NRS 410 Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors

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).

Li, K., & Malhotra, P. A. (2015). Spatial neglect. Practical neurology, 15(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/

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.

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

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.

NRS 410 Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors

References

Cleveland Clinic. (2021). Multiple sclerosis (ms): Symptoms, causes, diagnosis & treatments. https://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. JAMA, 325(8), 765. https://doi.org/10.1001/jama.2020.26858

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When nerve cells in the brain and spinal cord begin to degenerate, the condition is known as Amyotrophic Lateral Sclerosis (ALS). Motor neuron degradation and muscle atrophy lead to complete loss of muscle control in patients with ALS, which is a progressive disease. Speech, eating, moving, and breathing may become increasingly difficult for those who are unable to control their muscles (Masrori & Van Damme). Those who are affected are confined to a wheelchair and eventually require the use of a ventilator to maintain their airway pressure. Currently, there is no treatment for ALS. Patients’ lives can be improved by actively treating symptoms and using medical procedures and technology in a proactive manner, which may even assist to extend their lives. The medicine Rilutek has a limited effect on halting the course of the disease and extending life expectancy (Masrori & Van Damme) In ALS patients, this is the only known treatment to improve survival rates. Medical advances and new technology have the potential to significantly enhance one’s well-being. For patients with communication difficulties, speech therapists and speech-language pathologists are essential. They can instruct patients on how to reduce their consumption of oxygen and improve the clarity of their speech. Hand- or eye-activated electronic assistive communication devices are another possibility (Masrori & Van Damme). A common neurological or cognitive impairment can be identified, as well as the circumstances that contribute to it.

References

Masrori, P., & Van Damme, P. (2020). Amyotrophic lateral sclerosis: a clinical review. European Journal of Neurology, 27(10), 1918-1929. https://doi.org/10.1111/ene.14393

I believe mental illness could fit into all three of those categories. Having a mental illness can affect one’s cognition. People may find it hard to think clearly, pay attention, remember things, etc. Some of these problems are seen more with episodes of illness and for some people it is a persistent everyday thing (New York State Office of Mental Health, 2002). Mental illness is also neurological. Mental illness is no different that things like heart disease, diabetes, or any other chronic illness. With every chronic illness there is an organ involved, with mental illness the organ of interest is the brain. neurological disorders like mental illness are conditions that affect tour thoughts, emotions, behaviors, and relationships. Mental illness can also cause a person’s view of the world to be distorted. The way they see things and percept things may be very different. Mental illness for things like schizophrenia, can cause people to hallucinate and have auditory and visual disturbances (Chuang et al., 2019). Their perception of life may be in a whole other world.

New York State Office of Mental Health. (2002, October). Office of Mental Health. Dealing with Cognitive Dysfunction. Retrieved July 26, 2022, from https://omh.ny.gov/omhweb/cogdys_manual/cogdyshndbk.htm

Chuang, S. P., Wu, J., & Wang, C. S. (2019). Self-perception of mental illness, and subjective and objective cognitive functioning in people with schizophrenia. Neuropsychiatric disease and treatment, 15, 967–976. https://doi.org/10.2147/NDT.S193239

One common neurological issue is dementia. Dementia is the “impaired cognitive function evidenced by memory disorders, personality changes, and impaired reasoning caused by brain disease” (Falkner & Green, 2018). Dementia can happen as a result of Alzheimer’s disease (60%-80% of dementia cases), direct trauma, stroke, or other conditions (Falkner & Green, 2018). There are factors that increase a person’s risk to get dementia. These risk factors include head injury, obesity, sedentary lifestyle, type 2 diabetes, and smoking (Falkner & Green, 2018).

There are many things that can be done to help promote health in people with dementia. One thing is helping those with dementia stay in their community as long as possible while remaining active, and independent (CDC, 2022). Next providers must be assessing older adults and provide early diagnosis, prevention, and risk reduction for those at risk for dementia (CDC, 2022). Lastly, there should be increased use of preventative services like cancer, blood sugar, and blood pressure screenings (CDC, 2022). It is important to promote the health of older adults that have dementia.

Centers for Disease Control. (2022). Promoting Health for Older Adults. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/promoting-health-for-older-adults.htm

Falkner, A., & Green, S. (2018). Pathophysiology Clinical Applications for Client Health, Chapter 2, Neurological, Perceptual, and Cognitive Complexities. Grand Canyon University (Ed). https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/2

Dementia is a very common disease that affects cognitive and social abilities. The exact cause of dementia is unknown, and there is no cure available. It is no respecter of age and includes a decline in the person’s cognitive abilities due to damage to cerebral hemispheres and subcortical areas of memory and learning in the brain. It is estimated that 60%-80% of all Alzheimer’s disease cases are caused by dementia. Over time symptoms become worse for the patient. It usually starts with memory loss and ends in death. Dementia has different symptoms such as changes in mood, confusion, difficulty concentrating, getting lost, reduced vocabulary, poor judgment in decisions, and withdrawal from work or social events (Falkner & Green, 2018). Someone who has taken care of a dementia patient in the past may be able to give insight or tips into taking care of a dementia patient.

Reference

Falkner, A. & Green, S. (2018). Neurological, perceptive, and cognitive complexities. In Grand Canyon University. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1#/chapter/2

NRS 410 Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors