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Weakness and fatigue after a history of polio

Viral infection that attacks some parts of the anterior horn cells.

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A chronic debilitating demyelinating disease of the central nervous central.

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Medication: Monoamine oxidase inhibitors, L-Dopa (used to replace the lost dopamine agonist) and carbidopa, anticholinergics (helps with reducing the resting tremor)

Symptoms: flexed posture, dysphagia, festinating gait, freezing, dementia, fatigue.

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Disease-modifying medications including Avonex, Betaseron, Cortisone, Ditropan, Klonopin, Novantrone, Pro-Bathine, Provigil, Rebif, Tegretol, Urecholine, Valium, and Copaxone.

Symptoms:

Abnormal Sensations ("pins and needles", "burning", or "aching")

Grey, blurring, or double vision (diplopia)

Nystagmus

Poor balance

Ataxia gait

Fatigue

Weakness

Spasticity

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No cure for ALS

Multidisciplinary management (speech, OT, PT)

Riluzole is the only medication for tx of ALS

Medications can be given for cramping, depression, spasticity.

Symptoms:

Limb-Loss onset: asymmetric arm or leg weakness

Bulbar-loss onset: dysarthria or dysphagia

Weakness, muscle cramps, atrophy, and fatigue

Occurs distally then proximally

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Ambulation can be used with a dual task- timed, intensity should be based off their THR

Sit to Stand: performing 3 sets of 10-12 reps; small rest break we are working on intensity

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Plasmapheresis (plasma exchange) or infusion of intravenous immunoglobins (IVIG)

Symptoms:

Progressive loss of motor function (distal to proximal)

Impaired sensations

Respiratory compromise can occur

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IVIG treatments have been used to decrease pain. Management is based on physical activity

Symptoms:

having had polio, signs of residual weakness and muscle atrophy, signs of EMG

period of partial or complete functional recovery followed by relative stability which lasts 15+ years

New neurological weakness

symptoms present at least 1 year

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Address primary deficits (gait, postural instability)

Address secondary deficits (reconditioning, loss of muscle mass, MSK changes and stiffness).

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Resisted banded exercises: Exercises can be formed anywhere. Starting with 2 sets x 10 reps with a gradual increase

Transfer training: Practice transfers with breaks to help increase strength and improve independence

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Definition

Parkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking ( tremors) and trouble walking and moving.

Alternative Names

Paralysis agitans; Shaking palsy; Parkinson's disease

Causes

Nerve cells use a brain chemical called dopamine to help control muscle movement. With Parkinson disease, the brain cells that make dopamine slowly die. Without enough dopamine, the cells that control movement can't send proper messages to the muscles. This makes it hard to control the muscles. Slowly, over time, this damage gets worse. No one knows exactly why these brain cells waste away.

Parkinson disease most often develops after age 50. It is one of the most common nervous system problems in older adults.

The disease affects men more than women, although women also develop the disease. Parkinson disease sometimes runs in families.

The disease can occur in younger adults. In such cases, it is often due to the person's genes.

Parkinson disease is rare in children.

Symptoms

Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg is stiff and dragging. Jaw tremor has also been an early sign of Parkinson disease. Symptoms may affect one or both sides of the body.

General symptoms may include:

Problems with balance and walking

Rigid or stiff muscles

Muscle aches and pains

Low blood pressure when you stand up (orthostatic hypotension)

Stooped posture

Constipation

Sweating and not being able to control your body temperature

Slow or infrequent blinking

Difficulty swallowing

Drooling

Slowed, quieter speech and monotone voice

No expression in your face (like you are wearing a mask)

Unable to write clearly or handwriting is very small (micrographia)

Movement problems may include:

Difficulty starting movement, such as starting to walk or getting out of a chair

Difficulty continuing to move

Slowed movements

Loss of fine hand movements (writing may become small and difficult to read)

Difficulty eating

Symptoms of shaking (tremors):

Usually occur when your limbs are not moving. This is called resting tremor.

May occur when your arm or leg is held out.

Go away when you move.

May be worse when you are tired, excited, or stressed.

Can cause you to rub your finger and thumb together without meaning to (called pill-rolling tremor).

Eventually may occur in your head, lips, tongue, and feet.

Other symptoms may include:

Anxiety, stress, and tension

Cognitive changes

Confusion

Depression

Disturbed sleep

Fainting

Low blood pressure

Memory loss

Exams and Tests

Your health care provider may be able to diagnose Parkinson disease based on your symptoms and a physical exam. But the symptoms can be hard to pin down, particularly in older adults. Symptoms are easier to recognize as the illness gets worse.

The examination may show:

Difficulty starting or finishing a movement

Jerky, stiff movements

Muscle loss

Shaking (tremors)

Changes in your heart rate

Abnormal muscle reflexes

Your provider may do some tests to check for other conditions that can cause similar symptoms.

Treatment

There is no cure for Parkinson disease, but treatment can help control your symptoms.

MEDICINE

Your provider may prescribe medicines to help control your shaking and movement symptoms.

At certain times during the day, the medicine may wear off and symptoms can return. If this happens, your provider may need to change any of the following:

Type of medicine

Dose

Amount of time between doses

The way you take the medicine

You may also need to take medicines to help with:

Mood and thinking problems

Pain relief

Sleep problems

Drooling (botulinum toxin is often used)

Parkinson medicines can cause side effects that may be severe, including:

Confusion

Seeing or hearing things that are not there (hallucinations)

Nausea, vomiting, or diarrhea

Feeling lightheaded or fainting

Behaviors that are hard to control, such as gambling

Delirium

Tell your provider right away if you have these side effects. Never change or stop taking any medicines without talking with your provider. Stopping some medicines for Parkinson disease may lead to a severe reaction. Work with your provider to find a treatment plan that works for you.

As the disease gets worse, symptoms such as stooped posture, frozen movements, and speech problems may not respond to the medicines.

SURGERY

Surgery may be an option for some people. Surgery does not cure Parkinson disease, but it may help ease symptoms. Types of surgery include:

Deep brain stimulation -- This involves placing electric stimulators in areas of the brain that control movement.

Surgery to destroy brain tissue that causes Parkinson symptoms.

Stem cell transplant and other procedures are being studied.

LIFESTYLE

Certain lifestyle changes may help you cope with Parkinson disease:

Stay healthy by eating nutritious foods and not smoking.

Make changes in what you eat or drink if you have swallowing problems.

Use speech therapy to help you adjust to changes in your swallowing and speech.

Stay active as much as possible when you feel good. Do not overdo it when your energy is low.

Rest as needed during the day and avoid stress.

Use physical therapy and occupational therapy to help you stay independent and reduce the risk of falls.

Place handrails throughout your house to help prevent falls. Place them in bathrooms and along stairways.

Use assistive devices, when needed, to make movement easier. These devices may include special eating utensils, wheelchairs, bed lifts, shower chairs, and walkers.

Talk to a social worker or other counseling service to help you and your family cope with the disorder. These services can also help you get outside help, such as Meals on Wheels.

Support Groups

Parkinson disease support groups can help you cope with the changes caused by the disease. Sharing with others who have common experiences can help you feel less alone.

Outlook (Prognosis)

Medicines can help most people with Parkinson disease. How well medicines relieve symptoms and for how long they relieve symptoms can be different in each person.

The disorder gets worse until a person is totally disabled, although in some people, this can take decades. Parkinson disease may lead to a decline in brain function and early death. Medicines may prolong function and independence.

Possible Complications

Parkinson disease may cause problems such as:

Difficulty performing daily activities

Difficulty swallowing or eating

Disability (differs from person to person)

Injuries from falls

Pneumonia from breathing in saliva or from choking on food

Side effects of medicines

Effects from loss of strength and mobility (debilitation):

Breathing food, fluid, or mucus into the lungs (aspiration)

Blood clot in a deep vein (deep vein thrombosis)

Malnutrition

When to Contact a Medical Professional

Contact your provider if:

You have symptoms of Parkinson disease

Your symptoms get worse

New symptoms occur

If you take medicines for Parkinson disease, tell your provider about any side effects, which may include:

Changes in alertness, behavior, or mood

Delusional behavior

Dizziness

Hallucinations

Involuntary movements

Loss of mental functions

Nausea and vomiting

Severe confusion or disorientation

Also contact your provider if the condition gets worse and home care is no longer possible.

