´Dysphagia may result in malnutrition and aspiration
´General debilitation may lead to pneumonia, UTIs, and skin breakdown
´Orthostatic hypotension may occur
,´Falls and injuries
´Sleep disorders are common
Parkinson's Diagnosis
´No specific test
´Testing may be completed by prescription of medication and improvement of symptoms
Diagnosis based solely on history and clinical features: When at least 2 of the 3
characteristics of the classic triad are present
Mirapex, Requip, Neupro
Dopamine agonist; mimics dopamine effects not as affective as levodopa
Side effects: orthostatic hypotension, hallucinations, sleepiness, drowsiness
Levodopa
Long-term use may lead to dyskinesia; Improves motor function
Levadopa/Carbidopa (Sinemet)
Long term use leads to dyskinesia
Parkinson's interventions
PT/OT
Yoga
Dietary Support
Psychosocial support
Surgical Management
Stereotactic pallidotomy: Opening into the pallidum within corpus striatum to perform
electrical stimulation
´Thalamotomy: Opening in thalmus to improve brain function
´Deep brain stimulation: Electrodes placed in brain (pulse generator) for electrical
current to reduce involuntary movement
´Fetal tissue transplantation: Experimental fetal substantia nigra tissue transplanted in
candidates nucleus of the brain to slow movements
, If a Parkinson's patient gets "stuck"
-March in place (stepping over line)
-2 steps back, 1 step forward
-rocking back and forth
Huntington's disease
´Hereditary disease that is transmitted by an autosomal-dominant trait at conception (50
percent chance of passing to offspring)
´Gradual decline over 15 years of the cognitive and neuromuscular symptoms
´Characterized by dementia and choreiform movements (rapid, jerky movements)
´Chronic, terminal
´Alterations in amounts of dopamine, gamma-aminobutyric acid (GABA), and glutamate
from the basal ganglia
´30-50 years of age
´Equal in men and women
Juvenile Huntington's
under 20 years old
Huntington's diagnosis and treatment
´Made on basis of family history of disease and clinical assessment
´Safety Measures
´Supportive care
´Behavior management
´ADL assistance
´No known cure at this time
-PT/OT for balance
Multiple Sclerosis (MS)
destruction of the myelin sheath on neurons in the CNS and its replacement by plaques
of sclerotic (hard) tissue
´Diffuse, random or patchy plaques in white matter of the CNS = Definitive finding
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