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MOTOR AND NEUROLOGICAL IMPAIRMENTS (DIHCA Module 5).pptx

  1. MOTOR AND NEUROLOGICAL IMPAIRMENTS Prepared by: JENNIFER B. GARCIA, RN
  2. Main issues: mobility, communication, breathing Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig’s disease or motor neuron disease, is a progressive, neuromuscular disease that attacks nerve cells and pathways in the brain and spinal cord. Motor neurons, among the largest of all nerve cells, reach from the brain to the spinal cord and from the spinal cord to muscles throughout the body.When these motor neurons die, the brain can no longer start and control muscle movement. Amyotrophic comes from the Greek language. “A” means no or negative. “Myo” refers to muscle, and “trophic” means nourishment, thus “no muscle nourishment.”When a muscle receives no nourishment, it atrophies or wastes away. “Lateral” identifies the areas in a person's spinal cord where portions of the nerve cells that nourish the muscles are located. As this area degenerates, it leads to scarring or hardening (“sclerosis”) in the region. Amyotrophic Lateral Sclerosis:
  3. As more and more nerves and muscles are affected, the person with ALS loses the ability to move, eventually suffering complete paralysis.The muscles used for breathing, speaking, and swallowing also become affected. ALS does not affect the person’s mind, senses (feeling, tasting, smelling etc.), bladder and bowel function, or sexual drive and function. As muscle cells deteriorate, patients may experience stiffness, occasional jerking of the arms or legs, or twitching (fasciculations). Often symptoms begin in the hands and feet, then travel inward toward the center of the body. One side is usually more affected than the other. Eventually paralysis may be complete, except for the muscles of the eyes.
  4. Diagnosis Amyotrophic lateral sclerosis is difficult to diagnose early because it can mimic other neurological diseases.Tests to rule out other conditions might include: 1. Electromyogram (EMG).Your doctor inserts a needle electrode through your skin into various muscles.The test evaluates the electrical activity of your muscles when they contract and when they're at rest. Abnormalities in muscles seen in an EMG can help doctors diagnose or rule out ALS. An EMG can also help guide your exercise therapy. 2. Nerve conduction study.This study measures your nerves' ability to send impulses to muscles in different areas of your body.This test can determine if you have nerve damage or certain muscle or nerve diseases. 3. MRI. Using radio waves and a powerful magnetic field, an MRI produces detailed images of your brain and spinal cord. An MRI can reveal spinal cord tumors, herniated disks in your neck or other conditions that might be causing your symptoms. 4. Blood and urine tests. Analyzing samples of your blood and urine in the laboratory might help your doctor eliminate other possible causes of your signs and symptoms. 5. Spinal tap (lumbar puncture).This involves removing a sample of your spinal fluid for laboratory testing using a small needle inserted between two vertebrae in your lower back. 6. Muscle biopsy. If your doctor believes you may have a muscle disease rather than ALS, you might undergo a muscle biopsy.While you're under local anesthesia, a small portion of your muscle is removed and sent to a lab for analysis.
  5. Treatment Treatments can't reverse the damage of amyotrophic lateral sclerosis, but they can slow the progression of symptoms, prevent complications, and make you more comfortable and independent. You might need an integrated team of doctors trained in many areas and other health care professionals to provide your care.This might prolong your survival and improve your quality of life. Your team will help you select the right treatments for you.You have the right to choose or refuse any of the treatments suggested.
  6. Medications The Food and Drug Administration has approved three medicines for treating ALS: Riluzole (Rilutek, Exservan,Tiglutik kit).Taken orally, this medicine can increase life expectancy by 3 to 6 months. It can cause side effects such as dizziness, gastrointestinal conditions and liver function changes.Your health care provider will monitor your blood counts and liver function while you're taking the medicine. Edaravone (Radicava). This medicine, given through a vein in your arm or orally as a pill, can reduce the decline in daily functioning. Its effect on life span isn't yet known. Side effects can include bruising, headache and shortness of breath.This medicine is given daily for two weeks a month. Sodium phenylbutyrate and taurursodiol (Relyvrio).This medicine, recently approved by the FDA, can slow the rate of decline in people withALS. In particular, it may help people with performing daily tasks. It also may help people with ALS live longer, but more study is needed. Potential side effects of the medicine include diarrhea, belly pain, nausea and upper respiratory infection. People with disorders that affect bile acid circulation may experience diarrhea that gets worse when taking this medicine.
