PTAP130: Week 11 Guided Notes W22 Cerebral Palsy 1. CP is a non-progressive movement disorder that results from _brain___ __damage__, most often __prenatal______ (prenatal or peri/postnatal). 2. The most common presentation of muscle tone with CP is __hypertonia____. 3. List 3 characteristics of the clinical presentation of CP: a. Motor delays b. Abnormal muscle tone and motor control c. Reflex abnormalities d. Poor postural control e. arching neck or back into extension f. scissoring glegs (hip adduction) in standing g. Fisted hands h. High risk for hip dislocations i. Balance, gait impairments j. Intellect, vision, hearing, and perceptual skills often altered (cognitive impairment in 53% of CP cases) k. Seizures (50% of all CP cases) 4. List 3 types of pharmacological agents that may be indicated for patients with CP: a. Drug Class: __antianxiety____________________ b. Drug Class: __antispasticity__________________ c. Drug Class: __anticonvulsant/antiepileptic_______ Epilepsy 1. Chronic CNS disorder characterized by __recurrent____ __seizures____ due to abnormal neuronal activity within the brain. 2. Label each definition with its respective type of generalized seizure. Word bank: absence; tonicclonic; myoclonic; tonic; atonic; clonic ___Atonic____: brief seizures that cause a sudden loss muscle tone and the person often falls to the ground or will have a sudden head nod if sitting. __Tonic______: Can occur when a person is asleep or awake and involves a brief stiffening of the body, arms or legs. The person will suddenly fall if standing or sitting. ___Tonic-clonic___: the body stiffens (the tonic phase) and then the limbs begin to jerk rhythmically (the clonic phase) ___Absence_______: sudden lapse in awareness and responsiveness that look like brief staring spells or daydreaming ___Monoclonic______: sudden single jerks of a muscle or a group of muscles that may last no more than a second or two ___Clonic______: although uncommon they cause jerking in various parts of the body 3. List 3 potential triggers of a seizure: a. Stress b. missed medication c. skipped meal d. flickering lights e. illness f. lack of sleep g. strong emotion h. heat/humidity 4. What is one precaution for exercise with someone with a known history of epilepsy? Integrate hydration into activity as dehydration may trigger seizure Down Syndrome (aka Trisomy 21) 1. Down syndrome is caused by an abnormality in ___chromosome 21__, which can be detected as early as ___2nd trimester___. 2. Characteristics of Down syndrome include: a. __High___ tone (high or low?) b. Ligamentous ____laxity_____ c. Distinct facial features d. Intellectual ____disability____ e. Developmental ____delay____ 3. List 3 potential complications of Down syndrome: a. Scoliosis (52%) b. Heart defects (50%) c. Atlantoaxial instability (15%) d. Sensory, hearing (60%-80%), visual impairments e. Umbilical hernia (90%) f. Respiratory compromise g. Alzheimer’s disease h. Leukemia i. Increased incidence of celiac disease, epilepsy, constipation, blood, dermatologic, and MSK disorders (ex: hip subluxation) 4. Focus of physical therapy with Down syndrome patients includes teaching ____normalized movement patterns______ at a level that is consistent with the patient’s intellectual ability. Alzheimer’s Disease 1. Alzheimer’s is a type of ______dementia____ 2. The disease process of Alzheimer’s includes: a. Decreased ____acetylcholine_____ (name the neurotransmitter) b. Formation of ____neurofibrillary tangles____ within the cytoplasm and ___amyloid_____ ____plaques_____, which contain fragmented axons, altered glial cells, and cellular waste that result in an inflammatory response that causes further damage to brain tissue. c. Cerebral ____atrophy_______ 3. The primary drug class used to treat Alzheimer’s is ___acetylcholinesterase____ _____inhibitors_____, which are designed to increase levels of Ach 4. In Alzheimer’s patients, movement has been shown to a. _maintain____functional muscle strength_________; and b. _slow___disease progression_____ Guillain-Barre Syndrome (aka acute polyneuropathy) 1. GBS is an autoimmune response characterized by temporary inflammation and demyelination of ___PERIPHERAL_____ nerves and typically follows __an infection_____. 2. Clinical presentation of GBS includes distal symmetrical ___motor___ __weakness_ and mild distal sensory impairment. Weakness will progress from (distalproximal OR proximaldistal). 3. Pharmacology for GBS includes ____immunosuppressive agents____ and ____analgesic/narcotics_______. Corticosteroids, however, are typically _____CONTRAINDICATED______. 4. An important consideration for physical therapy intervention in the acute stage is ___limit overexertion and fatigue to avoid exacerbation of symptoms____.