1:30 Progressive vs non-progressive neurological disorders by

PSP - early S/S ofPSP

2017-03-10 05:50:01 UTC

Begin with inability to walk, falling spells, and stiffness.

Later Symptoms of PSP

2017-03-10 05:51:30 UTC

physical imbalance and stiffness which grows worse
walking very difficult or sometimes impossible

Problems with eyesight

2017-03-10 05:54:25 UTC

Spinocerebellar Ataxia (SCA) Treatment and Prognosis

2017-03-10 05:54:35 UTC

Treatment and prognosis

No known cure : progressive disease (irreversible),

Usually end up needing a wheelchair, may need assistance to perform daily tasks; although not all types cause equally severe disability.

Treatments: softening symptoms (Speech, Cognition, Tremor, Seizure, Ataxic Gait)

- In-coordination/ ataxia: use of adaptive devise to maintain as independence as possible; cane, crutches, walker, or wheelchair for impaired gait; communication devices for those with impaired speech; writing, feeding, and self cares if hand and arm coordination is impaired

- Protective device: helmet and orthosis (AFO)

- Medications: treat tremor, stiffness, depression, spasticity, and sleep disorders

- Rehabilitation: maintain social contact and normal life, keep happy and relax mental thinking, maintain exercise habit to maintain cardiopulmonary endurance, muscle strength, flexibility, maintain active ADL, change position routinely...
e.g. Hydrotherapy
physiotherapy emphasis on balance and gait training

Research showed that spinocerebellar ataxia 2 (SCA2) patients with a mild stage of the disease gained significant improvement in static balance and neurological indices after six months of a physical therapy exercise training program

- Stemcell treatment

Life Expectancy: according to types:
SCA8 and 11 have normal lifespan
mostly more than 10 years

2017-03-10 05:57:36 UTC

個人

Prognosis of MG

2017-03-10 05:58:18 UTC

Symptoms of myasthenia gravis usually progress to maximum severity within 3 years. After 3 years, patients usually stabilize or improve.

Infants with transient neonatal MG may develop acute respiratory failure within a few weeks after birth.

mortality rate from respiratory failure in MG patients ~ 3%.

Patients over the age of 40, those with a short history of severe disease, and those with thymoma (tumor of the thymus gland) have a worse prognosis.

Diagnosis of GBM

2017-03-10 05:59:35 UTC

T1-weighted axial gadolinium-enhanced magnetic resonance image demonstrates an enhancing tumor of the right frontal lobe.

MRI with or without contrast is the study of choice in diagnosing this disease. These lesions typically have an enhancing ring observed on T1-weighted images and a broad surrounding zone of edema apparent on T2-weighted images.

Currently, no specific laboratory studies are helpful in making a diagnosis of glioblastoma.

Positron emission tomography (PET) scans and magnetic resonance (MR) spectroscopy can be helpful in identifying glioblastomas in difficult cases, such as those associated with radiation necrosis or hemorrhage. On PET scans, increased regional glucose metabolism closely correlates with cellularity and reduced survival.Patients receiving chemotherapy will present with low white blood cell and platelet counts.

PSP vs Parkinson's disease

2017-03-10 05:59:37 UTC

Both cause stiffness, movement difficulties, and clumsiness

Both onset in late middle age, bradykinesia (slow movement), and rigidity of muscles.

PSP is more rapidly
Problems with speech and swallowing are much more common and severe in PSP

Eye movements are abnormal in PSP

Parkinson's disease patients benefit from the drug levodopa, people with PSP respond minimally

SCA Diagnosis

2017-03-10 06:02:40 UTC

first check sign and symptoms
then family history
them MRI and genetic test

SCA have a wide range of neurological symptoms including ataxia of gait, stance, and limbs, cerebellar dysarthria, oculomotor disturbances of cerebellar and supranuclear genesis, retinopathy, optic atrophy, spasticity, extra-pyramidal movement disorders, peripheral neuropathy, sphincter disturbances, cognitive impairment, and epilepsy.

2017-03-10 06:02:42 UTC

Diagnosis of GBM

2017-03-10 06:03:22 UTC

http://www.physio-pedia.com/File:Glioblastoma.jpg

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2017-03-10 06:05:06 UTC

SCA signs and symptoms

2017-03-10 06:05:21 UTC

Initial Stage
ataxic gait
decrease agility, skills
stiff
poor static standing balance, increase body sway

Middle stage
more difficulty in coordination, difficulty in writing
slurred speech
difficulty in moving eyeball
diplopia
dysphagia
drowsy, may spasm during sleep

Later stage
slurred speech
dysphagia
weakness
cognitive problem if affected cerebrum

Is GBM related to long term mobile phone use?

