UMN Neuron Lesions

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UMN Neuron Lesions
2011-02-22 22:04:12
UMN Lesions

UMN Lesions
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  1. Poliomyelitis
    "infantile paralysis"
    • Contagious viral infection affecting the CNS and produces no symptoms in aoubt 95% of the cases.
    • Attacks the anterior horn cells (LMN), but may also stirke the UMN and is considered an upper motor neuron problem, cardiovascular or respiratory systems.
  2. 3 forms of Polio
    • 1. Abortive polio-manifested by mild flu-like symptoms such as a mild upper respiratory infection, diarrhea, fever, sore throat and general feeling of malaise.
    • 2. Non-paralytic polio-associated w/ aseptic meningitis and neurological symptoms such as sensitivity to light and neck stiffness
  3. Post Polio Syndrome
    Approx. 50% of pts. w/ poloio experience an abrupt onset of fisorders 10 or more years after the initial bout w/ polio
  4. Multiple Sclerosis (MS)
    • Chronic, often disabling disease that attacks the CNS.
    • It si a slowly progressive disease characterized by disseminated patches of demyelindation in the brain and spinal cord, resulting in multiple and varied neurological sx's and signs, usually w/ remissions and exacerbations.
    • Affects women more than men
  5. Multiple Sclerosis (MS) is most commonlny a srelapsing and remitting course
    with relapses on the aver of every 1-2 years
  6. 4 disease courses of MS mild, moderate or sever
    • 1. Relapsing-Remitting MS
    • 2. Primary-Progressive MS
    • 3. Secondary-Progressive MS
    • 4. Progressive-Relapsing MS
  7. Relapsing-Remitting MS
    People with this type of MS experience clearly defined attacks fo worsening neurologic function. These attacks--which are called relapses, flare-ups or exacerbations--are followed by partial or complete recovery periods (remissions), during which no disease progression occurs. Approx. 85% of people are initially diagnosed w/ relapsing-remitting MS.
  8. Primary-Progressive MS
    This disease course is characterzied by slowly worsening neurologic function form the beginning--with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor imporovements. Approx. 10% of people are diagnosed w/ primary-progressive MS.
  9. Secondary-Progressive MS
    Following a n initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, w/ or w/o occasional flare-ups, minor recoveries (remissions), or plateaus. Before the disease-modifying medications became available, approx. 50% of people w/ relapsing-remitting MS developed this form of the disease w/i 10 years. Long-term data are not yet available todetermine if treatment significantly delays this transition.
  10. Progressive-Relapsing MS
    In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsesnging neurologic function along the way. They may or may not experience some recovery following these relapses, but the disease continues to progress w/o remissions.
  11. Amyotrophic Lateral Sclerosis
    • AKA "Lou Gehrig's" Disease
    • Rapidly progressing, fatal neurodegenerative disease that damages teh anterior horn cells in the s pinal cord and destorys the pyramdial tracts resulting in muscle atrophy.
    • NO sensory, cognitive, visual or hearing changes occur w/ ALS
  12. 3 forms of ALS
    • Sporadic-the most common form of ALS in the U.S-90 to 95% of all cases
    • Familial-occurring more than once in family lineage accounts for a very small number of cases in the US-5 to 10% of all cases
    • Guamanian-an extremely high incidence of ALS was observed in Guam iin 1950's
  13. Alzheimer's Disease is a
    progressive disorder characterized by "premature, severe, diffuse cerebral atrophy, particularly of the frontal lobes."
  14. Alzheimer's Disease generally affects
    individuals over 45 years of age and accounts for up to 50% of nursing home patients.
  15. Signs and Symptoms of Alzeheimer's Disease
    • Intellectual loss always occurs before motor loss
    • Posture, stance and gait are preserved until mental deterioration is extensive
    • Alzheimer's progrogresses over three stages in a period of 8-10 years
  16. Parkinson's disease (PD) is a
    • Degenerative disorder of the basal ganglia (midbrain) with the substantia nigra most often affected.
    • Degeneration of nerve cells and the neurotransmitting chemical, dopamine.
  17. Progressive nature of this disease (PD) allows it to be classified into 5 stages:
    • Stage I-Unilateral involvement only
    • Stage II-Bilateral involvement only
    • Stage III-Decreased postural and righting reactions; mild to moderate disability
    • Stage IV-Full developed, severe disease; marked disability
    • Stage V-confined to bed or wheelchair
  18. Acute Transverse Myelitis (TM) is a
    • neurological syndrome caused by inflammation on the spinal cord.
    • affects both gray and white matter in one or several adjacent cord segments cuasing local back pain followed by symptoms of spinal cord transaction that develops over a few hours
  19. Acute Transverse Myelitis (TM) Signs and Symptoms
    • Some cases are associated w/ acute encephalomyelitis, syphilis, viral infections or demyelination disease elsewhere in the nervous system, particularly optic neurmyelitis or multiple sclerosis, but usually no cause is found.
    • The deficit is usually severe, with global sensoriomotor paraplegia below the level of the lesion, urinary retention, and loss of bowel control.
    • Thoracic area is most often involved, so that abdominal parlysis also occurs. Eventual improvement is only slight