Degenerative & auto-immune Conditions
Parkinsons
Eaton Lambert syndrome
a neuromuscular junction disorder which may present as a paraneoplastic phenomenon or a primary autoimmune disorder
antibodies against presynaptic voltage-gated calcium channels
muscle weakness is primary symptom esp of prox leg muscles and is usually of prox to distal, caudal to cranial distribution & symmetrical. Post-exercise facilitation is common (return of reflexes and muscle strength post exercise)
Cranial Nerve involvement in >75% with oculobulbar weakness prominent
autonomic involvement in >80%
similar to Myasthenia Gravis but distinguished by - areflexia, autonomic dysfunction and the phenomenon of post-exercise facilitation
Management
PSP (Progressive Supra-Nuclear Palsy)
otherwise known as Steele-Richardson-Olszewski Syndrome condition
progressive impairment of balance and walking
impaired eye movement, especially in the downward direction
abnormal muscle tone (rigidity)
speech difficulties (dysarthria)
problems related to swallowing and eating (dysphagia)
frequently experience personality changes and cognitive impairment.
Spinocerebellar Ataxia
References include