  7. Therapies Breathing care.You'll eventually have more difficulty breathing as your muscles weaken. Doctors might test your breathing regularly and provide you with devices to assist your breathing at night. You can choose mechanical ventilation to help you breathe. Doctors insert a tube in a surgically created hole at the front of your neck leading to your windpipe (tracheostomy) that connects to a respirator. Physical therapy. A physical therapist can address pain, walking, mobility, bracing and equipment needs that help you stay independent. Practicing low-impact exercises can help maintain your cardiovascular fitness, muscle strength and range of motion for as long as possible. Regular exercise can also help improve your sense of well-being. Appropriate stretching can help prevent pain and help your muscles function at their best. A physical therapist can also help you adjust to a brace, walker or wheelchair and might suggest devices such as ramps that make it easier for you to get around. Occupational therapy. An occupational therapist can help you find ways to remain independent despite hand and arm weakness. Adaptive equipment can help you perform activities such as dressing, grooming, eating and bathing. An occupational therapist can also help you modify your home to allow accessibility if you have trouble walking safely. •Speech therapy. A speech therapist can teach you adaptive techniques to make your speech more understandable. Speech therapists can also help you explore other methods of communication, such as an alphabet board or pen and paper. •Ask your therapist about the possibility of borrowing or renting devices such as tablet computers with text-to-speech applications or computer-based equipment with synthesized speech that can help you communicate. •Nutritional support.Your team will work with you and your family members to ensure you're eating foods that are easier to swallow and meet your nutritional needs.You might eventually need a feeding tube. •Psychological and social support.Your team might include a social worker to help with financial issues, insurance, and getting equipment and paying for devices you need. Psychologists, social workers and others may provide emotional support for you and your family.
  8. Cerebrovascular Accident (CVA or commonly known as stroke): Main issues: paralysis or weakness, vision problems, communication, emotional, depression Ischemic stroke: Caused by a blockage in an artery, is responsible for about 85% of all strokes.The most common ischemic stroke subtypes are:  Thrombotic stroke: A blood clot (thrombus) forms in an artery in the neck or brain.These arteries may have a build-up of fatty deposits called plaques.  Embolic stroke: A blockage caused by blood clots that form elsewhere in the body (usually the heart) and travel to the brain.A common source is an abnormal rhythm in the heart's two upper chambers (atrial fibrillation), which may cause clots to form.  Hemorrhagic stroke: Hemorrhage means bleeding.This type of stroke is caused by a leak or rupture of an artery in the brain or on its surface. Such ruptures can be caused by an aneurysm (a thin, weak area on an artery wall) or by a malformation of the brain's blood vessel system. Hemorrhages may occur within the brain itself, or in the space between the brain and its protective outer layer. Approximately 15% of all strokes are caused by hemorrhage.
  9. Symptoms If you or someone you're with may be having a stroke, pay particular attention to the time the symptoms began. Some treatment options are most effective when given soon after a stroke begins. Signs and symptoms of stroke include: Trouble speaking and understanding what others are saying.You may experience confusion, slur words or have difficulty understanding speech. Paralysis or numbness of the face, arm or leg.You may develop sudden numbness, weakness or paralysis in the face, arm or leg.This often affects just one side of the body.Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile. Problems seeing in one or both eyes.You may suddenly have blurred or blackened vision in one or both eyes, or you may see double. Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate that you're having a stroke. Trouble walking.You may stumble or lose your balance.You may also have sudden dizziness or a loss of coordination.