2017-03-10 06:06:55 UTC

A population-based, case-control study conducted by Stefan Lönn and his colleagues includes a large number of long-term mobile phone users, and the authors conclude that the data do not support the hypothesis that mobile phone use is related to an increased risk of glioma or meningioma.

Symptoms of GBM - Because glioblastomas can grow rapidly, the most common symptoms are usually caused by increased pressure in the brain. These symptoms can include headache, nausea, vomiting, and drowsiness. Depending on the location of the tumor, patients can develop a variety of other symptoms such as weakness on one side of the body, memory and/or speech difficulties, and visual changes.

2017-03-10 06:07:16 UTC

Medication:

2017-03-10 06:07:24 UTC

acetalazolamide FOR SCA6
Other subtypes, usually just symptomatic

2017-03-10 06:10:47 UTC

presentationSeizures are a presenting symptom in approximately 20% of patients with supratentorial brain tumors. Increased Intracranial Pressureo Headache, especially retroorbital; sometimes worse upon awakening, improves during the dayo Vomiting (with or without nausea)o Visual changes (blurring, blind spots, diplopia, abnormal eye movements)o Changes in mentation (impaired thinking, difficulty concentrating or reading, memory or speech)o Personality change, irritabilityo Unusual drowsiness, increased sleepingo Sensory changeso Muscle weakness or hemiparesiso Bladder dysfunctiono Increased lower extremity reflexes compared with upper extremity reflexeso Decreased coordination, gait changes, ataxiao Positive Babinski reflexo Clonus (ankle or wrist)o Vertigo, head tilt [3]ns of gbm

2017-03-10 06:11:02 UTC

2017-03-10 06:13:18 UTC

MRI is the imaging of choice in SCA. Brain MRI is useful in patients with spinocerebellar syndromes in order to exclude differential diagnoses such as multiple sclerosis and cerebrovascular disease or malignancy. MRI helps in the diagnosis of SCA, but it is not diagnostic and may be normal in the first years after onset of symptoms. Corresponding to neuropathological findings in hereditary ataxia, there are three fundamental patterns of degeneration on MRI: spinal atrophy, olivopontocerebellar atrophy, and cortical cerebellar atrophy

2017-03-10 06:14:29 UTC

Risk factors of GMB - only radiation exposure has been shown to directly impact GBM development. Other factors including increased cell phone use and pesticide exposure have been suggested as possible risk factors for GBM (Adamson, 2009). Cell phones are known to release a small amount of non-ionizing electromagmetic radiation, and because cell phone use has become prevalent worldwide, electromagnetic radiation exposure due to cell phone use has become a concern

2017-03-10 06:16:04 UTC

2017-03-10 06:16:57 UTC

Speech machine

2017-03-10 06:17:13 UTC

44:24

2017-03-10 06:19:29 UTC

Physical therapists provide strengthening exercises where muscle tissue integrity is likely to return or plateau, and range of motion exercises where muscle movement is limited. Gait training is also an important part of rehabilitation for persons with ataxia, as physical therapists help persons adapt to abnormal muscle movements, while safely maintaining posture and walking. As

2017-03-10 06:22:15 UTC

c

2017-03-10 06:22:40 UTC

Myasthenia gravis is an autoimmune disease which results from antibodies that block or destroy nicotinic acetylcholine receptors at the junction between the nerve and muscle. This prevents nerve impulses from triggering muscle contractions


How MG affects Eye function?The initial symptom of MG is related to the muscles around the eye.[8] 
There may be eyelid drooping (ptosis due to weakness of levator palpebrae superioris)[11] and double vision (diplopia,[8] due to weakness of the extraocular muscles).[9] 
Eye symptoms tend to get worse when watching television, reading or driving, particularly in bright conditions.[8] Consequently, some affected individuals choose to wear sunglasses.[8] 

Classification 
Class | Description
I | Any eye muscle weakness, possible ptosis, no other evidence of muscle weakness elsewhere
II | Eye muscle weakness of any severity, mild weakness of other muscles
IIa | Predominantly limb or axial muscles
IIb | Predominantly bulbar and/or respiratory muscles
III | Eye muscle weakness of any severity, moderate weakness of other muscles
IIIa | Predominantly limb or axial muscles
IIIb | Predominantly bulbar and/or respiratory muscles
IV | Eye muscle weakness of any severity, severe weakness of other muscles
IVa | Predominantly limb or axial muscles
IVb | Predominantly bulbar and/or respiratory muscles
V | Intubation needed to maintain airway




Diagnosis Test  in Mythenia Gravis
-Ice Test

This is also a simple diagnostic test that can be done in the clinic. It is highly sensitive and specific for MG. The ice test is useful for ptosis. 

