PT MANAGEMENT OF INFECTIONS OF BRAIN
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Inflammation of the protective membranes surrounding the brain and spinal cord (meninges) can cause meningitis. Common symptoms include vomiting, seizures, stiff neck, rash, and altered consciousness. Assessment involves evaluating neurological, vascular, musculoskeletal and other systems. Management aims to provide psychological support, prevent complications like chest issues and blood clots, correct deformities, improve strength and balance, and train gait. Techniques include stretching, positioning, exercises and assisted walking.
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PT MANAGEMENT OF INFECTIONS OF BRAIN
- 1. ASSESSMENT & MANAGEMENT OF INFECTIONS OF BRAIN KEERTHI MPT NEUROLOGY ASSISTANT PROFESSOR
- 3. INTRODUCTION Inflammation of the protective membranes that surround the brain and spinal cord, known as the meninges. 3
- 4. SIGNS & SYMPTOMS Vomiting Seizures Stiff neck Blotchy skin or a rash Rapid breathing Floppy limbs Photophobia 4
- 5. CLINICAL FEATURES NEUROLOGICAL Inflammation of subarachnoid space Spread of inflammation to parenchyma Focal ischemic lesions Hydrocephaly Impaired consciousness 5
- 6. CLINICAL FEATURES Hemiparesis Seizures Cranial nerve palsy Hypothalamic dysfunction in children 6
- 7. CLINICAL FEATURES VASCULAR Inflammation of small subarachnoid vessels (especially veins) Thrombotic obstruction of vessels MUSCULOSKELETAL Opisthotonic posture Infectious spread to joints 7
- 8. CLINICAL FEATURES SENSORY Impaired hearing Loss of vision METABOLIC Dehydration Hyponatremia 8
- 10. Secondary complications such as: Muscle weakness Poor balance and co-ordination Poor body awareness (proprioception) 10
- 11. ENCEPHALITIS Encephalitis is an acute inflammation of the parenchyma of brain & spinal cord 11
- 12. CLINICAL FEATURES Fever Headache Nausea and vomiting Fatigue Confusion Seizures (fits) Problems with speech or hearing Memory loss 12
- 13. PHYSICAL SYMPTOMS Muscle weakness Reduced sensation Spasticity or flaccidity Poor balance Difficulty controlling movement of the arms and legs for everyday actions Reduced mobility Decreased exercise tolerance 13
- 14. ASSESMENT Demographic data Chief complaints History Pain Assessment: Site Side Duration Type Aggravating & Relieving Factors Intensity 14
- 15. ASSESMENT Observation : Patient is conscious or not Type of ventilation Pattern of breathing central lines skin changes 15
- 16. ASSESMENT Observation : Posture; abnormal posturing Gait: abnormalities (may be ataxic) Limb attitude: abnormal attitude (synergies) Type of ambulation 16
- 17. Examination : Higher function: GCS MMSE Cranial nerve assessment: Features of lower cranial nerve palsy will be seen Sensory system: 17 Superficial & deep RIGHT LEFT Touch INTACT/ NOT INTACT INTACT/ NOT INTACT Pain Temperature Position Vibration Kinaesthetic
- 18. Motor system: Tone by MAS Power by MMT ROM Reflexes: SUPERFICAIL & DEEP 18 Superficail Right Left Corneal Conjuctival Abdominal Plantar Scapular Deep Biceps Triceps Supinator Knee Ankle Right Left
- 19. Balance : BBS Gait Bowel & bladder Functional activities On auscultation: Air entry Secretions Breath hold capacity Chest expansion 19
- 20. Special test Kernick’s Brudjinski Glass tumbler test 20
- 21. MANAGEMENT AIMS: Psychological support Prevent chest complications Prevent DVT Prevent bed sores 21
- 22. MANAGEMENT AIMS: Correct deformity Normalize tone Improve strength & balance Gait training 22
- 23. Psychological Support counselling for patient and family members Relaxation techniques 23
- 24. Chest Complications Deep breathing & Segmental breathing exercises Postural drainage , vibration & percussions Clearing of secretions by ACBT, Huffing & Coughing Techniques 24
- 25. DVT Stockings Positioning Elevation Buergers exercise Ankle toe movements 25
- 26. BED SORES Changing position for every 1 hour Provide a foam or water bed Use soft cushions or pneumatic rings Maintain hygiene 26
- 27. CORRECT DEFORMITY splinting & casting Positioning Facilitatory & inhibitory techniques 27
- 28. NORMALIZE TONE Stretching Iceing Relaxed passive movements PNF techniques 28
- 30. STRENGTH & BALANCE IMPROVEMENT Exercise based on power and tone PNF techniques Static balance training in sitting Dynamic balance training on swiss ball Wobble board Trampoline 30
- 31. GAIT TRAINING Over parallel bars Over treadmill On different surfaces 31
- 32. 32
Editor's Notes
- Exaggerated DTR Positive Babinski's, Presence of primitive reflexes
- Exaggerated DTR Positive Babinski's, Presence of primitive reflexes
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.
- Facilitatory techVibration, stroking, joint approximation tech, quickiceing, quick stretching etc Inhibitory techSustained stretching, pressure, neural warmth, prolongediceing, joint traction Splinting & serial casting. Strengthening exercises to help improve muscle function. This can be in the form of simple exercises such as sit to stand or walking. Your child may find these tasks difficult after having Meningitis. Stretching exercises as your child may experience a stiff neck. Balance exercises such as standing with their eyes closed, standing on a wobble board or standing on one leg. This is important as they need balance for tasks such as walking, running and cycling. Co-ordination exercises such as catching balls, juggling and kicking a football.