Treatments for Arachnoiditis
Treatments for Arachnoiditis
The list of treatments mentioned in various sources
for Arachnoiditis
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Discussion of treatments for Arachnoiditis:
The goal of treatment should be to return the patient to
a functional role in society. Conservative therapy such as pain management
is generally recommended. In those patients whose arachnoiditis is
progressive, surgery to remove adhesions is only minimally effective
because scar tissue continues to develop. Also, surgery exposes the
already irritated spinal cord to additional trauma.
(Source: excerpt from
NINDS Arachnoiditis Information Page: NINDS)
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Book Excerpts: Treatment of Arachnoiditis
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Nuchal Rigidity:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Meningitis/encephalitis
–Broad-spectrum antibiotics
–Neurologic checks
–Dexamethasone may improve neurologic outcome and
lower incidence of postmeningitic deafness
-
Subarachnoid hemorrhage
–Immediate neurosurgical evaluation
–Consider MRA/conventional angiography
–Surgical clipping and excision
–Pharmacologic management of cerebral vasospasm
–Nimodipine is often used to prevent delayed ischemia
-
Torticollis: Treat with valium, botulinum toxin type A
-
Adenitis/dental abscess: Antibiotic treatment
-
Injury: Soft collar, NSAIDs
-
Cervical muscle spasms
–Heat, massage, soft cervical collar, analgesics
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Brudzinski's sign:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient is alert, ask him about headache, neck pain, nausea, and vision disturbances (blurred or double vision and photophobia) — all indications of increased intracranial pressure (ICP). Next, observe the patient for signs and symptoms of increased ICP, such as an altered level of consciousness (LOC) (restlessness, irritability, confusion, lethargy, personality changes, and coma), pupillary changes, bradycardia, widened pulse pressure, irregular respiratory patterns (Cheyne-Stokes or Kussmaul's respirations), vomiting, and moderate fever.
Keep artificial airways, intubation equipment, a handheld resuscitation bag, and suction equipment on hand because the patient's condition may suddenly deteriorate. Elevate the head of his bed 30 to 60 degrees to promote venous drainage. Administer an osmotic diuretic, such as mannitol, to reduce cerebral edema.
Monitor ICP and be alert for ICP that continues to rise. You may have to provide mechanical ventilation and administer a barbiturate and additional doses of a diuretic. Also, cerebrospinal fluid (CSF) may have to be drained.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Nuchal rigidity:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
After eliciting nuchal rigidity, attempt to elicit Kernig’s and Brudzinski’s signs. Quickly evaluate the patient’s level of consciousness (LOC). Take his vital signs. If you note signs of increased intracranial pressure (ICP), such as increased systolic pressure, bradycardia, and a widened pulse pressure, start an I.V. line for drug administration and deliver oxygen as necessary. Keep the head of the bed at least as low as 30 degrees. Draw a specimen for routine blood studies such as a complete blood count with a white blood cell count and electrolyte levels.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Meningococcal infections:
Treatment
(Professional Guide to Diseases (Eighth Edition))
As soon as meningococcal infection is suspected, treatment begins with high doses of aqueous penicillin G, ampicillin, or ceph-alosporins such as ceftriaxone; or, for the patient who is allergic to penicillin, I.V. chloramphenicol. Therapy may also include mannitol for cerebral edema, I.V. heparin for DIC, dopamine for shock, and digoxin and a diuretic if heart failure develops. Supportive measures include fluid and electrolyte maintenance, ventilation (maintenance of a patent airway and oxygen, if necessary), insertion of an arterial or central venous pressure (CVP) line to monitor cardiovascular status, and bed rest.
Prophylaxis with ciprofloxacin or rifampin aids health care personnel who work in close contact with the patient, such as those administering cardiopulmonary resuscitation or assisting with intubation or suctioning without wearing a surgical mask.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Tuberculosis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
First-line agents for the treatment of TB are isoniazid (INH), rifampin (RIF), ethambutol (EMB), and pyrazinamide. Latent TB is usually treated with daily INH for 9 months. RIF daily for 4 months may be used for people with latent TB whose contacts are INH resistant. For most adults with active TB, the recommended dosing includes the administration of all four drugs daily for 2 months, followed by 4 months of INH and RIF. Drug therapy must be selected according to patient condition and organism susceptibility. Another first-line drug used for TB is rifapentine. Second-line agents, such as cycloserine, ethionamide, p-Aminosalicylic acid, streptomycin, and capreomycin, are reserved for special circumstances or drug-resistant strains. Interruption of drug therapy may require initiation of therapy from the beginning of the regimen or additional treatment.
