Chronic Neurologic disorders
The difference between autoimmune and degenerative disease is how it affects the body
Degenerative disease is caused by a physical breakdown, the neurons that affect neurologic
communication, muscle contractions, nerves fibers that affect mvmt
Autoimmune- Caused by a rxn in the immune system that attacks itself.
The brain functions in a complex chemically mediated environment, the environment happens
via neurons and neurotransmitters.
o Neurons are the brain cells, there are billions of them
They are capable of instant communication, instant communication happens
between the neuron and neurotransmitter
o Neurotransmitters- are referred to as chemical messengers
o The brain is comprised of 700,00 different types of neurotransmitters
o Neurons communicate with neurotransmitters to create a messenger like response to
relay information
Contract with muscle turn the head, blink, etc
o Neurotransmitters are categorized as excitatory or inhibitor
o Excitatory- stimulates electrical activity of the brain cell
o Inhibitory- calms the activity
At one end of each neuron there are dendrites- they receive the information
At the other end there is an axon
o Its acts as a roadway, it’s how information moves through the neuron
o Axon terminals- contain vesicles where neurotransmitters are stored
When a brain cell receives info its fires an electrical impulse that travels down the axon to the
axon terminal where the neurotransmitters are stored. Triggers the release of chemical
messenger and the processing of info begins
Processing has 3 categories
o When process is complete the info can be degenerated, deactivated, or delivered
o If info is degraded -the brain just gets rid of it
Brain does not try to process it
o If info is deactivated the brain tried to process it but didn’t like it and gets rid of it
o Delievered- the message is sent and received
Info cannot get to where it needs to be to elicit a response
Seizures
A seizure is a burst of uncontrolled electrical activity between brain cells that causes temporary
abnormalities in muscle tone or movements, behaviors, and sensations or states of awareness.
o Can be cause by autoimmune or degenerative diseases
o Abnormalities in muscle tones or strength can look like stiffness, twitching, fatigue, or
tremor (Parkinson’s), spasticity or limpness
, o Seizure is a symptom of epilepsy
Generalized seizures
Tonic-clonic (grand mal)- grand mal
o In the tonic stage the muscles stiffen
Loss of consciousness
o Clonic stage consists of rapid muscle contraction, sometimes referred to as compulsions
o Usually, last 1-3 minutes
o If its lasts more than 5 minutes, it’s a medical emergency
o Caused by hypoglycemia, high fever, and stroke
o During a seizure the pt loses consciousness and falls to the ground, if upright. The body
stiffens (tonic phase) for 10- 20 seconds and the extremities jerk (clonic phase) for
another 30 -40 seconds. Cyanosis, excessive salivation, tongue or check biting, and
incontinence may occur during seizure
o Postictal: pt has muscle soreness, feels tired, and may sleep for several hours pt has not
memory of the seizure
Absence (petit mal)
o Involve brief sudden lapses in attention
o Typical
A person will suddenly stop activity, flat affect (looks like they are staring off
into space)
Eyes will turn upward and there will be a fluttering in their eye lids
Usually lasts 10 seconds are less
Brief staring spell that resembles daydreaming. Often goes unnoticed because it
lasts less than 10 seconds. Pt is usually unresponsive when spoken to.
