Neuro Notes
Multiple sclerosis: autoimmune disorder where plaque develops
in white matter of the CNS. Age of onset is typically 20 – 40
years of age, more common in women. Characterized by
periods of relapsing and remitting.
Triggers: temperature extremes, stress/injury, pregnancy,
fatigue
Symptoms:
o eye problems (diplopia/nystagmus)
o muscle spasticity and weakness
o bowel/bladder dysfunction
o cognitive changes
o ear problems (tinnitus/hearing issues)
o dysphagia, fatigue
Dx: No official test, but lumbar puncture can be done.
(increased protein in CSF)
Teaching: avoid triggers (stress. Fatigue, illness, extreme
temp changes)
meds:
o interferon – teratogenic (NO pregos)
o immunosuppressive agents – cyclosporine
o corticosteroids – (prednisone, methylprednisolone)-
reduce edema and inflammation, SE- high BS, weight
gain, thin skin, immunosuppression,
o muscle relaxants – baclofen
o anti-seizure – phenytoin
, Stroke / cerebrovascular accident (CVA): ischemia to part of
the brain.
3 types of strokes:
o Hemorrhagic: ruptured artery/ aneurysm
o Thrombotic: blood clot in cerebral artery
o Embolic: blood clot from other part of body that
travels to cerebral artery.
Risk factors: smoking, HTN, DM, hyperlipidemia, A. fib
Symptoms: visual disturbances, dizziness, slurred speech,
weak extremity
LEFT hemisphere: language skills, math skills, analytical
thinking. Left = Language
o Symptoms: expressive aphasia (inability to speak and
understand language), reading and writing difficulty,
right-sided hemiparesis (weakness) or hemiplegia
(paralysis)
RIGHT hemisphere: visual and spatial awareness
o Symptoms: overestimation of abilities, poor judgment
and impulse control, one-sided neglect syndrome
(ignore L side of body), left-sided hemiparesis or
hemiplegia. Right = Reckless (poor judgement)
Nursing care:
o Monitor patient’s BP. (SBP > 180 or DBP > 110
can indicate an ischemic stroke)
o Assess swallowing and gag reflex before allowing
patient to eat. Thicken liquids if needed. Teach
patient to swallow with head and neck flexed
forward.
Multiple sclerosis: autoimmune disorder where plaque develops
in white matter of the CNS. Age of onset is typically 20 – 40
years of age, more common in women. Characterized by
periods of relapsing and remitting.
Triggers: temperature extremes, stress/injury, pregnancy,
fatigue
Symptoms:
o eye problems (diplopia/nystagmus)
o muscle spasticity and weakness
o bowel/bladder dysfunction
o cognitive changes
o ear problems (tinnitus/hearing issues)
o dysphagia, fatigue
Dx: No official test, but lumbar puncture can be done.
(increased protein in CSF)
Teaching: avoid triggers (stress. Fatigue, illness, extreme
temp changes)
meds:
o interferon – teratogenic (NO pregos)
o immunosuppressive agents – cyclosporine
o corticosteroids – (prednisone, methylprednisolone)-
reduce edema and inflammation, SE- high BS, weight
gain, thin skin, immunosuppression,
o muscle relaxants – baclofen
o anti-seizure – phenytoin
, Stroke / cerebrovascular accident (CVA): ischemia to part of
the brain.
3 types of strokes:
o Hemorrhagic: ruptured artery/ aneurysm
o Thrombotic: blood clot in cerebral artery
o Embolic: blood clot from other part of body that
travels to cerebral artery.
Risk factors: smoking, HTN, DM, hyperlipidemia, A. fib
Symptoms: visual disturbances, dizziness, slurred speech,
weak extremity
LEFT hemisphere: language skills, math skills, analytical
thinking. Left = Language
o Symptoms: expressive aphasia (inability to speak and
understand language), reading and writing difficulty,
right-sided hemiparesis (weakness) or hemiplegia
(paralysis)
RIGHT hemisphere: visual and spatial awareness
o Symptoms: overestimation of abilities, poor judgment
and impulse control, one-sided neglect syndrome
(ignore L side of body), left-sided hemiparesis or
hemiplegia. Right = Reckless (poor judgement)
Nursing care:
o Monitor patient’s BP. (SBP > 180 or DBP > 110
can indicate an ischemic stroke)
o Assess swallowing and gag reflex before allowing
patient to eat. Thicken liquids if needed. Teach
patient to swallow with head and neck flexed
forward.
