Susan Fralick-Ball – Advances in Diagnosis and Treatment of Neuromuscular & Neurodegenerative Disorders

Susan Fralick-Ball – Advances in Diagnosis and Treatment of Neuromuscular & Neurodegenerative Disorders

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Multiple Sclerosis

• 4 classifications
• Risk factors: Low Vitamin D, abnormal lipid metabolism
• Making the diagnosis 1-2-3
  • Neuromyelitis Optica, nystagmus
  • Genomic markers
• MRI plain and 3-D
• Treating multiple complications
• Get Dancing and Get on a Bike exercises for MS
• Medication updates 2016
• Case Study

Parkinson’s Disease

• Degeneration, Decline, and Autonomic Disease
  • A Prion Disease?
• T-R-A-P symptoms
• Non-motor complications
• Biomarkers, LRRK variants
• Medical treatment
  • Medications
  • Neuroprotection
• Surgical treatment
  • Palidotomy, Thalamotomy, DBS, Stem cell transplantation
• New PT/OT/SP guidelines for early engagement
  • Bikes, boxing, Big & Loud programs, forced exercise
  • Electrical stimulation
• PD chameleons
  • Essential Tremor
  • Progressive supranuclear palsy
  • Corticobasilar degeneration
• Case Study

Myasthenia Gravis

• Neuromuscular Junction Disorder
  • Autoimmune
  • T-cell interference at NMJ
• Edrophonium (Enlon™) Test for Diagnosis
  • MG vs. Lambert-Eaton
• Short-acting anticholinesterase inhibitors
• Thymectomy
• Crisis: Myasthenic vs. Cholinergic
• Emergent Treatment: Steroids, IVIG, Plasma
• Exchange
• Case Study

Muscular Dystrophy

• Symptoms & causes
• Complications over time
• Treatment: Medical and surgical
• Case Study

Guillain-Barré Syndrome

• Syndrome of peripheral demyelination
  • Ascending
  • Pure motor
  • Descending
  • Miller-Fisher
• Early diagnosis, earlier recovery
• Causes: Viral, bacterial, surgical, vaccines, hyponatremia
• Medical treatment: The Big 3 (steroids, IVIG, Plasmapheresis)
• PT/OT/ST/Psych guidelines
• Case Study

Chronic Inflammatory Demyelinating Polyneuropathy/radiculopathy

• The elusive diagnosis dilemma
  • Symptoms, testing
• Medical treatment for the short- and long-term
  • Living with neuropathic pain
  • Medication, spinal/brain stimulation
• Best PT/OT guidelines
• Case Study

Amyotrophic Lateral Sclerosis

• Degeneration of the motor neurons
• Genetic or generic disease?
  • Rule out everything else
• Risk factors and neuroprotection
• Medications help the complications
  • Alternative treatments
  • Stem cell research
• Palliative considerations

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