EEG has a spike- wave pattern with 3 per second
o Atypical- seizure will start with staring off into space but then there is a change in muscle
tone and mvmt
Change in muscle tone (repetitive smacking of the lips or chewing mvmt) they
may be rubbing their fingers together
Lasts up to 20 seconds (longer than a typical)
Staring spell is accompanied by other S&S such as eye blinking or jerking mvmts
of the lips. Often lasts more than 10 seconds with a gradual beginning and end
EEG shows spike- and- wave patterns, with fewer than 3 per second
Myoclonic
o Brief
o Shock like jerking of a muscle or group of muscles
o Myo= muscle; clonus=rapid alternating contraction and relaxion
o Usually only lasts a few seconds
o Mvmt is seen with Tourette’s (it’s a myoclonic mvmt)
, o Characterized by rhythmic arm abduction (3 mvmts per second) leading to progressive
arm elevation. Usually last 10 to 60 seconds
o Eyelid myoclonia refers to jerking of the eyelids often with upward eye deviation- usually
last 10 seconds
Atonic or Akinetic
o Tone- having tone is the muscles normal tension (you’re supposed to have tone)
o Atonic- without tone
Muscles suddenly become limp
Dropping of eye lid
Pt may nod or lean forward and drop to the floor
Lasts less than 15 seconds
Focal/Partial
o Focal- Nerve cells in the brain send out sudden excessive uncontrolled electrical activity
Excitatory like response
o Symptoms are dependent on the area of the brain affected
Muscle jerking, lose of muscle tone, repeated mvmts
Most commonly= changes in emotion, changes in thinking, and changes in
sensation
o Difference between simple and complex (unconscious or conscious)
Simple- pt maintain awareness
Complex- pt loses awareness
o Cause sensory, motor, cognitive, or emotional manifestations based on the function of
the involved area of the brain
o Focal awareness (partial)- pt are conscious and alert but have unusual feelings or
sensations that can take many forms. They may have sudden and unexplainable feelings
of joy, anger, sadness, or nausea. They may hear, smell, taste, see, or feel things that are
not real
o Focal impaired awareness (partial)- patient have a loss of consciousness or a change in
their awareness, producing a dreamlike state. Their eyes are open. They make mvmts
that may seem purposeful, but they cannot interact with observers.
Some people can do things that are dangerous or embarrassing (walking into
traffic or removing clothes) after seizure they do not remember the activity
Seizures last 1-2 minutes
o Motor or nonmotor
Motor- atonic (loss of tone), tonic (sustained stiffening), clonic (rhythmic
jerking), myoclonic (irregular, brief jerking) or epileptic spasms (fleion or
extension of arms with flexion of trunk
Lip smacking or other repetitive, purposeless actions
Emotional manifestations- fear, joy, strange feelings, or symptoms such as a
racing heart, goose bumps, or wave of heat or cold
Seizure epilepticus
The difference between autoimmune and degenerative disease is how it affects the body
Degenerative disease is caused by a physical breakdown, the neurons that affect neurologic
communication, muscle contractions, nerves fibers that affect mvmt
Autoimmune- Caused by a rxn in the immune system that attacks itself.
The brain functions in a complex chemically mediated environment, the environment happens
via neurons and neurotransmitters.
o Neurons are the brain cells, there are billions of them
They are capable of instant communication, instant communication happens
between the neuron and neurotransmitter
o Neurotransmitters- are referred to as chemical messengers
o The brain is comprised of 700,00 different types of neurotransmitters
o Neurons communicate with neurotransmitters to create a messenger like response to
relay information
Contract with muscle turn the head, blink, etc
o Neurotransmitters are categorized as excitatory or inhibitor
o Excitatory- stimulates electrical activity of the brain cell
o Inhibitory- calms the activity
At one end of each neuron there are dendrites- they receive the information
At the other end there is an axon
o Its acts as a roadway, it’s how information moves through the neuron
o Axon terminals- contain vesicles where neurotransmitters are stored
When a brain cell receives info its fires an electrical impulse that travels down the axon to the
axon terminal where the neurotransmitters are stored. Triggers the release of chemical
messenger and the processing of info begins
Processing has 3 categories
o When process is complete the info can be degenerated, deactivated, or delivered
o If info is degraded -the brain just gets rid of it
Brain does not try to process it
o If info is deactivated the brain tried to process it but didn’t like it and gets rid of it
o Delievered- the message is sent and received
Info cannot get to where it needs to be to elicit a response
Seizures
A seizure is a burst of uncontrolled electrical activity between brain cells that causes temporary
abnormalities in muscle tone or movements, behaviors, and sensations or states of awareness.