Directly observed therapy (DOT) may be selected or required. In this therapy, an assigned caregiver directly observes the administration of the drug. The goal of DOT is to monitor the treatment regimen and reduce the development of resistant organisms.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Encephalitis:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Anticonvulsants, acyclovir (if viral), glucocorticoids, mannitol, furosemide, supportive care (mild analgesics, bed rest, seizure precautions)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
West Nile encephalitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
There is no specific therapy utilized to treat West Nile encephalitis and no known cure. Treatment is generally aimed at controlling the specific symptoms. Supportive care, such as I.V. fluids, fever control, and respiratory support, is rendered when necessary.
There is no vaccine present to prevent the transmission of West Nile encephalitis. Research trials are underway to determine if ribavirin, an antiviral drug, may be helpful.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Meningitis:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Antibiotics, supportive care (analgesics; bed rest; sedatives, anticonvulsants, and cardiac glycosides, as appropriate)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Brudzinski's sign:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient is alert, ask him about headache, neck pain, nausea, and vision disturbances (blurred or double vision and photophobia)—all indications of increased intracranial pressure (ICP). Next, observe the patient for signs and symptoms of increased ICP, such as an altered level of consciousness (LOC), pupillary changes, bradycardia, widened pulse pressure, irregular respiratory patterns (Cheyne-Stokes or Kussmaul’s respirations), vomiting, and moderate fever.
Keep artificial airways, intubation equipment, a handheld resuscitation bag, and suction equipment on hand because the patient’s condition may suddenly deteriorate. Elevate the head of his bed 30 to 60 degrees to promote venous drainage. Administer an osmotic diuretic, such as mannitol, to reduce cerebral edema.
Be alert for further increases in ICP. You may have to provide mechanical ventilation and administer a barbiturate and additional doses of a diuretic. Also, cerebrospinal fluid (CSF) may have to be drained.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Nuchal rigidity:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
After eliciting nuchal rigidity, attempt to elicit Kernig’s and Brudzinski’s signs. Quickly evaluate level of consciousness (LOC). Take vital signs. If you note signs of increased intracranial pressure (ICP), such as increased systolic pressure, bradycardia, and widened pulse pressure, start an I.V. line for drug administration and deliver oxygen as necessary, and keep the head of the bed at least as low as 30 degrees. Draw a specimen for routine blood studies such as a complete blood count with a white blood cell count and electrolyte levels.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Tuberculosis:
Treatment
(Handbook of Diseases)
Treatment includes antitubercular therapy with daily oral doses of isoniazid, rifampin, and pyrazinamide (and sometimes ethambutol) for at least 6 months. Longer courses may be required for patients with AIDS or for patients who respond slowly. After 2 to 4 weeks, the disease generally is no longer infectious. The patient can resume his normal lifestyle while taking medication.
Patients with atypical mycobacterial disease or drug-resistant TB may require treatment with second-line drugs, such as capreomycin, streptomycin, para-aminosalicylic acid, cycloserine, amikacin, and quinolone drugs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Encephalitis:
Treatment
(Handbook of Diseases)
The antiviral agent acyclovir is effective only against herpes encephalitis. Treatment of all other forms of encephalitis is entirely supportive.
Drug therapy includes phenytoin or another anticonvulsant, usually given I.V.; glucocorticoids to reduce cerebral inflammation and edema; furosemide or mannitol to reduce cerebral swelling; sedatives for restlessness; and aspirin or acetaminophen to relieve headache and reduce fever.
Other supportive measures include adequate fluid and electrolyte intake to prevent dehydration and antibiotics for an associated infection such as pneumonia. Isolation is unnecessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
West Nile encephalitis:
Treatment
(Handbook of Diseases)
No specific therapy is used to treat West Nile encephalitis, and no known cure exists. Treatment is generally aimed at controlling the specific symptoms. Supportive care, such as intravenous fluids, fever control, and respiratory support, is rendered when necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Kernig's sign:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Prepare the patient for diagnostic tests, such as a computed tomography scan, magnetic resonance imaging, spinal X-ray, myelography, and lumbar puncture. Closely monitor his vital signs, ICP, and cardiopulmonary and neurologic status. Ensure bed rest, quiet, and minimal stress.
