Treatments for Hereditary Spastic Paraplegia
Treatments for Hereditary Spastic Paraplegia
The list of treatments mentioned in various sources
for Hereditary Spastic Paraplegia
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Hospital statistics for Hereditary Spastic Paraplegia:
These medical statistics relate to hospitals, hospitalization and Hereditary Spastic Paraplegia:
- 0.0005% (58) of hospital consultant episodes were for hereditary spastic paraplegia in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 83% of hospital consultant episodes for hereditary spastic paraplegia required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 53% of hospital consultant episodes for hereditary spastic paraplegia were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 47% of hospital consultant episodes for hereditary spastic paraplegia were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Discussion of treatments for Hereditary Spastic Paraplegia:
There is no specific treatment to prevent, slow, or
reverse HSP's progressive disability. Treatment is symptomatic.
(Source: excerpt from
NINDS Hereditary Spastic Paraplegia Information Page: NINDS)
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Facial Paralysis & Bell's Palsy:
Treatment
(In a Page: Signs and Symptoms)
- Bell's palsy
–IV acyclovir and corticosteroids may lead to better recovery and less neuronal degeneration
–Tape eye and use eye shade to protect the eye during
sleep
–Massage of weakened muscles
–Electrical stimulation of paralyzed muscles in cases with
delayed recovery
-
In other cases, treat the inciting causes (e.g., control of blood pressure and hyperlipidemia in patients with CVA, antibiotics for patients with Lyme disease, antivirals in Ramsay Hunt's syndrome, steroids for sarcoidosis)
-
Consider neurologic referral
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Paraplegia:
Treatment
(In a Page: Signs and Symptoms)
- Paralysis or paraplegia is best managed by identifying and treating the underlying cause
–In cases of compressive lesions of the spinal cord, cauda equina, or nerve roots, surgical therapy is usually required
–Traumatic spinal cord injury often requires surgical stabilization; also, acute high-dose steroid treatment is effective in improving outcomes of traumatic myelopathy
-
Spinal dysraphism is often treated surgically
-
Infectious myelopathies: Antimicrobial agents
-
Multiple sclerosis: Acute exacerbations may be treated with steroids; prevent exacerbations with interferons, glatiramer acetate, and mitoxantrone
-
Guillain-Barré syndrome: Plasmapheresis or IVIG within 2 weeks of onset of symptoms
-
Physical therapy, assistive devices, orthotics, and wheelchairs may all be beneficial in improving the functional abilities of patients with paraplegia/paresis
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Facial Paralysis:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treat underlying cause, if identified
–E.g., tympanomastoidectomy for cholesteatoma, resection or chemoradiation for malignancy
-
Psychological counseling when studies indicate expected poor prognosis
- Eye care
–Prevent exposure and drying of eye: Artificial tears, lubricating ointment, and moisture chamber at night
–Ophthalmologic exam to rule out exposure keratitis
–Surgical correction: Tarsorrhaphy, upper lid gold
weight or spring placement
-
Pharmacologic
–Steroids: Recommended, but exact benefit unclear
–Acyclovir: Suspected viral etiology of Bell palsy
-
Surgery
–Facial nerve decompression
–Facial reanimation procedures (nerve and/or muscle
grafting and/or transpositions)
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Paralysis:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If paralysis has developed suddenly, suspect trauma or an acute vascular insult. After ensuring that the patient’s spine is properly immobilized, quickly determine his level of consciousness (LOC) and take his vital signs. Elevated systolic blood pressure, widening pulse pressure, and bradycardia may signal increasing intracranial pressure (ICP). If possible, elevate the patient’s head 30 degrees to decrease ICP, and attempt to keep his head straight and facing forward.
Evaluate the patient’s respiratory status, and be prepared to administer oxygen, insert an artificial airway, or provide intubation and mechanical ventilation, as needed. To help determine the nature of the patient’s injury, ask him for an account of the precipitating events. If he can’t respond, try to find an eyewitness.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Vocal cord paralysis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment for unilateral vocal cord paralysis consists of injection of Teflon into the paralyzed cord, under direct laryngoscopy. This procedure enlarges the cord and brings it closer to the other cord, which usually strengthens the voice and protects the airway from aspiration. Thyroplasty also serves to reposition the vocal cord, but in this procedure an implant is placed through a neck incision. The ansa cervicalis nerve transfer allows for reinnervation of the muscles of the vocal cord. Bilateral cord paralysis in an adducted position necessitates a tracheostomy.
Alternative treatments for adults include endoscopic arytenoidectomy to open the glottis, and lateral fixation of the arytenoid cartilage through an external neck incision. Excision or fixation of the arytenoid cartilage improves airway patency but produces residual voice impairment.
Treatment for hysterical aphonia may include psychotherapy and hypnosis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Paralysis:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If paralysis has developed suddenly, suspect trauma or an acute vascular insult. After ensuring that the patient’s spine is properly immobilized, quickly determine his level of consciousness (LOC) and take his vital signs. Elevated systolic blood pressure, widening pulse pressure, and bradycardia may signal increasing intracranial pressure (ICP). If possible, elevate the patient’s head 30 degrees to decrease ICP.