  10. When to see a doctor Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to come and go or they disappear completely.Think "FAST" and do the following: Face.Ask the person to smile. Does one side of the face droop? Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to rise? Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange? Time. If you observe any of these signs, call 911 or emergency medical help immediately. Call 911 or your local emergency number right away. Don't wait to see if symptoms stop. Every minute counts.The longer a stroke goes untreated, the greater the potential for brain damage and disability. If you're with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.
  11. Causes There are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA), that doesn't cause lasting symptoms. 1. Ischemic stroke This is the most common type of stroke. It happens when the brain's blood vessels become narrowed or blocked, causing severely reduced blood flow (ischemia). Blocked or narrowed blood vessels are caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through the bloodstream, most often from the heart, and lodge in the blood vessels in the brain. Some initial research shows that COVID-19 infection may increase the risk of ischemic stroke, but more study is needed.
  12. 2. Hemorrhagic stroke Hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect the blood vessels. Factors related to hemorrhagic stroke include: -Uncontrolled high blood pressure -Overtreatment with blood thinners (anticoagulants) -Bulges at weak spots in your blood vessel walls (aneurysms) -Trauma (such as a car accident) -Protein deposits in blood vessel walls that lead to weakness in the vessel wall (cerebral amyloid angiopathy) Ischemic stroke leading to hemorrhage A less common cause of bleeding in the brain is the rupture of an irregular tangle of thin-walled blood vessels (arteriovenous malformation).
  13. Transient ischemic attack (TIA) A transient ischemic attack (TIA) — sometimes known as a ministroke — is a temporary period of symptoms similar to those in a stroke. ATIA doesn't cause permanent damage.ATIA is caused by a temporary decrease in blood supply to part of the brain, which may last as little as five minutes. Like an ischemic stroke, aTIA occurs when a clot or debris reduces or blocks blood flow to part of the nervous system. Seek emergency care even if you think you've had aTIA because your symptoms got better. It's not possible to tell if you're having a stroke orTIA based only on the symptoms. If you've had aTIA, it means you may have a partially blocked or narrowed artery leading to the brain. Having aTIA increases your risk of having a full-blown stroke later.
  14. Risk factors Many factors can increase the risk of stroke. Potentially treatable stroke risk factors include: Lifestyle risk factors Being overweight or obese Physical inactivity Heavy or binge drinking Use of illegal drugs such as cocaine and methamphetamine Medical risk factors High blood pressure Cigarette smoking or secondhand smoke exposure High cholesterol Diabetes Obstructive sleep apnea Cardiovascular disease, including heart failure, heart defects, heart infection or irregular heart rhythm, such as atrial fibrillation Personal or family history of stroke, heart attack or transient ischemic attack COVID-19 infection
  15. Other factors associated with a higher risk of stroke include: Age — People age 55 or older have a higher risk of stroke than do younger people. Race or ethnicity —African Americans and Hispanics have a higher risk of stroke than do people of other races or ethnicities. Sex — Men have a higher risk of stroke than do women.Women are usually older when they have strokes, and they're more likely to die of strokes than are men. Hormones — Use of birth control pills or hormone therapies that include estrogen increases risk.
  16. Complications A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part is affected. Complications may include: Paralysis or loss of muscle movement.You may become paralyzed on one side of the body, or lose control of certain muscles, such as those on one side of the face or one arm. Difficulty talking or swallowing. A stroke might affect control of the muscles in the mouth and throat, making it difficult for you to talk clearly, swallow or eat.You also may have difficulty with language, including speaking or understanding speech, reading, or writing. Memory loss or thinking difficulties. Many people who have had strokes experience some memory loss.Others may have difficulty thinking, reasoning, making judgments and understanding concepts. Emotional problems. People who have had strokes may have more difficulty controlling their emotions, or they may develop depression. Pain. Pain, numbness or other unusual sensations may occur in the parts of the body affected by stroke. For example, if a stroke causes you to lose feeling in the left arm, you may develop an uncomfortable tingling sensation in that arm. Changes in behavior and self-care ability. People who have had strokes may become more withdrawn. They may need help with grooming and daily chores.
