Chapter 63: Chronic Neurologic Problems

Treatment modalities encompass pharmacological interventions such as triptans and CGRP antagonists, along with non-pharmacological approaches including biofeedback and oxygen therapy. Seizure disorders represent a major focus, exploring the pathophysiology of abnormal electrical brain activity leading to generalized or focal seizures, with detailed examination of seizure phases from prodromal through postictal periods. Management strategies include antiseizure medications like phenytoin and levetiracetam, surgical interventions, and advanced therapies such as vagal nerve stimulation and responsive neurostimulation. The chapter addresses restless legs syndrome as a movement disorder involving uncomfortable sensations and motor restlessness, typically managed through dopamine agonists and lifestyle modifications. Progressive degenerative diseases receive extensive coverage, including multiple sclerosis as an autoimmune demyelinating condition with relapsing-remitting or progressive patterns, treated with disease-modifying therapies and immunomodulators. Parkinson disease is explored as a movement disorder resulting from dopaminergic dysfunction, managed through carbidopa-levodopa combinations and deep brain stimulation. Additional conditions include myasthenia gravis involving neuromuscular junction dysfunction, amyotrophic lateral sclerosis affecting motor neurons, and Huntington disease characterized by progressive movement and cognitive deterioration. Throughout, nursing considerations emphasize patient safety, medication adherence, symptom management, and comprehensive patient education.