deep brain stimulation [DBS]
• Ablation [destruction]
• Transplantation
 DBS
• Most common surgery for PD
• Placing an electrode in in the thalamus, globus
pallidus or sub thalamic nucleus.
• Electrode connected to a generator placed in
the upper chest.
• It delivers specific amount of current to the area
of electrode.
• It can be adjusted with patients symptoms
• It is reversible
 Diet is an important concern for PD patients.
 Malnutrition and constipation is major concern.
 Easily chewable food
 Include roughage and fruits
 Six small meals per day
 Provide ample time for eating
 Decrease protein intake [impair levodopa
absorption]
 Supplement Vitamin B6 and multivitamin
 Nursing assessment
• Subjective data
 Past health history
 Family history
 Medications
 Objective data
 Physical examination
 Neurological examination
 Musculoskeletal examination
 Impaired physical mobility related to
rigidity,

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