  17. Prevention Knowing your stroke risk factors, following your health care provider's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. If you've had a stroke or a transient ischemic attack (TIA), these measures might help prevent another stroke.The follow-up care you receive in the hospital and afterward also may play a role. Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include: Controlling high blood pressure (hypertension).This is one of the most important things you can do to reduce your stroke risk. If you've had a stroke, lowering your blood pressure can help prevent a subsequentTIA or stroke. Healthy lifestyle changes and medications are often used to treat high blood pressure. Lowering the amount of cholesterol and saturated fat in your diet. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce buildup in the arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a cholesterol-lowering medication. Quitting tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting tobacco use reduces the risk of stroke. Managing diabetes. Diet, exercise and losing weight can help you keep your blood sugar in a healthy range. If lifestyle factors don't seem to be enough to control your diabetes, your doctor may prescribe diabetes medication.
  18. Maintaining a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes. Eating a diet rich in fruits and vegetables. A diet containing five or more daily servings of fruits or vegetables may reduce the risk of stroke.The Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful. Exercising regularly. Aerobic exercise reduces the risk of stroke in many ways. Exercise can lower blood pressure, increase the levels of good cholesterol, and improve the overall health of the blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to at least 30 minutes of moderate physical activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week. Drinking alcohol in moderation, if at all. Heavy alcohol consumption increases the risk of high blood pressure, ischemic strokes and hemorrhagic strokes. Alcohol may also interact with other drugs you're taking. However, drinking small to moderate amounts of alcohol, such as one drink a day, may help prevent ischemic stroke and decrease the blood's clotting tendency.Talk to your doctor about what's appropriate for you. Treating obstructive sleep apnea (OSA).Your doctor may recommend a sleep study if you have symptoms of OSA — a sleep disorder that causes you to stop breathing for short periods repeatedly during sleep. Treatment for OSA includes a device that delivers positive airway pressure through a mask to keep the airway open while you sleep. Avoiding illegal drugs. Certain street drugs, such as cocaine and methamphetamine, are established risk factors for aTIA or a stroke.
  19. Preventive medications If you've had an ischemic stroke or aTIA, your doctor may recommend medications to help reduce your risk of having another stroke.These include: Anti-platelet drugs. Platelets are cells in the blood that form clots. Anti-platelet drugs make these cells less sticky and less likely to clot.The most commonly used anti-platelet medication is aspirin.Your doctor can help you determine the right dose of aspirin for you. After aTIA or minor stroke, your doctor may give you aspirin and an anti-platelet drug such as clopidogrel (Plavix) for a period of time to reduce the risk of another stroke. If you can't take aspirin, your doctor may prescribe clopidogrel alone. Anticoagulants.These drugs reduce blood clotting. Heparin is fast acting and may be used short-term in the hospital. Slower-acting warfarin (Jantoven) may be used over a longer term.Warfarin is a powerful blood-thinning drug, so you'll need to take it exactly as directed and watch for side effects.You'll also need to have regular blood tests to monitor warfarin's effects. Several newer blood-thinning medications (anticoagulants) are available for preventing strokes in people who have a high risk.These medications include dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa).They're shorter acting than warfarin and usually don't require regular blood tests or monitoring by your doctor.These drugs are also associated with a lower risk of bleeding complications compared to warfarin.
