This summary is to help physiotherapy students prepare for Neuro OSPE and/or placements. The summary consist of a pathology table which explains the pathophysiology, symptoms, risk factors and MDT involvement. The summary also includes a functional problem table, where it explains what treatment is...
Pathology Symptoms/ clinical features Pathophysiology (relevant to anatomy and Risk Factors/ MDT Surgical/medical
physiology of cardio respiratory symptom) Epidemiology Intervention
Multiple Sclerosis - Optic neuritis – demyelination Autoimmune component: OT - Initial corticosteroids
of the optic nerve. - Some foreign antigen (either a bacteria, viral or - Gender (more - See and explore
A common idiopathic chemicals) activates T cells (immune cells) and common in possibilities for - Immune Modulating
inflammatory demyelinating - spasticity trigger them to become active. woman patients to go back to Treatments (IMT/DMD)
disease of the central nervous work to modify the disease,
system (brain and spinal cord). - motor weakness - The T cells accumulate and then directly attach - Average age in - Regain functions for reduce frequency/
to and attack those cells that bear antigenic diagnosis (20- hobbies severity of attacks
Secondary Complications: - sensory changes (paresthesia) material. 40, peak at 30) (Beta interferon for
Contractures Social Worker relapsing/remitting &
Pressure ulcers - Autonomic dysfunction - The T cells then become reactive to myelin - Ethnicity – - provide financial secondary progressive
Depression (molecular mimicry) and the T cells that express linked to support, family MS)
adhesion molecules will attach onto the receptors geography support, caregivers
- Sexual dysfunction
Diagnosis: of endothelial cells and triggers this autoimmune North America - advise on benefits - Treatment of
Early stage, often response. and Europe and transport symptoms:
- Cerebellar symptoms –
missed or 110/100,000 Pain/Spasticity
Nystagmus, dysarthria, ataxia,
misdiagnosed Inflammatory component: Eastern Asia & Psychologist (Baclofen or
tremor
Tests: - Inflammation then occurs after the autoimmune Sub Saharan - prevent secondary Gabapentin)
MRI response Africa complications of Continence
- Fatigue
Lumbar puncture 2/100,000 depression, Depression
Evoked potentials - leading to the blood-brain barrier becoming - provide counselling Fatigue
- Pain -strategies to cope
(measures speed of permeable. - Worldwide :
nerve transmission >2.3 million on anxiety - Oral
reduced speed - Respiratory Dysfunction: - UK : 130,000 Methylprednisolone for
- Leading to infiltration of macrophages, T-cells,
indicates lesions) muscle weakness people have exacerbations
lymphocytes into central nervous system,
bulbar dysfunction MS
commonly be at the choroid plexus (just in front
cough impairments
of the cerebellum) and at the fourth ventricle
sleep disordered
(sitting in front of the cerebellum).
breathing – central
Classifications: sleep apnea
- Relapse remitting MS (RRMS) – - When they've infiltrated the central nervous
80 – 85 % system, we get further inflammatory response,
- Heat intolerance +/- Uhthoff
Phenomenon causing damage to the brain (cerebellum etc.)
- Primary progressive (PPMS) – There is also damage to astrogliosis and
10% oligodendrocytes leading to unable to properly
- Subjective cognitive
produce myelin.
difficulties:
- Secondary progressive (SPMS) attention span,
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