Method: An ice pack is applied to the affected upper eyelid for 5 minutes. 

Positive sign: A positive test is the improvement of ptosis by > 2mm or more. 

Rationale: This transient improvement in ptosis is due to the cold decreasing the acetylcholinesterase break-down of acetylcholine at the neuromuscular junction. More acetylcholine collects in the junction and therefore increases the muscle contraction.


- The Tensilon Test

The Tensilon test uses the drug Tensilon (edrophonium) to diagnose myasthenia gravis. Tensilon prevents the breaking down of the chemical acetylcholine, which then helps stimulate the muscles. A person tests positive for myasthenia gravis if their muscles get stronger after being injected with Tensilon.

Treatment of GBM - Glioblastoma can be difficult to treat because the tumors contain so many different types of cells. Some cells may respond well to certain therapies, while others may not be affected at all. This is why the treatment plan for glioblastoma may combine several approaches. The first step in treating glioblastoma is a procedure to make a diagnosis, relieve pressure on the brain, and safely remove as much tumor as possible through surgery. Because gliblastomas have finger-like tentacles, they are very difficult to completely remove. This is particularly true when they are growing near the parts of the brain that control important functions such as language and coordination. Radiation and chemotherapy may be used to slow the growth of tumors that cannot be removed with surgery. Chemotherapy may also be used to delay the need for radiation in young children.

2017-03-10 06:23:20 UTC

2017-03-10 06:23:21 UTC

2017-03-10 06:25:14 UTC

Interesting facts on iphone airpods and GBM

2017-03-10 06:26:28 UTC

Both supportive and objective views

Supportive:
wireless transmission can open up BBB

animal studies

Chemical toxins can get into brian tissue more easily

Easy to cause inflammtion

more prone to brain cancer

objective:
output is small(10-18mW)

use diff. frequency and waveform from traditional wireless transmission

only transmit from phone a few feet away, but not from a distant station-> in really low power

wont't cause brain tumour

2017-03-10 06:30:34 UTC

MG Exercise ConsideraEons

All stable MG patients who are exercising should consider 5 items:

 The Dollar Per Day Rule
 Exercise at your best time of day
 Exercise at peak dose pyridostigmine
 Exercise large, proximal muscle groups for short periods of time building up only to moderate intensity only
 Do not exceed Moderate Intensity Exercise Levels, mild to moderate levels of exercise are the best

Physiotherapy

2017-03-10 06:36:21 UTC

4:18

Prognosis of GBM - With standard treatment, median survival for adults with an anaplastic astrocytoma is about two to three years. For adults with more aggressive glioblastoma, treated with concurrent temozolamide and radiation therapy, median survival is about 14.6 months and two-year survival is 30%. However, a 2009 study reported that almost 10% of patients with glioblastoma may live five years or longer.

2017-03-10 06:36:55 UTC

Mobility

2017-03-10 06:40:01 UTC

0:32

Mobility

2017-03-10 06:42:41 UTC

0:31

2017-03-10 06:46:11 UTC

2017-03-10 06:46:49 UTC

http://topick.hket.com/article/1672169/%E6%89%8B%E6%A9%9F%E7%99%BC%E5%B0%84%E7%AB%99%E4%B8%8B%E7%9A%84%E9%AD%94%E5%92%92%20%E8%85%A6%E7%99%8C%E5%B8%B6%E8%B5%B0%E4%B8%80%E5%AE%B6%E6%9C%80%E6%84%9B

2017-03-10 06:47:46 UTC

2017-03-10 06:56:12 UTC

2017-03-10 06:59:45 UTC

Physiotherapy for Spinocerebellar Ataxia

2017-03-10 07:02:32 UTC

Maintain muscle strength
Relieve stiffness
Encourage smooth flow of movement
Develop balance
Reduce your risk of falling
Improve your quality of life

During an initial assessment your physiotherapist will assess your current levels of mobility, range of movement, strength, balance and coordination. In order to do this your therapist will also assess your functional ability in carrying out activities of daily life such as walking, standing and sitting down, and getting into a lying position.

Following this assessment you will discuss and agree some key goals to work towards to help improve your functional ability. Following your assessment you will follow a prescribed programme of physiotherapy which will involve sessions with your physiotherapist and some activities that can be carried out at home in between sessions to help your progression. Your sessions will include any of the following, depending on the goals that are agreed with your therapist
:Exercises that will help you to improve your muscle strength
Activities to help improve your range of movement and reduce stiffness
Activities that will help you to remain as independent as possible and work to improve your balance
Exercises that will aim to improve the smoothness of your movements