  20. Parkinson’s Disease: Main issues: tremor, rigidity, walking, balance, bradykinesia/akinesia Parkinson’s disease (PD) is a progressive, neurological disease that mainly affects movement but can also affect cognition. Parkinson’s disease results from the destruction of nerve cells in a part of the brain called the basal ganglia. Different parts of the brain work together by sending signals to each other to coordinate all of our thoughts, movements, emotions, and senses. When we want to move, a signal is sent from the basal ganglia to the thalamus and then to the cerebral cortex, all different parts of the brain. Nerve cells in the brain communicate by using chemicals. A chemical (neurotransmitter) called dopamine is produced in a group of cells called the substantia nigra and is essential for normal movement. When the cells die, they can no longer produce and send dopamine, so the signal to move doesn’t get communicated. By the time a person starts to experience motor symptoms of Parkinson’s, they’ve already lost approximately 50% of their dopamine producing cells. People may experience non-motor symptoms from loss of other neurotransmitters up to ten years before motor symptoms are noticed.
  21. Main issues: tremors, swallowing, incontinence, fatigue, coordination, vision MS is an autoimmune disorder of the central nervous system. Scientifically speaking, in someone with MS, the body starts to attack the myelin sheath, the special protective membrane coating the spinal cord and nerve endings. The myelin sheath is responsible for helping signals being sent back and forth between the brain and the body get to where they need to go quickly and efficiently. As MS progresses, the myelin sheath starts to break down and problems happen with the signals. Nerve fibers become damaged and die off, lesions can grow on the brain, and spinal cord and bodily functions are affected. Multiple Sclerosis:
  22. Alzheimer’s disease: Main issues: memory, attention, forgetfulness, withdrawal, behavioral, communication, coordination, personal care, incontinence, eating Alzheimerʼs disease (AD) is a condition that causes abnormal changes in the brain mainly affecting memory and other mental abilities. Alzheimerʼs is a disease, not a normal part of aging. Loss of memory is the usual first symptom. As the disease progresses, the loss of reasoning ability, language, decision- making ability, judgment, and other critical skills make navigating day-to-day living impossible without help from others, most often a family member or friend. Sometimes, but not always, difficult changes in personality and behavior occur. Although the cause and progression of AD are not fully understood, increasing evidence shows that the first changes in the brain happen as much as 15 years before symptoms of dementia are exhibited by the person with AD. Certain kinds of brain scans can detect these changes. However, this work is not yet advanced enough for it to be of practical use in predicting who will later develop Alzheimerʼs disease.
  23. Cerebral Palsy: Main issues: coordination, posture, movement, balance, muscle tone/control, eating Also known as CP, this is a physical disability that affects movement and posture. It is an umbrella term that refers to a group of disorders affecting a person’s ability to move. It is a permanent life- long condition but generally does not worsen over time. It is due to damage to the developing brain either during pregnancy or shortly after birth. CP affects people in different ways and can affect body movement, muscle control, muscle coordination, muscle tone, relax, posture, and balance.The cause is unknown. Some considerations are insufficient oxygen (problems with placenta or umbilical cord in utero, or difficult/delayed delivery), maternal infection during pregnancy, low birth weight, or maternal blood group incompatibility.
  24. There are 4 types: 1. Spastic: Characterized by stiffness and contractions of muscles. 2. Athetoid/dyskinetic: slow, writhing, uncontrolled movements. 3. Ataxic: Lack of coordination and muscle tone. Balance difficulties. 4.Mixed: More than one area of the brain is affected, so several types might be present.
  25. Traumatic Brain Injury: Main Issues: cognitive, behavioral, emotional, speech, weakness, coordination, senses, sleep Referred to as a TBI, traumatic brain injury (head injury) occurs when a jolt or blow to the head causes damage to the brain. Bruising, lack of oxygen to an area of the brain, or broken neurons (as a result of shaking) occur and cause damage to affected areas of the brain. Mild brain injury – concussion Severe brain injury—Penetration Injury, Contusions, Diffuse Axonal Injury (ie shaken baby syndrome)
  26. Neuroplasticity: The brain's ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment. Brain reorganization takes place by mechanisms such as "axonal sprouting" in which undamaged axons grow new nerve endings to reconnect neurons whose links were injured or severed. Undamaged axons can also sprout nerve endings and connect with other undamaged nerve cells, forming new neural pathways to accomplish a needed function. For example, if one hemisphere of the brain is damaged, the intact hemisphere may take over some of its functions.The brain compensates for damage in effect by reorganizing and forming new connections between intact neurons. In order to reconnect, the neurons need to be stimulated through activity. For neurons to form beneficial connections, they must be correctly stimulated. Neuroplasticity is also called brain plasticity or brain malleability.