Parkinson disease is a slowly progressive disorder that affects movement, muscle control, and balance. Part of the disease process develops as cells are destroyed in certain parts of the brain stem, particularly the crescent-shaped cell mass known as the substantia nigra. Nerve cells in the substantia nigra send out fibers to tissue located in both sides of the brain. There the cells release essential neurotransmitters that help control movement and coordination.

The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

References

Fox SH, Katzenschlager R, Lim SY, et al; Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and Movement Disorder Society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018;33(8):1248-1266. PMID: 29570866 pubmed.ncbi.nlm.nih.gov/29570866/.

Jankovic J. Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 96.

Ostrem JL, Okun MS. Parkinsonism. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 378.

Pringsheim T, Day GS, Smith DB, et al. The American Academy of Neurology Guideline Subcommittee. Dopaminergic therapy for motor symptoms in early Parkinson disease practice guideline summary. Neurology. 2021;97(20):942-957. www.neurology.org/doi/10.1212/WNL.0000000000012868.

Radder DLM, Sturkenboom IH, van Nimwegen M, et al. Physical therapy and occupational therapy in Parkinson's disease. Int J Neurosci. 2017;127(10):930-943. PMID: 28007002 pubmed.ncbi.nlm.nih.gov/28007002/.

Last reviewed March 31, 2024 by Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

Related conditions & treatments

Related specialties

Aftercare and more

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Patient education - Parkinson Disease - UF Health

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Parkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking ( tremors) and trouble walking and moving. Paralysis agitans; Shaking palsy; Parkinson's disease Nerve cells use a brain chemical called dopamine to help control muscle movement.

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Avoid heavy eccentric exercises

Moderate resistance can increase strength

Overuse is not an issue if the MMT is 3/5

Balance and rest is important

Precaution with aspiration

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The Sean M. Healey & AMG Center for ALS has compiled these informational articles for ALS patients and their families.

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Frenkel Exercises

- Abduct and adduct leg with knee and hip extended, leg sliding on the table in supine position x5 bilaterally

(in neuro book - pg 544)

Seated sticky note toe touches x8 bilaterally

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Minimize progression

Maintain functional independence

Prevent or decrease secondary complications

maintain respiratory function

conserve energy/manage fatigue

Educate patient and family/caregivers

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Multiple sclerosis (MS) is a long-lasting (chronic) disease of the central nervous system. It is thought to be an autoimmune disorder, a condition in which the body attacks itself by mistake. MS is an unpredictable disease that affects people differently. Some people with MS may have only mild symptoms. Others may lose their ability to see clearly, write, speak, or walk when communication between the brain and other parts of the body becomes disrupted.

Myelin is the fatty tissue that surrounds and protects nerve fibers. In MS, the myelin is destroyed in many areas. This loss of myelin forms scar tissue called sclerosis. These areas are also called plaques or lesions. When the nerves are damaged in this way, they can't conduct electrical impulses to and from the brain.

What causes multiple sclerosis?

There are many possible causes of MS, including:

What are the symptoms of multiple sclerosis?

The symptoms of MS are often unpredictable. They may be mild or severe, short-term or long-lasting. They may appear in different combinations, depending on the area of the nervous system affected. The following are the most common symptoms of MS. But each person may have different symptoms.

First symptoms of MS

The following are often the first symptoms of MS:

Blurred or double vision

Red-green color distortion

Pain and loss of vision because of swelling of the optic nerve (optic neuritis)

Trouble walking

An abnormal feeling or pain, such as numbness, prickling, or pins and needles (paresthesia)

Other symptoms of multiple sclerosis

Muscle weakness in the arms and legs

Trouble with coordination. You may have problems walking or standing. You may also be partially or completely paralyzed.

Spasticity. The involuntary increased tone of muscles leading to stiffness and spasms.

Fatigue. This may be brought on by physical activity, but it may ease with rest. You may have constant tiredness that doesn't go away.

