1. Students with Neuromuscular Disabilities and Brain Injury

2. Neuromuscular disabilities and brain injuries Epilepsy Cerebral Palsy Traumatic Brain Muscular Dystrophy

3. Epilepsy- What is it? It is a condition that produces brief disturbances in the electrical functioning of the brain, causing seizers. (Kuder, 2006) Seizers happen without immediate cause and usually are repeated. Epilepsy is broken down into two groups. Generalized epilepsy affects both hemispheres of the brain. Partial epilepsy focuses on one side of the brain.

4. Epilepsy

5. Epilepsy – Etiology Causes are unknown, unless it was caused by an injury. Research has shown that epilepsy is more prevalent in people that have experienced severe illness, brain damage, strokes, brain abscess, problems present at birth, tumors, kidney failure, low oxygen to the brain during birth and abnormal levels of blood sugar or sodium.

6. Epilepsy- Etiology cont. Researchers have said some forms of epilepsy may be inherited. Sometimes women experience spontaneous seizers because of changing in their hormones throughout their life. If females have to much estrogen it can cause more electrical discharge to the brain.

7. Epilepsy - Symptoms During seizures Unconsciousness Convolsions Jerking of limbs Usually eachseizure is similar to the last Social communication problems An aura consisting of a strange sensation (such as tingling, smelling an odor that isn't actually there, or emotional changes) occurs in some people prior to each seizure. Severe epilepsy can cause aphasia which is memory loss after a seizure.

8. Epilepsy- Diagnosis Neurological examination EGG (electroencephalograph) exam which is reading of the electrical activity in the brain Varies blood testing Eligible for services under IDEA through other health impairments.

9. Epilepsy - Treatment Removal of tumor, abnormal blood vessel. Medication called anticonvulsants may reduce the number ofseizures. Brain surgery Vagal nerve stimulator Special diets

10. Epilepsy- Interventions/ Services Intervene early Mnemonic devices Color coded notebooks to help organize work Repetitive lesson strategies throughout the unit. Therapies like yoga to relieve stress

11. Cerebral Palsy- What is it? A term describing a group of muscle and nerve disorders that affect a child’s ability to move. Types: Hypertonia(spasticity) Athetoid Ataxic Mixed

12. Cerebral Palsy- What is it? Continued. Hypertonia (spasticity)-Significant limitations to range of motion. Muscles contracted, movements are slow and jerky. Muscular stiffness, over-reaction, and tightness, often due to oversensitive stretch reflexes Athetoid- involuntary movement of limbs, lack of head control. Flailing of arms and legs. Writhing movements. Ataxic- difficulty with balance and poor coordination Mixed-combination of two or more types. *Of the children who have cerebral palsy, approximately 60% have spasticity.

13. Cerebral Palsy- Etiology Prenatally(before birth) - Anoxia (lack of oxygen), radiation exposure, drugs that harm the fetus, genetic disorder, fetal stroke, injury, infection of the uterus or kidney, toxemia, anemia, Rh factor, rubella. Perinatally(during birth)- Anoxia, Rh factor, high bilirubin levels, injury. Postnatally (after birth) - Anoxia; injury; infections such as toxoplasmosis, meningitis; other central nervous system disease. Cerebral Palsy is non-progressive. *For nearly 40% of all children with this disorder, we don't know what causes the damage.

14. Cerebral Palsy- Symptoms Things to look for: Delay in reaching motor milestones, such as sitting or walking. Abnormal movement, muscle tone that is too low (hypotonia) or too high (hypertonia). Unusual reflexes, such as a very active knee-jerk; persistent primitive reflexes. Lethargy, or lack of alertness Irritability or fussiness Abnormal, high-pitched cry Trembling of the arms and legs Abnormal posture, such as the child favoring one side of the body

15. Cerebral Palsy- Diagnosis Check motor skills, muscle tone, and posture CT (computed tomography). Image of the brain that can determine underdeveloped areas of brain tissue. MRI (magnetic resonance imaging). Generates a picture of the brain to determine areas that may be damaged Intelligence testing

16. Cerebral Palsy- Interventions/Services Early Intervention Alternative Augmentative Communication Assistive technology Speech Language Therapy Physical Therapy Occupational Therapy Eligible for services under IDEA through Orthopedic Impairments Great Resource!

18. Open-head injury: also known as localized. A visible injury that usually is confined to one portion of the brain. (example, gunshot wound)

20. Cognitive impairments: Memory difficulties; slowness in thinking; problems concentrating; problems with perception and attention; problems planning and sequencing

22. Types of responses that are looked at:

23. Eye opening response

24. Verbal response

26. Subacute Treatment

28. Clear patients' airways

29. Medicate patients (to calm them, prevent seizures or otherwise prevent further injury)

30. Monitor and surgically relieve high levels of intracranial pressure(the pressure caused by the buildup of excess brain fluid in the skull)

32. Doctors will outline a course of appropriate treatments, helping patients and their families build the right team of medical professionals necessary for rehabilitation and chronic TBI treatment.

33. Although most traumatic brain injury patients enter subacute treatment centers in shock or a state of post-traumatic amnesia, they leave these facilities ready to live independently, live with home care or move onto to long-term care centers.

35. Counseling and/or therapy (physical and/or speech)

37. Co-morbid conditions (other medical issues existing with the primary condition)

38. Severity of TBI

40. Overcoming low self-esteem, depression or other emotional issues

42. Low pupil-teacher ratio

43. Intensive and repetitive instruction

44. Emphasis on process

45. Behavioral programming

46. Integrated instructional therapies

47. Stimulation experiences

48. Cuing, fading, and shadowing

49. Readjustment counseling

51. Muscular Dystrophy- Causes An absence of dystrophin, a protein that helps keel muscle cells intact. Duchenne is x-linked recessive and primarily affects boys. It is usually inherited from the mother. Most women who are carriers don’t have any types of symptoms.

52. Muscular Dystrophy- Symptoms Generalized weakness and muscle wasting first affecting the muscles of the hips, pelvic area, thighs, and shoulders. Calf pseudohypertrophy- enlarged calf muscles due to muscle tissue being destroyed and replaced by fat. Fatigue Progressive difficulty walking Typical life expectancy is 25 years

53. Muscular Dystrophy- Diagnosis Electromyography- a medical instrument that records the electrical waves associated with the activity of skeletal muscles Genetic tests- techniques used to test for genetic disorders, involve direct examination of the DNA molecule itself. Muscle biopsy- a procedure in which a piece of muscle tissue is removed from an organism and examined microscopically. Serum CPK- a blood test where levels ofcreatinephosphokinase are measured

54. Muscular Dystrophy- Treatment There is no known cure, but the treatments are meant to treat the symptoms Treatments include activity such as physical therapy and steroids to prolong muscle strength.

55. Muscular Dystrophy- Interventions Genetic counseling Since there is no cure it is had to prevent this disease but they are trying to develop gene therapy.