Notes de l'éditeur

  1. A substantial number of neurological diseases lead to chronic impairment of activities of daily living (ADL) and dependence. Neurological patients are cared for in their homes if impairments (motor, sensory, vegetative, cognitive, neuropsychiatric, or behavioral deficits) are manageable and if homecare is not precluded by spatial or socioeconomic limitations and support is sufficiently provided by family members alone or in cooperation with professional care persons. Otherwise, dependent patients move to the homes of family members or nursing homes. A need for professional care may occur unexpectedly as a consequence of significant deterioration of neurological symptoms or steadily increasing or acute failure of family-based homecare. In this context, concomitant or newly emerging non-neurological disorders and injuries of the patient and health problems of the caregiver (CG) may play a crucial role. Why is it important that educators like you study motor learning and motor control? Because learning a complex motor skill involves developing the appropriate coordination and control to achieve the goal of the skill, investigating feedback information provided to the learner about different features of a complex skill can provide insight into how learners use information in the learning process. What are examples of neurological impairment? Neurological disabilities include a wide range of disorders, such as epilepsy, learning disabilities, neuromuscular disorders, autism, ADD, brain tumors, and cerebral palsy, just to name a few. Some neurological conditions are congenital, emerging before birth. Types of Motor Impairment Spinal cord injury. Lost or damaged limb. Cerebral palsy. Muscular dystrophy. Multiple sclerosis. Spina bifida. Lou Gehrig's disease. Arthritis.
  2. ALS often starts in the hands, feet or limbs, and then spreads to other parts of your body. As the disease advances and nerve cells are destroyed, your muscles get weaker. This eventually affects chewing, swallowing, speaking and breathing. There's generally no pain in the early stages of ALS, and pain is uncommon in the later stages. ALS doesn't usually affect your bladder control or your senses.
  3. ALS often starts in the hands, feet or limbs, and then spreads to other parts of your body. As the disease advances and nerve cells are destroyed, your muscles get weaker. This eventually affects chewing, swallowing, speaking and breathing. There's generally no pain in the early stages of ALS, and pain is uncommon in the later stages. ALS doesn't usually affect your bladder control or your senses. *ALS often starts in the hands, feet or limbs, and then spreads to other parts of your body. As the disease advances and nerve cells are destroyed, your muscles get weaker. This eventually affects chewing, swallowing, speaking and breathing. There's generally no pain in the early stages of ALS, and pain is uncommon in the later stages. ALS doesn't usually affect your bladder control or your senses. Causes ALS affects the nerve cells that control voluntary muscle movements such as walking and talking (motor neurons). ALS causes the motor neurons to gradually deteriorate, and then die. Motor neurons extend from the brain to the spinal cord to muscles throughout the body. When motor neurons are damaged, they stop sending messages to the muscles, so the muscles can't function. ALS is inherited in 5% to 10% of people. For the rest, the cause isn't known. Researchers continue to study possible causes of ALS. Most theories center on a complex interaction between genetic and environmental factors. Risk factors Established risk factors for ALS include: Heredity. Five to 10 percent of the people with ALS inherited it (familial ALS). In most people with familial ALS, their children have a 50-50 chance of developing the disease. Age. ALS risk increases with age, and is most common between the ages of 40 and the mid-60s. Sex. Before the age of 65, slightly more men than women develop ALS. This sex difference disappears after age 70. Genetics. Some studies examining the entire human genome found many similarities in the genetic variations of people with familial ALS and some people with noninherited ALS. These genetic variations might make people more susceptible to ALS. Environmental factors, such as the following, might trigger ALS. > Smoking. Smoking is the only likely environmental risk factor for ALS. The risk seems to be greatest for women, particularly after menopause. Environmental toxin exposure. Some evidence suggests that exposure to lead or other substances in the workplace or at home might be linked