Loss of sensation

Speech problems

Hearing loss

Bowel and bladder problems

Depression

Changes in sexual function

About 50% of all people with MS have thinking (cognitive) problems linked to the disease. The effects of these problems may be mild. Your healthcare provider may only find them after much testing. The problems may be with:

Symptoms of MS are grouped as primary, secondary, or tertiary as described below:

These symptoms are a direct result of the destruction of myelin:

These are complications that may occur as a result of the primary symptoms, for example:

Paralysis can lead to bedsores.

Bladder problems may cause repeated urinary tract infections.

Inactivity can result in weakness, poor posture muscle imbalances, decreased bone density, and breathing problems.

Becoming less mobile because of weakness and trouble swallowing can lead to a greater risk of pneumonia.

These are social, job-related, and psychological problems:

A person who becomes unable to walk or drive may lose his or her livelihood.

Strain of dealing with a chronic neurological illness may disrupt personal relationships.

Depression is often seen among people with MS.

The symptoms of MS may look like other health conditions or problems. Always talk with your healthcare provider for a diagnosis.

How is multiple sclerosis diagnosed?

No specific test is available to diagnose multiple sclerosis. But a healthcare provider can make a diagnosis by following a careful process to rule out other causes and diseases. Two things must be true to make a diagnosis of MS:

1. You must have had 2 attacks at least 1 month apart. An attack is when any MS symptoms show up suddenly. Or when any MS symptoms get worse for at least 24 hours.

2. You must have more than 1 area of damage to the central nervous system myelin. Myelin is the sheath that surrounds and protects nerve fibers. This damage must have occurred at more than 1 point in time and not have been caused by any other disease.

Generally a single attack along with certain patterns of changes in brain tissue seen on an MRI scan of the brain performed with contrast can mean that you have MS.

An MS evaluation involves a complete health history and neurological exam. This includes:

The following may be used when evaluating a person for multiple sclerosis:

MRI. A diagnostic test that uses a combination of large magnets, sound waves, and a computer to make detailed pictures of organs and structures within the body. It can find plaques or scarring caused by MS.

Evoked potentials. These tests record the brain's electrical response to visual, auditory, and sensory stimuli. These tests show if you have a slowing of messages in the different parts of the brain.

Cerebral spinal fluid analysis. This is also called a spinal tap or lumbar puncture. It looks at the fluid taken from the spinal column to make an evaluation or diagnosis. This test checks for cellular and chemical abnormalities seen with MS.

Blood tests. These are done to rule out other causes for various neurological symptoms.

Evaluation and diagnosis of MS requires a variety of tools to rule out other possible disorders. It also requires a series of lab tests that, if positive, confirms the diagnosis.

How is multiple sclerosis treated?

Your healthcare provider will figure out the best treatment plan for you based on:

Your age, overall health, and past health

How sick you are

How well you can handle certain medicines, treatments, or therapies

How long your condition is expected to last

Your opinion or preference

There is no cure yet for MS. But you can do things to help change the course of the disease, treat flare-ups, manage symptoms, and improve your function and mobility.

Treatments for the conditions seen with MS may include:

Medicines (talk with your provider to see what medicines may be an option for you)

Equipment such as canes, braces, or walkers

Rehabilitation activities

Rehabilitation varies depending on your symptoms and how severe they are. MS rehabilitation may help you to:

Get back functions that are important for daily living

Be as independent as you can

Involve your family

Make the right decisions relating to your care

Learn about equipment like canes, braces, or walkers that can make is easier to move around

Set up an exercise program that builds muscle strength, endurance, and control

Get back motor skills

Speak more easily if you have weakness or a lack of coordination of face and tongue muscles

Manage bowel or bladder incontinence

Relearn thinking skills

Change the way your home is set up to keep you safe but allow you to move about as easily as possible

What are the complications of multiple sclerosis?

The complications of MS range from mild to severe. They can range from fatigue to the inability to walk. Other problems include loss of vision, balance, and bowel or bladder control. Depression can result from the difficulty of living with a chronic condition.

Living with multiple sclerosis

It's important to take your medicines as directed. You may get help by taking part in a clinical trial. Using equipment like canes or walkers can help you get around as walking becomes more difficult. Rehabilitation activities can also help you keep or get back functioning. Changing the way your home is set up can help you stay independent. Talk with your family and healthcare providers about what you need.

