Disturbance in Nervous System :Disturbance in Nervous System By: Maria Hazel T. Organo, RN


POLIOMYELITIS :POLIOMYELITIS viral disease cc affects the CNS thru the bloodstream & causes muscle weakness & paralysis common in infants and young children and occurs under conditions of poor hygiene CA: poliovirus or Legio Debilitans MOT: fecal-oral route IP: 6-20 days for paralytic cases, with a range of 3-35 days


POLIOMYELITIS :POLIOMYELITIS Types Abortive – did not progress to systemic infection Non-paralytic may result in fever, vomiting, abdominal pain, lethargy, and irritability, and some muscle tenderness Paralytic Virus affects the anterior horn cells in the spinal column which control movement of the trunk and limb muscles including intercostal muscles


POLIOMYELITIS :POLIOMYELITIS Bulbar Polio Virus infiltrates cranial nerves: Optic & Oculomotor: eyeball movements Trigeminal nerve and Facial nerve: innervate cheeks, tears, gums, and muscles of the face Glossopharyngeal nerve: swallowing and functions in the throat, tongue movement and taste Vagus: sends signals to the heart, intestines, and lungs Accessory nerve: controls upper neck movement


POLIOMYELITIS :POLIOMYELITIS Dx Throat swab Stool exam Lumbar puncture CSF analysis – increased WBCs


POLIOMYELITIS :POLIOMYELITIS Ingested virus GIT (Alimentary tract) Multiply (intestinal phase) Bloostream (Viremia) CNS (Neural) Flaccid paralysis


POLIOMYELITIS :POLIOMYELITIS Management Strict isolation Hot & moist compress to relieve spasms antibiotics to prevent infections analgesics for pain moderate exercise Bedrest with footboard nutritious diet physical therapy, braces, corrective shoes and, in some cases, orthopedic surgery


RABIES :RABIES Acute viral encephalomyelitis caused by rhabdovirus of the genus lyssavirus Fatal once s/s appear Types: Urban or Canine Rabies Sylvatic Rabies MOT: usually by bites of rabid animal whose saliva has the virus Or thru a scratch or fresh break in the skin (rare) Man-to-man is possible


RABIES :RABIES IP: 2-8 weeks or as long as a year or several years depending on Severity of the wounds Site of the wound (distance from the brain) Amount of virus introduced Protection provided by clothing PC: in dogs & cats, for 3-10d before onset of clinical s/s (rarely over 3d), & thru out duration of disease


RABIES :RABIES Bite of an infected animal thru a broken skin Virus begins replicating in the striated muscle cells at the bite site Virus spreads along the nerve pathways Spinal cord Brain (replicates again) Virus moves thru the nerves into other tissues, including salivary glands


RABIES :RABIES s/s In MAN Prodromal Headache, sore throat, unusual salivation, diaphoresis, low grade fever Excitement Increased anxiety, hydrophobia d/t pharyngospasm, photophobia, aerophobia d/t laryngospasm, maniacal behavior Paralytic Death d/t respiratory paralysis or cardiac arrest


RABIES :RABIES S/S In DOGS withdrawn/dumb/paralytic ferocious or aggressive Management Intensive supportive & symptomatic care Proper wound care Wash wound immediately with soap & water & let it bleed Consult a health worker at the nearest health center Active immunization by rabies vaccine (Lysavac @ deltoid)


RABIES :RABIES Passive immunization by Rabies Human Immune Globulin (Human rabies Ig), IM at gluteal Sedatives: Haloperidol & Benadryl Restrain pt; cover IV lines Healthy dog is observed for 14d, if it dies & shows signs of rabies, consult a physician. Kill rabid dog & bring head for examination (positive for Negri bodies) Submit to immunization while waiting for result or if dog is not available for observation


TETANUS :TETANUS Acute disease induced by toxin of tetanus bacillus growing anaerobically in wounds & at site of umbilicus among infants Characterized by: muscular contractions Etiologic Agent: Clostridium tetani Source of Infection: soil, street dust, animal & human feces


TETANUS :TETANUS MOT: unhygienic cutting of umbilical cord; improper handling of cord stump IP: 3 days – 1 mo or more; 7-14d Resistance: active immunity is induced by TT Diagnosis: wound culture, clinical observation


TETANUS :TETANUS Neurotoxin (tetanospasmin) and a hemolysin(tetanolysin) are produced Multiplication of bacilli Brought by lymphatics and blood to the CNS Stimulates contractions in the muscles supplied by these neurons Diffusion of contactions


TETANUS :TETANUS s/s In NB, assess for hx of all three: Normal suck & cry for the 1st 2d of life Onset of illness b/n 3 & 28d Inability to suck followed by stiffness of the body &/or convulsions


TETANUS :TETANUS In adults headache muscle stiffness in the jaw (Trismus/Lockjaw) stiffness of the neck difficulty swallowing muscle spasms Sweating fever Opisthotonos Risus sardonicus


TETANUS :TETANUS Management Antibiotic prophylactic therapy – penicillin, erythromycin, tetracycline Administered within 4H of injury Anti-tetanus anti-serum Daily cleansing of wound Promote safety


tetanus :tetanus Preventive Measures Aseptic handling of neonatal umbilical cord Tetanus toxoid immunization DPT