Evaluate respiratory status, and be prepared to administer oxygen, insert an artificial airway, or provide intubation and mechanical ventilation, as needed. To help determine the nature of the patient’s injury, ask him for an account of the precipitating events. If he’s unable to respond, try to find an eyewitness.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Vocal cord paralysis:
Treatment
(Handbook of Diseases)
In unilateral vocal cord paralysis, treatment consists of injection of Teflon into the paralyzed cord, under direct laryngoscopy. This procedure enlarges the cord and brings it closer to the other cord, which usually strengthens the voice and protects the airway from aspiration.
Thyroplasty also serves to medialize the vocal cord, but in this procedure an implant is placed through a neck incision. The ansa cervicalis nerve transfer allows for reinnervation of the vocal cord muscles. Bilateral cord paralysis in an adducted position necessitates tracheotomy.
Alternative treatments for adults include encloscopic arytenoidectomy to open the glottis, and lateral fixation of the arytenoid cartilage through an external neck incision. Excision or fixation of the arytenoid cartilage improves airway patency but produces residual voice impairment. Treatment of hysterical aphonia may include psychotherapy and hypnosis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Paralysis:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Because a paralyzed patient is particularly susceptible to complications of prolonged immobility, provide frequent position changes, meticulous skin care, and frequent chest physiotherapy. He may benefit from passive range-of-motion exercises to maintain muscle tone, application of splints to prevent contractures, and the use of footboards or other devices to prevent footdrop. If his cranial nerves are affected, the patient will have difficulty chewing and swallowing. Provide a liquid or soft diet, and keep suction equipment on hand in case aspiration occurs. Feeding tubes or total parenteral nutrition may be necessary with severe paralysis. Paralysis and accompanying vision disturbances may make ambulation hazardous; provide a call light and show the patient how to call for help. As appropriate, arrange for physical, speech, or occupational therapy.
Patient teaching
Provide information and referrals to home care and other support services, which may include social services, occupational therapy, speech therapy, physical therapy, and wound care. Assess the home environment and provide information to the family about safety measures and physical alterations that may be required to allow wheelchair access and maneuverability. Provide teaching on equipment that may be needed and used at home.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Paralysis:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If paralysis has developed suddenly, suspect trauma or an acute vascular insult. After ensuring that the patient’s spine is properly immobilized, quickly determine his level of consciousness (LOC) and take his vital signs. Elevated systolic blood pressure, widening pulse pressure, and bradycardia may signal increasing intracranial pressure (ICP). If possible, elevate the patient’s head 30 degrees to decrease ICP.
Evaluate respiratory status, and be prepared to administer oxygen, insert an artificial airway, or provide intubation and mechanical ventilation, as needed. To help determine the nature of the patient’s injury, ask him for an account of the precipitating events. If he’s unable to respond, try to find an eyewitness.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Muscle spasticity:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Keep in mind that generalized spasticity and trismus in a patient with a recent skin puncture or laceration indicates tetanus. If you suspect this rare disorder, look for signs of respiratory distress. Provide ventilatory support, if necessary, and monitor the patient closely.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Paralysis:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Provide frequent position changes and meticulous skin care to prevent skin breakdown.
▪ Administer frequent chest physiotherapy.
▪ Perform passive range-of-motion exercises to maintain muscle tone.
▪ Apply splints to prevent contractures and footboards or other devices to prevent footdrop.
▪ Provide a thickened liquid or soft diet, and keep suction equipment on hand in case aspiration occurs, if the patient has difficulty chewing or swallowing.
▪ As appropriate, arrange for physical, speech, swallowing, or occupational therapy.
Patient teaching
▪ Explain all diagnostic tests and procedures.
▪ Explain the disorder and treatment plan.
▪ Teach the patient and his family how to prevent complications.
▪ Provide referrals to social and psychological services.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Muscle spasticity [Muscle hypertonicity]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, which may include electromyography, muscle biopsy, or intracranial or spinal magnetic resonance imaging or computed tomography.
▪ Administer pain medication and an antispasmodic, as ordered.
▪ Perform passive range-of-motion exercises, splinting, traction, and application of heat to help relieve spasms and prevent contractures.
▪ Maintain a calm, quiet environment to help relieve muscle spasms and prevent recurrence, and encourage bed rest.
▪ In cases of prolonged, uncontrollable muscle spasticity, as with spastic paralysis, prepare the patient for nerve blocks or surgical transection to provide permanent relief, as indicated.
Patient teaching
▪ Teach the patient to use assistive devices as needed.
▪ Help the patient to identify ways to maintain independence.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Gait, spastic [Hemiplegic gait]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Provide the patient with daily exercise and active and passive ROM exercises.
▪ Refer the patient to a physical therapist for gait retraining and possible in-shoe splints or leg braces to maintain proper foot alignment for standing and walking.
▪ Assist the patient with ambulation.
Patient teaching
▪ Reinforce the importance of ambulating with assistance.
▪ Teach the patient to use a cane or a walker, as indicated.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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