Key points

Multiple sclerosis (MS) is a chronic disease of the central nervous system.

MS is unpredictable. Some people may be only mildly affected. Others may lose the ability to see clearly, write, speak, or walk.

Early symptoms can include vision problems, trouble walking, and tingling feelings.

MS affects people differently. But common problems are trouble with movement and thinking, and bowel and bladder incontinence.

Medicines and rehabilitation can help to keep or restore functioning.

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Multiple sclerosis is a disease in which the fatty tissue that surrounds the nerves is destroyed. When this happens, the nerves are unable to conduct electrical impulses to and from the brain. It causes muscle weakness, impaired coordination, and fatigue.

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- Seated edge of table/EOB x2 minutes with SBA x1-2

- ROM of effective extremities/body to avoid contractures due to immobilization for lengthy periods of time - full available ROM x10 ea. P/AA/AROM depending on patient strength and abilities

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Acute phase:

Pulmonary/respiratory support

Positioning

Pain management

Education

Plateau phase:

Gradually increase activity while avoiding overuse

Increase upright posture tolerance

Maintain ROM

Improve pulmonary function

Recovery phase:

Return motor function (usually proximal to distal)

Avoid overuse and DOMS

Plan for rest breaks

Strengthening and maximizing functional abilities

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Nustep: 60%-70% of THR, 3 times per week, 15-30 minutes

Strengthing: Short intervals with rest in-between, every-other day basis, avoid increase of muscle or joint pain

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Overview

Guillain-Barre (gee-YAH-buh-RAY) syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms.

These sensations can quickly spread, eventually paralyzing your whole body. In its most severe form Guillain-Barre syndrome is a medical emergency. Most people with the condition must be hospitalized to receive treatment.

The exact cause of Guillain-Barre syndrome is unknown. But two-thirds of patients report symptoms of an infection in the six weeks preceding. These include respiratory or a gastrointestinal infection or Zika virus.

There's no known cure for Guillain-Barre syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Although most people recover from Guillain-Barre syndrome, the mortality rate is 4% to 7%. Between 60-80% of people are able to walk at six months. Patients may experience lingering effects from it, such as weakness, numbness or fatigue.

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Symptoms

Guillain-Barre syndrome often begins with tingling and weakness starting in your feet and legs and spreading to your upper body and arms. In about 10% of people with the disorder, symptoms begin in the arms or face. As Guillain-Barre syndrome progresses, muscle weakness can evolve into paralysis.

Signs and symptoms of Guillain-Barre syndrome may include:

Prickling, pins and needles sensations in your fingers, toes, ankles or wrists

Weakness in your legs that spreads to your upper body

Unsteady walking or inability to walk or climb stairs

Difficulty with facial movements, including speaking, chewing or swallowing

Double vision or inability to move eyes

Severe pain that may feel achy, shooting or cramplike and may be worse at night

Difficulty with bladder control or bowel function

Rapid heart rate

Low or high blood pressure

Difficulty breathing

People with Guillain-Barre syndrome usually experience their most significant weakness within two weeks after symptoms begin.

Types

Once thought to be a single disorder, Guillain-Barre syndrome is now known to occur in several forms. The main types are:

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP), the most common form in North America and Europe. The most common sign of AIDP is muscle weakness that starts in the lower part of your body and spreads upward.

Miller Fisher syndrome (MFS), in which paralysis starts in the eyes. MFS is also associated with unsteady gait. MFS is less common in the U.S. but more common in Asia.

Acute motor axonal neuropathy (AMAN) and acute motor-sensory axonal neuropathy (AMSAN) are less common in the U.S. But AMAN and AMSAN are more frequent in China, Japan and Mexico.

When to see a doctor

Call your doctor if you have mild tingling in your toes or fingers that doesn't seem to be spreading or getting worse. Seek emergency medical help if you have any of these severe signs or symptoms:

Tingling that started in your feet or toes and is now moving up your body

Tingling or weakness that's spreading rapidly

Difficulty catching your breath or shortness of breath when lying flat

Choking on saliva

Guillain-Barre syndrome is a serious condition that requires immediate hospitalization because it can worsen rapidly. The sooner appropriate treatment is started, the better the chance of a good outcome.

