THEORIE REVALIDATIE
Inhoud
Cerebellair letsel........................................................................................................................................................3
Hoorcollege: cerebellaire stoornissen na CNA..........................................................................................................3
Cerebellum................................................................................................................................................................6
Cerebellaire stoornissen............................................................................................................................................7
Lichamelijk onderzoek...........................................................................................................................................8
Revisiting the symptoms and signs of cerebellar syndrome.....................................................................................9
Casus........................................................................................................................................................................13
Praktijk.....................................................................................................................................................................14
Casus........................................................................................................................................................................16
Dementie.................................................................................................................................................................17
Boek Klinische neurologie.......................................................................................................................................17
Ziekte van Alzheimer...........................................................................................................................................17
Vasculaire dementie............................................................................................................................................19
Fronto-temporale dementie...............................................................................................................................20
Lewy Body-dementie...........................................................................................................................................20
Ziekte van Creutzfeldt-Jakob...............................................................................................................................21
Dementie bij aids.................................................................................................................................................21
Dementia paralytica............................................................................................................................................21
Symptomen.............................................................................................................................................................22
Fasen van dementie en benaderingswijze..............................................................................................................23
Geriatrie in de fysiotherapie en kinesitherapie......................................................................................................24
WHO guideline: Risk reduction of cignitieve decline and dementia.......................................................................28
Rehabilitation for Individuals with Dementia.........................................................................................................29
Multiple Sclerose.....................................................................................................................................................33
Hoorcollege 1: MS...................................................................................................................................................33
Oorzaak van MS...................................................................................................................................................34
Prevalentie en incidentie.....................................................................................................................................34
Diagnose..............................................................................................................................................................34
Vormen van MS...................................................................................................................................................34
Symptomen.........................................................................................................................................................35
Symptomen en hersengebieden.........................................................................................................................36
Exacerbatie..........................................................................................................................................................36
Boek: klinische neurologie......................................................................................................................................36
, Klinische verschijnselen.......................................................................................................................................37
Invaliditeit............................................................................................................................................................38
Beloop.................................................................................................................................................................38
Genetische exogene factoren.............................................................................................................................39
Diagnose..............................................................................................................................................................39
Therapie...............................................................................................................................................................39
Richtlijn (Federatie van medisch specialisten, 2012)..............................................................................................41
Anamnese............................................................................................................................................................41
Diagnostiek..........................................................................................................................................................41
Behandeling.........................................................................................................................................................43
Rehabilitation for people with MS (Amatya, Khan & Galea, 2019)........................................................................44
TherapiE casus.........................................................................................................................................................46
Praktijk.....................................................................................................................................................................48
Parkinson.................................................................................................................................................................49
Hoorcollege: Neuro anatomie Parkinson................................................................................................................49
Hoorcollege: Stoornissen Parkinson.......................................................................................................................51
Typische parkinsonisme..........................................................................................................................................53
Motorische symptomen..................................................................................................................................53
Niet-motorische symptomen..........................................................................................................................54
Prevalentie......................................................................................................................................................55
Pathofysiologie................................................................................................................................................55
Oorzaak............................................................................................................................................................56
Klinische diagnose...........................................................................................................................................56
Behandeling.....................................................................................................................................................56
Multidisciplinaire behandeling........................................................................................................................57
Beloop en prognose........................................................................................................................................57
Atypische Parkinsonisme.........................................................................................................................................57
KNFG richlijn parkinson...........................................................................................................................................58
Screening.........................................................................................................................................................58
Anamnese........................................................................................................................................................59
Lichamelijk onderzoek.....................................................................................................................................59
Therapie...........................................................................................................................................................60
Motorisch leren...............................................................................................................................................64
The many facets of motor learning and their relevance for Parkinson’s disease...................................................65
,CEREBELLAIR LETSEL
HOORCOLLEGE: CEREBELLAIRE STOORNISSEN NA CNA
Functies
1. Motoriek: fijnsturing en correctie d.m.v. feedback en feedforward en betrokken bij beginfase van
aanleren nieuwe vaardigheden
2. Cognitie: verwerken ruimtelijke en auditieve informatie
3. Emotie/gedrag: invloed of affectieve functies
Functionele anatomie
Vermis: connectie met gebieden van emotie en motivatie, hypothalamus en amygdala en
beloningssysteem
Spino cerebellum: info uit het ruggenmerg, stuurt bewegingen bij (externe feedback),
bewegingscoördinatie en tonus
Cerebro cerebellum: verbonden met de cortex, geeft informatie hieraan voor motoriek,
bewegingsplanning, procedurele verheugen (vermogen om te weten hoe bepaalde handelingen
verricht moeten worden)
Vestibulocerebellum: oogbewegingen, houding en balans
Vascularisatie
Cirkel van Willis = ACP, ACA, ACM, ACOM, a. carotis interna, a. communicans posterior
ACM: grootste deel van cortex, vaakst betrokken bij CVA (25%)
ACA en ACP: voorzijde van het brein
A. Basilaris en a. vertebralis: cerebellum
A. vertebralis PICA
A. basilaris SCA en AICA
Motorische symptomen
Ataxie: ongecontroleerd bewegingen zonder krachtsvermindering
- Dysmetrie
- Tremor (intentietremor, titubatie)
- Nystagmus
- Dysatrie
- Dysdiadocokinese
- Gestoorde rebound
- Gangataxie: been verstijft om te compenseren voor coördinatie
probleem
- Rompataxie
Hypotonie
Onbalans
Dysfagie
Oogbewegingsstoornissen (diplopie, trage oogvolgbewegingen, nystagmus)
Gestoorde proprioceptie
Gestoorde perceptie van kracht
Vertigo (draaiduizeligheid)