to ALS. Much study has been done, but no single agent or chemical has been consistently associated with ALS. >Military service. Studies indicate that people who have served in the military are at higher risk of ALS. It's unclear what about military service might trigger the development of ALS. It might include exposure to certain metals or chemicals, traumatic injuries, viral infections, and intense exertion. Complications As the disease progresses, ALS causes complications, such as: >Breathing problems Over time, ALS paralyzes the muscles you use to breathe. You might need a device to help you breathe at night, similar to what someone with sleep apnea might wear. For example, you may be given a bilevel positive airway pressure (BiPAP) device to help with your breathing at night. This type of device supports your breathing through a mask worn over your nose, your mouth or both. Some people with advanced ALS choose to have a tracheostomy — a surgically created hole at the front of the neck leading to the windpipe (trachea) — for full-time use of a respirator that inflates and deflates their lungs. The most common cause of death for people with ALS is respiratory failure. On average, death occurs within 3 to 5 years after symptoms begin. However, some people with ALS live 10 or more years. >Speaking problems Most people with ALS develop trouble speaking. This usually starts as occasional, mild slurring of words, but becomes more severe. Speech eventually becomes difficult for others to understand, and people with ALS often rely on other communication technologies to communicate. >Eating problems People with ALS can develop malnutrition and dehydration from damage to the muscles that control swallowing. They are also at higher risk of getting food, liquids or saliva into the lungs, which can cause pneumonia. A feeding tube can reduce these risks and ensure proper hydration and nutrition. >Dementia Some people with ALS have problems with memory and decision-making, and some are eventually diagnosed with a form of dementia called frontotemporal dementia.
  4. A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die. A stroke can cause lasting brain damage, long-term disability, or even death. An ischemic stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. Ischemia is a condition in which blood flow (and thus oxygen) is restricted or reduced in a part of the body.  A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications. The good news is that many fewer Americans die of stroke now than in the past. Effective treatments can also help prevent disability from stroke.
  5. The acronym FAST (Facial drooping, Arm weakness, Speech difficulties and Time) has been used by the National Stroke Association, American Heart Association and others to educate the public on detecting symptoms of a stroke. FAST was first introduced in the United Kingdom in 1998.
  6. Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerve fibers. Signs and symptoms of MS vary widely between patients and depend on the location and severity of nerve fiber damage in the central nevous system. Some people with severe MS may lose the ability to walk independently or ambulate at all. Other individuals may experience long periods of remission without any new symptoms depending on the type of MS they have. There's no cure for multiple sclerosis. However, there are treatments to help speed the recovery from attacks, modify the course of the disease and manage symptoms.
  7. A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. Concussions are usually caused by a blow to the head. Penetrating trauma is an injury caused by a foreign object piercing the skin, which damages the underlying tissues and results in an open wound. The most common causes of such trauma are gunshots, explosive devices, and stab wounds. Contusion is the medical term for a bruise. It is the result of a direct blow or an impact, such as a fall. Contusions are common sports injuries. Most people think of a bruise as a black-and-blue spot. This happens when small blood vessels get torn and leak blood under the skin. Shaken baby syndrome is a serious brain injury resulting from forcefully shaking an infant or toddler. It's also known as abusive head trauma, shaken impact syndrome, inflicted head injury or whiplash shaken infant syndrome. Diffuse axonal injury is the shearing (tearing) of the brain's long connecting nerve fibers (axons) that happens when the brain is injured as it shifts and rotates inside the bony skull. DAI usually causes coma and injury to many different parts of the brain.
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