PERIPHERAL NERVOUS SYSTEM DISORDERS WITH ACCURATE
QUESTIONS AND ANSWERS
ALS CM - -Fatigue
Muscle atrophy
Weakness
Tongue atrophy
Dysphagia
Weakness of hands and arms
Progression:
Muscle atrophy
Quadriplegia
Respiratory muscles involved —-> death
-ALS management - -1. No cure
2. Goals of Treatment:
--Slow the progression of symptoms
--Prevent complications
--Promote comfort / independence
Edaravone: drug that slows progression
-amyotrophic lateral sclerosis (ALS) patho - -Motor neurons in the brain stem and spinal cord gradually
degenerate. Electrical and chemical messages originating in the brain do not reach the muscles to
activate them. Lou Gehrig's disease.
-Bell's palsy CM - -Droopy eye
Twitching
Droopy corner of mouth
Not able to move one side of face
Pain behind ear or face
Paralysis
Face is mask like and sags
Taste impaired
Tearing of eye on affected side
-Bell's palsy NC - -Facial sling
Instruct pt to grimace, whistle, wrinkle brow, force eyes closed QID for 5 minute
Warm, moist heat for pain
Gentle massage
Cover eye at night
Eye ointment
Close the eye manually before sleep
Wear wraparound sunglasses to decrease evaporation
, Chew on unaffected side
Soft foods
Good oral hygiene
-Bell's palsy patho - -Acute paralysis of CN VII
-Common sleep disturbances seen in PD - -Difficulty initiating and maintaining sleep
Nightmares
Sleepiness and sleep attacks
Restless leg syndrome
-GBS CM
How does it impact vital signs - -Progressive weakness —-> Landry ascending paralysis (starts at feet and
moves up bilaterally)
Muscle tenderness
Paresthesias
Areflexia
Problems with
Respiration
Talking
Swallowing
Bowel and bladder fxn
Impacts BP, HR, RR
-Guillain barre syndrome
Is is acute or chronic - -It is an acute inflammatory peripheral neuropathy that causes autoimmune
mediated demyelination of peripheral nerves
-How does GBS impact swallowing? - -It affects the nerves that controls the muscles for swallowing
-How is a pt with MG assessed - -Assess for severe symptoms like
Ptosis
Diplopia
Bulbar symptoms
Dysphagia
Dysarthria
Dysphonia
Generalized weakness
-How is GBS managed medically - -Tx should be started ASAP bc after 2 weeks it's not effective
Plasmapheresis - IVIg first choice
Glucocorticoids
Help with breathing
Tracheal tube if respiratory failure happens
Passive ROM
Test gag reflex and elevate HOB to prevent aspiration
QUESTIONS AND ANSWERS
ALS CM - -Fatigue
Muscle atrophy
Weakness
Tongue atrophy
Dysphagia
Weakness of hands and arms
Progression:
Muscle atrophy
Quadriplegia
Respiratory muscles involved —-> death
-ALS management - -1. No cure
2. Goals of Treatment:
--Slow the progression of symptoms
--Prevent complications
--Promote comfort / independence
Edaravone: drug that slows progression
-amyotrophic lateral sclerosis (ALS) patho - -Motor neurons in the brain stem and spinal cord gradually
degenerate. Electrical and chemical messages originating in the brain do not reach the muscles to
activate them. Lou Gehrig's disease.
-Bell's palsy CM - -Droopy eye
Twitching
Droopy corner of mouth
Not able to move one side of face
Pain behind ear or face
Paralysis
Face is mask like and sags
Taste impaired
Tearing of eye on affected side
-Bell's palsy NC - -Facial sling
Instruct pt to grimace, whistle, wrinkle brow, force eyes closed QID for 5 minute
Warm, moist heat for pain
Gentle massage
Cover eye at night
Eye ointment
Close the eye manually before sleep
Wear wraparound sunglasses to decrease evaporation
, Chew on unaffected side
Soft foods
Good oral hygiene
-Bell's palsy patho - -Acute paralysis of CN VII
-Common sleep disturbances seen in PD - -Difficulty initiating and maintaining sleep
Nightmares
Sleepiness and sleep attacks
Restless leg syndrome
-GBS CM
How does it impact vital signs - -Progressive weakness —-> Landry ascending paralysis (starts at feet and
moves up bilaterally)
Muscle tenderness
Paresthesias
Areflexia
Problems with
Respiration
Talking
Swallowing
Bowel and bladder fxn
Impacts BP, HR, RR
-Guillain barre syndrome
Is is acute or chronic - -It is an acute inflammatory peripheral neuropathy that causes autoimmune
mediated demyelination of peripheral nerves
-How does GBS impact swallowing? - -It affects the nerves that controls the muscles for swallowing
-How is a pt with MG assessed - -Assess for severe symptoms like
Ptosis
Diplopia
Bulbar symptoms
Dysphagia
Dysarthria
Dysphonia
Generalized weakness
-How is GBS managed medically - -Tx should be started ASAP bc after 2 weeks it's not effective
Plasmapheresis - IVIg first choice
Glucocorticoids
Help with breathing
Tracheal tube if respiratory failure happens
Passive ROM
Test gag reflex and elevate HOB to prevent aspiration
