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Neuromuscular Diseases and TBI Prelearning

Neuromuscular Diseases and TBI Prelearning






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  • Diplegia—This means only the legs are affected.Hemiplegia—This means one half of the body (such as the right arm and leg) is affected.Quadriplegia—This means both arms and legs are affected, sometimes including the facial muscles and torso.

Neuromuscular Diseases and TBI Prelearning Neuromuscular Diseases and TBI Prelearning Presentation Transcript

  • Students with Neuromuscular Disabilities and Brain Injury
  • Neuromuscular disabilities and brain injuries
    Cerebral Palsy
    Traumatic Brain
    Muscular Dystrophy
  • Epilepsy- What is it?
    It is a condition that produces brief disturbances in the electrical functioning of the brain, causing seizers. (Kuder, 2006)
    Seizers happen without immediate cause and usually are repeated.
    Epilepsy is broken down into two groups.
    Generalized epilepsy affects both hemispheres of the brain.
    Partial epilepsy focuses on one side of the brain.
  • Epilepsy
  • Epilepsy – Etiology
    Causes are unknown, unless it was caused by an injury.
    Research has shown that epilepsy is more prevalent in people that have experienced severe illness, brain damage, strokes, brain abscess, problems present at birth, tumors, kidney failure, low oxygen to the brain during birth and abnormal levels of blood sugar or sodium.
  • Epilepsy- Etiology cont.
    Researchers have said some forms of epilepsy may be inherited.
    Sometimes women experience spontaneous seizers because of changing in their hormones throughout their life. If females have to much estrogen it can cause more electrical discharge to the brain.
  • Epilepsy - Symptoms
    During seizures
    Jerking of limbs
    Usually eachseizure is similar to the last
    Social communication problems
    An aura consisting of a strange sensation (such as tingling, smelling an odor that isn't actually there, or emotional changes) occurs in some people prior to each seizure.
    Severe epilepsy can cause aphasia which is memory loss after a seizure.
  • Epilepsy- Diagnosis
    Neurological examination
    EGG (electroencephalograph) exam which is reading of the electrical activity in the brain
    Varies blood testing
    Eligible for services under IDEA through other health impairments.
  • Epilepsy - Treatment
    Removal of tumor, abnormal blood vessel.
    Medication called anticonvulsants may reduce the number ofseizures.
    Brain surgery
    Vagal nerve stimulator
    Special diets
  • Epilepsy- Interventions/ Services
    Intervene early
    Mnemonic devices
    Color coded notebooks to help organize work
    Repetitive lesson strategies throughout the unit.
    Therapies like yoga to relieve stress
  • Cerebral Palsy- What is it?
    A term describing a group of muscle and nerve disorders that affect a child’s ability to move.
  • Cerebral Palsy- What is it? Continued.
    Hypertonia (spasticity)-Significant limitations to range of motion. Muscles contracted, movements are slow and jerky. Muscular stiffness, over-reaction, and tightness, often due to oversensitive stretch reflexes
    Athetoid- involuntary movement of limbs, lack of head control. Flailing of arms and legs. Writhing movements.
    Ataxic- difficulty with balance and poor coordination
    Mixed-combination of two or more types.
    *Of the children who have cerebral palsy, approximately 60% have spasticity.
  • Cerebral Palsy- Etiology
    Prenatally(before birth) - Anoxia (lack of oxygen), radiation exposure, drugs that harm the fetus, genetic disorder, fetal stroke, injury, infection of the uterus or kidney, toxemia, anemia, Rh factor, rubella.
    Perinatally(during birth)- Anoxia, Rh factor, high bilirubin levels, injury.
    Postnatally (after birth) - Anoxia; injury; infections such as toxoplasmosis, meningitis; other central nervous system disease.
    Cerebral Palsy is non-progressive.
    *For nearly 40% of all children with this disorder, we don't know what causes the damage.
  • Cerebral Palsy- Symptoms
    Things to look for:
    Delay in reaching motor milestones, such as sitting or walking.
    Abnormal movement, muscle tone that is too low (hypotonia) or too high (hypertonia).
    Unusual reflexes, such as a very active knee-jerk; persistent primitive reflexes.
    Lethargy, or lack of alertness
    Irritability or fussiness
    Abnormal, high-pitched cry
    Trembling of the arms and legs
    Abnormal posture, such as the child favoring one side of the body
  • Cerebral Palsy- Diagnosis
    Check motor skills, muscle tone, and posture
    CT (computed tomography).  Image of the brain that can determine underdeveloped areas of brain tissue.
    MRI (magnetic resonance imaging). Generates a picture of the brain to determine areas that may be damaged
    Intelligence testing
  • Cerebral Palsy- Interventions/Services
    Early Intervention
    Alternative Augmentative Communication
    Assistive technology
    Speech Language Therapy
    Physical Therapy
    Occupational Therapy
    Eligible for services under IDEA through Orthopedic Impairments
    Great Resource!
  • TBI- What is it?
    • Traumatic Brain Injury is caused by an external physical force.
    • Open-head injury: also known as localized. A visible injury that usually is confined to one portion of the brain. (example, gunshot wound)
    • Close-head injury: caused by a rapid acceleration and deceleration of the head, during which the brain bounces around inside the skull. (example, car accidents, falls, and sports injuries)
  • TBI- Symptoms
    • Physical impairments: Speech, vision, hearing, and other sensory impairment; headaches, problems with coordination; spasticity and/or paralysis