If the patient has a subarachnoid hemorrhage, darken the room and elevate the head of the bed at least 30 degrees to reduce ICP. If he has a herniated disk or spinal tumor, he may require pelvic traction.
Patient teaching
Teach the patient the signs and symptoms of meningitis. Discuss measures to prevent meningitis. Explain the activities that a patient with a herniated disk should avoid. Teach the patient how to apply a back brace or cervical collar, as needed.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Brudzinski's sign:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient is alert, ask him about headache, neck pain, nausea, and vision disturbances (blurred or double vision and photophobia) — all indications of increased intracranial pressure (ICP). Next, observe the patient for altered level of consciousness (LOC) (restlessness, irritability, confusion, lethargy, personality changes, and coma), pupillary changes, bradycardia, widened pulse pressure, irregular respiratory patterns (Cheyne-Stokes or Kussmaul’s respirations), vomiting, and moderate fever.
Keep artificial airways, intubation equipment, a handheld resuscitation bag, and suction equipment on hand because your patient’s condition may suddenly deteriorate. Elevate the head of his bed 30 to 60 degrees to promote venous drainage. Administer an osmotic diuretic, such as mannitol, to reduce cerebral edema. Monitor and be alert for ICP that continues to rise. You may have to provide mechanical ventilation and administer a barbiturate and additional doses of a diuretic. Also, cerebrospinal fluid (CSF) may have to be drained.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Kernig's sign:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient how to recognize signs and symptoms of meningitis as well as measures to prevent this infection. If the patient has a herniated disk, tell him to avoid activities such as lifting, sleeping prone, climbing stairs, and riding in a car. Show the patient how to apply a back brace or cervical collar, as needed, then have him give a return demonstration.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Nuchal rigidity:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
After eliciting nuchal rigidity, attempt to elicit Kernig’s and Brudzinski’s signs. Quickly evaluate level of consciousness (LOC). Take vital signs. If you note signs of increased intracranial pressure (ICP), such as increased systolic pressure, bradycardia, and widened pulse pressure, start an I.V. line for drug administration and deliver oxygen as necessary, and keep the head of the bed at least as low as 30 degrees. Draw a sample for routine blood studies such as a complete blood count with a white blood cell count and electrolyte levels.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Brudzinski's sign:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Provide constant ICP monitoring and perform frequent neurologic checks.
▪ Monitor vital signs, intake and output, and cardiorespiratory status.
▪ To promote patient comfort, maintain low lights and minimal noise and elevate the head of the bed.
▪ Prepare the patient for diagnostic tests, such as blood, urine, and sputum cultures to identify bacteria; lumbar puncture to assess CSF and relieve pressure; and computed tomography scan, magnetic resonance imaging, cerebral angiography, and spinal X-rays to locate a hemorrhage.
Patient teaching
▪ Discuss the signs and symptoms of meningitis and subdural hematoma, if these are the cause of Brudzinski's sign.
▪ Advise the patient and his family to seek immediate medical attention if these signs and symptoms occur.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Kernig's sign:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, such as a computed tomography scan, magnetic resonance imaging, spinal X-ray, myelography, and lumbar puncture.
▪ Closely monitor the patient's vital signs, ICP, and cardiopulmonary and neurologic status.
▪ Ensure bed rest, quiet environment, and minimal stress.
▪ If the patient has a subarachnoid hemorrhage, darken the room and elevate the head of the bed at least 30 degrees to reduce ICP.
▪ If he has a herniated disk or spinal tumor, he may require pelvic traction.
Patient teaching
▪ Teach the patient and his family signs and symptoms of meningitis and treatment.
▪ Discuss ways to prevent meningitis.
▪ Explain activities that the patient with a herniated disk should avoid.
▪ Teach the patient how to apply a back brace or cervical collar as ordered.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Nuchal rigidity:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, such as computed tomography scans, magnetic resonance imaging, and cervical spinal X-rays.
▪ Monitor the patient's vital signs, intake and output, and neurologic status closely.
▪ Avoid routine administration of opioid analgesics because these may mask signs of increasing ICP.
▪ Enforce strict bed rest; keep the head of the bed elevated at least 30 degrees to help minimize ICP.
Patient teaching
▪ Explain all procedures and diagnostic tests to the patient and his family.
▪ Orient the patient, as appropriate.
▪ Explain the cause of nuccal rigidity and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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