Causes

The exact cause of Guillain-Barre syndrome isn't known. The disorder usually appears days or weeks after a respiratory or digestive tract infection. Rarely, recent surgery or vaccination can trigger Guillain-Barre syndrome. Recently, there have been cases reported following infection with the Zika virus. Guillain-Barre syndrome may also occur after infection with the COVID-19.

In Guillain-Barre syndrome, your immune system - which usually attacks only invading organisms - begins attacking the nerves. In AIDP, the most common form of Guillain-Barre syndrome in the U.S., the nerves' protective covering (myelin sheath) is damaged. The damage prevents nerves from transmitting signals to your brain, causing weakness, numbness or paralysis.

Risk factors

Guillain-Barre syndrome can affect all age groups. But your risk increases as you age. It's also more common in males than females.

Guillain-Barre syndrome may be triggered by:

Most commonly, infection with campylobacter, a type of bacteria often found in undercooked poultry

Influenza virus

Cytomegalovirus

Epstein-Barr virus

Zika virus

Hepatitis A, B, C and E

HIV, the virus that causes AIDS

Mycoplasma pneumonia

Surgery

Trauma

Hodgkin's lymphoma

Rarely, influenza vaccinations or childhood vaccinations

Complications

Guillain-Barre syndrome affects your nerves. Because nerves control your movements and body functions, people with Guillain-Barre may experience:

Breathing difficulties. The weakness or paralysis can spread to the muscles that control your breathing, a potentially fatal complication. Up to 22% of people with Guillain-Barre syndrome need temporary help from a machine to breathe within the first week when they're hospitalized for treatment.

Residual numbness or other sensations. Most people with Guillain-Barre syndrome recover completely or have only minor, residual weakness, numbness or tingling.

Heart and blood pressure problems. Blood pressure fluctuations and irregular heart rhythms (cardiac arrhythmias) are common side effects of Guillain-Barre syndrome.

Pain. One-third of people with Guillain-Barre syndrome experience severe nerve pain, which may be eased with medication.

Bowel and bladder function problems. Sluggish bowel function and urine retention may result from Guillain-Barre syndrome.

Blood clots. People who are immobile due to Guillain-Barre syndrome are at risk of developing blood clots. Until you're able to walk independently, taking blood thinners and wearing support stockings may be recommended.

Pressure sores. Being immobile also puts you at risk of developing bedsores (pressure sores). Frequent repositioning may help avoid this problem.

Relapse. From 2% to 5% of people with Guillain-Barre syndrome experience a relapse.

Severe, early symptoms of Guillain-Barre syndrome significantly increase the risk of serious long-term complications. Rarely, death may occur from complications such as respiratory distress syndrome and heart attacks.

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Guillain-Barre syndrome - Symptoms and causes

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Guillain-Barre (gee-YAH-buh-RAY) syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms. These sensations can quickly spread, eventually paralyzing your whole body. In its most severe form Guillain-Barre syndrome is a medical emergency.

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Fatigued, pain, weakness are things to be aware of,

Ambulate safely

Achieve optimal functional independence

Avoid fatigue

Avoid Muscular overuse

Educate the patient and family

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Post-polio syndrome-Post-polio syndrome - Diagnosis & treatment - Mayo Clinic

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This syndrome causes a number of potentially serious symptoms that appear decades after the polio virus.

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Is a dysfunction within the substantial nigra, a component of the basal ganglia. Decrease in dopamine.

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A terminal progressive disease involving both UMNs and LMNs.

Also known as Lou Gehrigs disease.

UMN degenerate in the cortex and corticospinal tract

LMN degenerate in the brain stem and anterior horn cells

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A LMN disorder that involves peripheral nerves and results in flaccid paralysis.

Referred to as a syndrome because it covers a broad group of demyelinating inflammatory polyradiculoneuropathies.

Subtypes:

- Acquired inflammatory demyelinating polyneuropathy (AIDP)

- Acute motor axonal neuropathy