Duizeligheid
,
Inhoud
Cerebellair letsel........................................................................................................................................................3
Hoorcollege: cerebellaire stoornissen na CNA..........................................................................................................3
Cerebellum................................................................................................................................................................6
Cerebellaire stoornissen............................................................................................................................................7
Lichamelijk onderzoek...........................................................................................................................................8
Revisiting the symptoms and signs of cerebellar syndrome.....................................................................................9
Casus........................................................................................................................................................................13
Praktijk.....................................................................................................................................................................14
Casus........................................................................................................................................................................16
Dementie.................................................................................................................................................................17
Boek Klinische neurologie.......................................................................................................................................17
Ziekte van Alzheimer...........................................................................................................................................17
Vasculaire dementie............................................................................................................................................19
Fronto-temporale dementie...............................................................................................................................20
Lewy Body-dementie...........................................................................................................................................20
Ziekte van Creutzfeldt-Jakob...............................................................................................................................21
Dementie bij aids.................................................................................................................................................21
Dementia paralytica............................................................................................................................................21
Symptomen.............................................................................................................................................................22
Fasen van dementie en benaderingswijze..............................................................................................................23
Geriatrie in de fysiotherapie en kinesitherapie......................................................................................................24
WHO guideline: Risk reduction of cignitieve decline and dementia.......................................................................28
Rehabilitation for Individuals with Dementia.........................................................................................................29
Multiple Sclerose.....................................................................................................................................................33
Hoorcollege 1: MS...................................................................................................................................................33
Oorzaak van MS...................................................................................................................................................34
Prevalentie en incidentie.....................................................................................................................................34
Diagnose..............................................................................................................................................................34
Vormen van MS...................................................................................................................................................34
Symptomen.........................................................................................................................................................35
Symptomen en hersengebieden.........................................................................................................................36
Exacerbatie..........................................................................................................................................................36
Boek: klinische neurologie......................................................................................................................................36
, Klinische verschijnselen.......................................................................................................................................37
Invaliditeit............................................................................................................................................................38
Beloop.................................................................................................................................................................38
Genetische exogene factoren.............................................................................................................................39
Diagnose..............................................................................................................................................................39
Therapie...............................................................................................................................................................39
Richtlijn (Federatie van medisch specialisten, 2012)..............................................................................................41
Anamnese............................................................................................................................................................41
Diagnostiek..........................................................................................................................................................41
Behandeling.........................................................................................................................................................43
Rehabilitation for people with MS (Amatya, Khan & Galea, 2019)........................................................................44
TherapiE casus.........................................................................................................................................................46
Praktijk.....................................................................................................................................................................48
Parkinson.................................................................................................................................................................49
Hoorcollege: Neuro anatomie Parkinson................................................................................................................49
Hoorcollege: Stoornissen Parkinson.......................................................................................................................51
Typische parkinsonisme..........................................................................................................................................53
Motorische symptomen..................................................................................................................................53
Niet-motorische symptomen..........................................................................................................................54
Prevalentie......................................................................................................................................................55
Pathofysiologie................................................................................................................................................55
Oorzaak............................................................................................................................................................56
Klinische diagnose...........................................................................................................................................56
Behandeling.....................................................................................................................................................56
Multidisciplinaire behandeling........................................................................................................................57
Beloop en prognose........................................................................................................................................57
Atypische Parkinsonisme.........................................................................................................................................57
KNFG richlijn parkinson...........................................................................................................................................58
Screening.........................................................................................................................................................58
Anamnese........................................................................................................................................................59
Lichamelijk onderzoek.....................................................................................................................................59
Therapie...........................................................................................................................................................60
Motorisch leren...............................................................................................................................................64
The many facets of motor learning and their relevance for Parkinson’s disease...................................................65
,CEREBELLAIR LETSEL
HOORCOLLEGE: CEREBELLAIRE STOORNISSEN NA CNA
Functies
1. Motoriek: fijnsturing en correctie d.m.v. feedback en feedforward en betrokken bij beginfase van
aanleren nieuwe vaardigheden
2. Cognitie: verwerken ruimtelijke en auditieve informatie
3. Emotie/gedrag: invloed of affectieve functies
Functionele anatomie
Vermis: connectie met gebieden van emotie en motivatie, hypothalamus en amygdala en
beloningssysteem
Spino cerebellum: info uit het ruggenmerg, stuurt bewegingen bij (externe feedback),
bewegingscoördinatie en tonus
Cerebro cerebellum: verbonden met de cortex, geeft informatie hieraan voor motoriek,
bewegingsplanning, procedurele verheugen (vermogen om te weten hoe bepaalde handelingen
verricht moeten worden)
Vestibulocerebellum: oogbewegingen, houding en balans
Vascularisatie
Cirkel van Willis = ACP, ACA, ACM, ACOM, a. carotis interna, a. communicans posterior
ACM: grootste deel van cortex, vaakst betrokken bij CVA (25%)
ACA en ACP: voorzijde van het brein
A. Basilaris en a. vertebralis: cerebellum
A. vertebralis PICA
A. basilaris SCA en AICA
Motorische symptomen
Ataxie: ongecontroleerd bewegingen zonder krachtsvermindering
- Dysmetrie
- Tremor (intentietremor, titubatie)
- Nystagmus
- Dysatrie
- Dysdiadocokinese
- Gestoorde rebound
- Gangataxie: been verstijft om te compenseren voor coördinatie
probleem
- Rompataxie
Hypotonie
Onbalans
Dysfagie
Oogbewegingsstoornissen (diplopie, trage oogvolgbewegingen, nystagmus)
Gestoorde proprioceptie
Gestoorde perceptie van kracht
Vertigo (draaiduizeligheid)
Duizeligheid
,
