Blurred vision, diplopia, metal poisoning, stroke, Steroids for exacerbations nystagmus brain tumor Biological modifiers Tinnitus, vertigo Antidepressants Hypalgesia – decreased feeling NO CURE Numbness, tingling, burning Education: Bowel/bladder dysfunction Avoid stress, extreme temps, Late cognitive changes in infections memory, concentration, Exercise & mobility program judgment, depression Amyotrophic Lateral Genetic/family hx Slurred speech - dysarthria EMG: fibrillations ADLs and muscle function Sclerosis (ALS) Men in their 30s Falling CBC outside normal Antispasticity meds No cognitive defects, always Genetic markers Exercise & mobility program motor R/O syphilis, HIV, heavy Periods of rest Upper and lower motor metal poisoning, stroke, Manage swallowing, resp weakness brain tumor Support groups Muscle atrophy Dysphagia, fasciculations Spasticity, cramping, fatigue Twitching of limb, tongue Dyspnea Guillain Barre Previous viral infection Motor weakness CBC outside normal Comprehensive baseline Syndrome Areflexia assessment Flaccid paralysis Ongoing monitoring Ascending (sometimes Assess pain descending) symmetrical Provide support for fearful weakness progression patients Paresthesia and pain Antivirals – reversible Autonomic changes Pain management No pupillary/cerebral S/S NO CORTICOSTEROIDS Changes in cardinal vision, IV immunoglobulin diplopia Plasmapheresis Ineffective Breathing Pattern Cardiac Dysfunction Myasthenia Gravis Younger women, older men Specific muscle weakness Tensilon testing –increase Periods of rest around Voluntary muscle fatigue Ach if improved, myasthenic mealtimes FACE – cranial nerves Ptosis (droopy eyelids) crisis Cholinergic crisis – Thymoma Diplopia EMG: fibrillations overmedication; withhold Dysarthria (speech) CBC outside normal meds; atropine, airway Myasthenic crisis: Dysphagia (swallowing) R/O syphilis, HIV, heavy Myasthenic crisis – increased droopy eye Snarling look metal poisoning, stroke, undermedication; maintain Cholinergic crisis: NO COGNITIVE brain tumor respiratory fxn; reintroduce abdominal cramps, meds little by little
Blurred vision, diplopia, nystagmus Tinnitus, vertigo Hypalgesia – decreased feeling Numbness, tingling, burning Bowel/bladder dysfunction Late cognitive changes in memory, concentration, judgment, depression metal poisoning, stroke, brain tumor Steroids for exacerbations Biological modifiers Antidepressants NO CURE Education: Avoid stress, extreme temps, infections Exercise & mobility program Amyotrophic Lateral Sclerosis (ALS) Genetic/family hx Men in their 30s Slurred speech - dysarthria Falling No cognitive defects, always motor Upper and lower motor weakness Muscle atrophy Dysphagia, fasciculations Spasticity, cramping, fatigue Twitching of limb, tongue Dyspnea EMG: fibrillations CBC outside normal Genetic markers R/O syphilis, HIV, heavy metal poisoning, stroke, brain tumor ADLs and muscle function Antispasticity meds Exercise & mobility program Periods of rest Manage swallowing, resp Support groups Guillain Barre Syndrome Previous viral infection Motor weakness Areflexia Flaccid paralysis Ascending (sometimes descending) symmetrical weakness progression Paresthesia and pain Autonomic changes No pupillary/cerebral S/S Changes in cardinal vision, diplopia CBC outside normal Comprehensive baseline assessment Ongoing monitoring Assess pain Provide support for fearful patients Antivirals – reversible Pain management NO CORTICOSTEROIDS IV immunoglobulin Plasmapheresis Ineffective Breathing Pattern Cardiac Dysfunction Myasthenia Gravis FACE – cranial nerves Thymoma Myasthenic crisis: increased droopy eye Cholinergic crisis: abdominal cramps, Younger women, older men Specific muscle weakness Voluntary muscle fatigue Ptosis (droopy eyelids) Diplopia Dysarthria (speech) Dysphagia (swallowing) Snarling look NO COGNITIVE Tensilon testing –increase Ach if improved, myasthenic crisis EMG: fibrillations CBC outside normal R/O syphilis, HIV, heavy metal poisoning, stroke, brain tumor Periods of rest around mealtimes Cholinergic crisis – overmedication; withhold meds; atropine, airway Myasthenic crisis – undermedication; maintain respiratory fxn; reintroduce meds little by little
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