    • Cognitive impairments: Memory difficulties; slowness in thinking; problems concentrating; problems with perception and attention; problems planning and sequencing
    • Behavior and personality problems: Fatigue; mood swings; anxiety; depression; difficulty with emotional control
  • TBI- Testing
    • Glasgow Coma Scale: Scale that assesses the response to stimuli in patients with craniocerebral injuries. This 15-point test helps a doctor or other emergency medical personnel assess the initial severity of a brain injury by checking a person's ability to follow directions and move their eyes and limbs. The coherence of speech also provides important clues. Abilities are scored numerically. Higher scores mean milder injuries.
    • Types of responses that are looked at:
    • Eye opening response
    • Verbal response
    • Motor response
  • TBI- Treatment
    • In most cases, children with head injuries show improvement over time, but there may be lasting effects that can have an impact on classroom performance.
    There are three main types of treatments for TBI:
    • Acute Treatment
    • Subacute Treatment
    • Chronic Treatment and Long-Term Rehabilitation
  • Acute Treatment of TBI
    • Immediately after the incident, patients are generally rushed to the hospital for immediate acute treatment.
    Things that are done during Acute Treatment:
    • Check for and surgically remove life-threatening blood clots
    • Clear patients' airways
    • Medicate patients (to calm them, prevent seizures or otherwise prevent further injury)
    • Monitor and surgically relieve high levels of intracranial pressure(the pressure caused by the buildup of excess brain fluid in the skull)
    • Put patients on life support systems, if necessary
  • Subacute Treatment of TBI
    • Medical staff will fully evaluate the patient's impairments, disabilities and probability of recovery.
    • Doctors will outline a course of appropriate treatments, helping patients and their families build the right team of medical professionals necessary for rehabilitation and chronic TBI treatment.
    • Although most traumatic brain injury patients enter subacute treatment centers in shock or a state of post-traumatic amnesia, they leave these facilities ready to live independently, live with home care or move onto to long-term care centers.
    • Patients with mild to moderate TBI spend little, if no time in subacute treatment centers. In contrast, those with severe traumatic brain injury usually spend anywhere from 5 to 10 years getting critical care in subacute treatment facilities.
  • Chronic Treatment of TBI
    Because the complications of TBI can cause lifelong impairment, patients will need ongoing treatment in the form of:
    • Assistive technologies (These include any device, ranging from a wheelchair to a specialized keyboard, that facilitates perception, comprehension and/or mobility.)
    • Counseling and/or therapy (physical and/or speech)
    • Medications
    Patients' individual complications and conditions will vary depending on their:
    • Age
    • Co-morbid conditions (other medical issues existing with the primary condition)
    • Severity of TBI
    • Type of TBI
    Short-term goals that help achievement may include:
    • Being able to socialize
    • Overcoming low self-esteem, depression or other emotional issues
    • Re-learning to speak and otherwise communicate
  • TBI- Interventions
    Prevention is the best intervention for head injuries. They include:
    • Wear seat belts, helmets, and appropriate sports equipment
    Ten elements that should be part of an educational program for students with TBI:
    • Maximally controlled environment
    • Low pupil-teacher ratio
    • Intensive and repetitive instruction
    • Emphasis on process
    • Behavioral programming
    • Integrated instructional therapies
    • Stimulation experiences
    • Cuing, fading, and shadowing
    • Readjustment counseling
    • Home-school liaison
  • Muscular dystrophy- What is it?
    A group of inherited disorders that involve muscle weakness and loss of muscle tissue which gets worse over time
    There are nine types of muscular dystrophy, all affecting different parts of the body and all being onset in different stages of life
    There are also five motor neuron diseases including Spinal Muscular Atrophy, which is one of the most severe and least common forms of muscular dystrophy
    The most common kind is Duchenne Muscular Dystrophy
  • Muscular Dystrophy- Causes
    An absence of dystrophin, a protein that helps keel muscle cells intact.
    Duchenne is x-linked recessive and primarily affects boys. It is usually inherited from the mother. Most women who are carriers don’t have any types of symptoms.
  • Muscular Dystrophy- Symptoms
    Generalized weakness and muscle wasting first affecting the muscles of the hips, pelvic area, thighs, and shoulders.
    Calf pseudohypertrophy- enlarged calf muscles due to muscle tissue being destroyed and replaced by fat.
    Progressive difficulty walking
    Typical life expectancy is 25 years
  • Muscular Dystrophy- Diagnosis
    Electromyography- a medical instrument that records the electrical waves associated with the activity of skeletal muscles
    Genetic tests- techniques used to test for genetic disorders, involve direct examination of the DNA molecule itself.
    Muscle biopsy- a procedure in which a piece of muscle tissue is removed from an organism and examined microscopically.
    Serum CPK- a blood test where levels ofcreatinephosphokinase are measured
  • Muscular Dystrophy- Treatment
    There is no known cure, but the treatments are meant to treat the symptoms
    Treatments include activity such as physical therapy and steroids to prolong muscle strength.
  • Muscular Dystrophy- Interventions
    Genetic counseling
    Since there is no cure it is had to prevent this disease but they are trying to develop gene therapy.