o Can be cause by autoimmune or degenerative diseases
o Abnormalities in muscle tones or strength can look like stiffness, twitching, fatigue, or
tremor (Parkinson’s), spasticity or limpness
, o Seizure is a symptom of epilepsy
Generalized seizures
Tonic-clonic (grand mal)- grand mal
o In the tonic stage the muscles stiffen
Loss of consciousness
o Clonic stage consists of rapid muscle contraction, sometimes referred to as compulsions
o Usually, last 1-3 minutes
o If its lasts more than 5 minutes, it’s a medical emergency
o Caused by hypoglycemia, high fever, and stroke
o During a seizure the pt loses consciousness and falls to the ground, if upright. The body
stiffens (tonic phase) for 10- 20 seconds and the extremities jerk (clonic phase) for
another 30 -40 seconds. Cyanosis, excessive salivation, tongue or check biting, and
incontinence may occur during seizure
o Postictal: pt has muscle soreness, feels tired, and may sleep for several hours pt has not
memory of the seizure
Absence (petit mal)
o Involve brief sudden lapses in attention
o Typical
A person will suddenly stop activity, flat affect (looks like they are staring off
into space)
Eyes will turn upward and there will be a fluttering in their eye lids
Usually lasts 10 seconds are less
Brief staring spell that resembles daydreaming. Often goes unnoticed because it
lasts less than 10 seconds. Pt is usually unresponsive when spoken to.
EEG has a spike- wave pattern with 3 per second
o Atypical- seizure will start with staring off into space but then there is a change in muscle
tone and mvmt
Change in muscle tone (repetitive smacking of the lips or chewing mvmt) they
may be rubbing their fingers together
Lasts up to 20 seconds (longer than a typical)
Staring spell is accompanied by other S&S such as eye blinking or jerking mvmts
of the lips. Often lasts more than 10 seconds with a gradual beginning and end
EEG shows spike- and- wave patterns, with fewer than 3 per second
Myoclonic
o Brief
o Shock like jerking of a muscle or group of muscles
o Myo= muscle; clonus=rapid alternating contraction and relaxion
o Usually only lasts a few seconds
o Mvmt is seen with Tourette’s (it’s a myoclonic mvmt)
, o Characterized by rhythmic arm abduction (3 mvmts per second) leading to progressive
arm elevation. Usually last 10 to 60 seconds
o Eyelid myoclonia refers to jerking of the eyelids often with upward eye deviation- usually
last 10 seconds
Atonic or Akinetic
o Tone- having tone is the muscles normal tension (you’re supposed to have tone)
o Atonic- without tone
Muscles suddenly become limp
Dropping of eye lid
Pt may nod or lean forward and drop to the floor
Lasts less than 15 seconds
Focal/Partial
o Focal- Nerve cells in the brain send out sudden excessive uncontrolled electrical activity
Excitatory like response
o Symptoms are dependent on the area of the brain affected
Muscle jerking, lose of muscle tone, repeated mvmts
Most commonly= changes in emotion, changes in thinking, and changes in
sensation
o Difference between simple and complex (unconscious or conscious)
Simple- pt maintain awareness
Complex- pt loses awareness
o Cause sensory, motor, cognitive, or emotional manifestations based on the function of
the involved area of the brain
o Focal awareness (partial)- pt are conscious and alert but have unusual feelings or
sensations that can take many forms. They may have sudden and unexplainable feelings
of joy, anger, sadness, or nausea. They may hear, smell, taste, see, or feel things that are
not real
o Focal impaired awareness (partial)- patient have a loss of consciousness or a change in
their awareness, producing a dreamlike state. Their eyes are open. They make mvmts
that may seem purposeful, but they cannot interact with observers.
Some people can do things that are dangerous or embarrassing (walking into
traffic or removing clothes) after seizure they do not remember the activity
Seizures last 1-2 minutes
o Motor or nonmotor
Motor- atonic (loss of tone), tonic (sustained stiffening), clonic (rhythmic
jerking), myoclonic (irregular, brief jerking) or epileptic spasms (fleion or
extension of arms with flexion of trunk
Lip smacking or other repetitive, purposeless actions
Emotional manifestations- fear, joy, strange feelings, or symptoms such as a
racing heart, goose bumps, or wave of heat or cold
Seizure epilepticus
