IDENTIFY A COMMON PERCEPTUAL, NEUROLOGICAL, OR COGNITIVE ISSUE AND DISCUSS CONTRIBUTING FACTORS NRS 410

IDENTIFY A COMMON PERCEPTUAL, NEUROLOGICAL, OR COGNITIVE ISSUE AND DISCUSS CONTRIBUTING FACTORS NRS 410

Topic 2 DQ 1

Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors. Outline steps for prevention or health promotion for the patient and family.

Class, are there conditions that could have a perceptual, neurological, as well as cognitive problem, all at once? Please explain your answer.

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         Yes, many of these neurological conditions are also perceptual and cognitive. Since the brain functions on each of these levels anytime the brain is disrupted from its normal function it can erroneously create or miss perceptual experiences that would have otherwise been different. The same is true for cognition, the brain is responsible for learning and understanding but the disruption can impact this process also. An example is that of a middle cerebral artery (MCA) stroke, this manifests with classic symptoms of unilateral motor loss but also involves speech aphasia, which is related to cognition, (Nogles & Galuska, 2022). The MCA stroke also can cause perceptual problems with its related visuospatial neglect, (Li & Malhotra, 2015).

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Li, K., & Malhotra, P. A. (2015). Spatial neglect. Practical neurology15(5), 333–339. https://doi.org/10.1136/practneurol-2015-001115

Nogles, T.E., & Galuska, M.A. Middle Cerebral Artery Stroke. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556132/

·  Atoyia Ortiz

replied toBarb McGraw

Jul 26, 2022, 6:54 AM

·  Replies to Barb McGraw

Hi Professor McGraw,

When I read your question, my immediate thought was about traumatic brain injury, or TBI.

TBI occurs when a sudden trauma damages the brain. It can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. According to the NIH (2022), a reported 3.6 million people in the U.S. sustain brain injuries every year. The recent tragic death of the actor, Bob Saget highlights just how serious any head injury can be (he accidentally hit the back of his head, didn’t realize the severity, and went to sleep, as far too many people do).

TBI can display an array of symptoms, to include perceptual, neurological, and cognitive impairment, with varying levels of severity. Some of those symptoms include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking. Capizzi et al (2019) discuss how a person with a moderate or severe TBI may show these same symptoms but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.

REFERENCES

Capizzi, A., Woo, J., & Verduzco-Gutierrez, M. (2019). Traumatic brain injury: An overview of epidemiology, pathophysiology, and medical management. Science Direct, 104(2), 213-238. https://doi.org/10.1016/j.mcna.2019.11.001

National Institute of Neurological Disorders and Stroke. (2022). Traumatic brain injury: What research is being done? National Institutes of Health. https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury#:~:text=Traumatic%20brain%20injury%20(TBI)%2C,skull%20and%20enters%20brain%20tissue.

·  Sandra Noel-Lewis

replied toBarb McGraw

Jul 26, 2022, 1:56 PM

·  Replies to Barb McGraw

Hi Professor McGraw,

The central nervous system is affected by the condition known as multiple sclerosis. Myelin, the barrier that surrounds nerve fibers, is attacked by the immune system, which results in inflammation and lesions. This makes it challenging for the brain to communicate with the rest of the body. Also, the nerve cells to the spinal cord are disrupted. About 50% of MS patients develop cognitive impairments, which can include memory loss, poor judgment, and attention and focus problems (U.S Dept. of Health and Human Resources (n.d.). Each patient’s experience with MS is unique and varies from moderately losing the ability to walk, speak, or write (McNamara, L. (2015). Since the underlying cause is unknown, a diagnosis must be made by ruling out other possibilities.

References

McNamara, L. (2015, October 5). What is multiple sclerosis (MS)?: The Johns Hopkins Multiple Sclerosis Center. What is Multiple Sclerosis (MS)? | The Johns Hopkins Multiple Sclerosis Center. Retrieved July 26, 2022, from https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/multiple_sclerosis/conditions/ 

U.S. Department of Health and Human Services. (n.d.). Multiple sclerosis. National Institute of Neurological Disorders and Stroke. Retrieved July 26, 2022, from https://www.ninds.nih.gov/health-information/disorders/multiple-sclerosis 

·  Grace Ochulor

replied toBarb McGraw

Jul 26, 2022, 9:35 PM

·  Replies to Barb McGraw

Professor McGraw,

Yes, a patient can have a perceptual, neurological and cognitive condition. The patient who has sustained an initial cerebral vascular accident (CVA) is thought to have focal or localized damage to discrete areas of the brain, often resulting in discrete cognitive or perceptual deficits. A patient who have sustained a TBI are presumed to have generalized brain damage resulting in cognitive impairment with generalized deficits in attention, memory, learning, and so forth, rather than specific difficulties in discrete cognitive or perceptual functions (Mandal, A. 2016). Cognitive and perceptual deficits are some of the most puzzling and disabling difficulties that a person can experience. Effective treatment of many patients with brain damage depends on understanding perception and cognition.

Mandal, A. (2016). Function of the nervous system. Retrieved from https://www.news-medical.net/health/Function-of-the-Nervous-System.aspx

·  Mary Bonillos

replied toBarb McGraw

Jul 26, 2022, 10:32 PM

Replies to Barb McGraw

Multiple sclerosis (MS) is an autoimmune disease that causes damage to nerve fibers in the central nervous system (lesions), which can lead to vision problems, sensory disturbance, muscle weakness, or loss of balance (Cleveland Clinic, 2021). MS is characterized by physical disability, cognitive impairment, and other symptoms which affect one’s quality of life. Typically, providers measure disease activity and progression by relapses, MRI activity, and short-term progression of disability (McGinley et al., 2021). With no cure for MS., treatment focuses on symptom management, reducing relapses (periods when symptoms worsen), and slowing the disease’s progression. Treatment to slow the progression of the disease include disease-modifying therapies that help reduce flare-ups and prevent the new formation of lesions on the brain and spinal cord—Corticosteroids slow damage to the myelin sheath during a severe attack (Cleveland Clinic, 2021). Symptom management is integral to treatment, including spasticity, pain, fatigue, cognitive impairment, bladder and bowel issues, gait dysfunction, mood dysregulation, and sleep disturbance, and should include a combination of pharmacological and nonpharmacological treatments (McGinley et al., 2021). Patients are also referred to rehabilitation for PT/OT and counseling to help them cope. 

References

Cleveland Clinic. (2021). Multiple sclerosis (ms): Symptoms, causes, diagnosis & treatmentshttps://my.clevelandclinic.org/health/diseases/17248-multiple-sclerosis

McGinley, M. P., Goldschmidt, C. H., & Rae-Grant, A. D. (2021). Diagnosis and treatment of multiple sclerosis. JAMA325(8), 765. https://doi.org/10.1001/jama.2020.26858

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