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PALS

(pălz) pediatric advanced life support.

palsy

(pal′zē) [Fr. palesie, paralisie, fr L. paralysis, fr Gr. paralysis, loosening, disabling] Paralysis.

birth p. SEE: birth paralysis.

bulbar p. Palsy caused by degeneration of the nuclear cells of the lower cranial nerves. This causes progressive muscular paralysis.

cerebral p. ABBR: CP. SEE: cerebral palsy.

Erb p. SEE: Duchenne-Erb paralysis.

facial p. SEE: Bell palsy.

facial nerve p. SEE: Bell palsy.

lateral gaze p. In ophthalmology, an inability to make conjugate, horizontal eye movements in one or both directions.

peroneal nerve p. Paralysis of the peroneal nerve, often caused by automobile accidents in which a pedestrian’s leg is injured, by fractures of the tibia, or by other occurrences of nerve disruption or compression. It produces footdrop.

progressive supranuclear p. A chronic progressive neurodegenerative disorder in which features of symmetrical Parkinson disease are combined with dementia, falls, impaired gait, and vertical gaze paresis.

 INCIDENCE: The disease is most often found in men over the age of 60.

 CAUSES: It is caused by damage to cells in the frontal lobes, the basal ganglia, the cerebellum and the brainstem.

 SYMPTOMS AND SIGNS: Patients often report unsteadiness when walking. They fall frequently, are forgetful, have difficulty swallowing and initiating movements. Parkinsonian tremors are often present. Partners or family members of PSP patients may note apathy and other personality changes (such as increased irritability, frustration and moodiness), and gradually worsening loss of language and other cognitive functions. Signs include loss of facial expressiveness, facial muscle jerking, arm and leg rigidity, and reduced eye movements, esp. up or down movements of the eyes.

 DIAGNOSIS: The diagnosis is made clinically but can be difficult to distinguish from Parkinson disease and multiple systems atrophy, esp. during its early phases. One feature that distinguishes PSP from Parkinson disease is preservation of the sense of smell in PSP. MR imaging of the brain may demonstrate loss of brainstem parenchyma (the “hummingbird sign”).

 TREATMENT: No curative treatments are currently known for PSP. Some patients respond for a while to drugs such as levodopa-carbidopa which alleviate the Parkinsonian symptoms.

 IMPACT ON HEALTH: Progressive neurological deterioration over the course of 5 to 10 years is typical.

PATIENT CARE: Learning to use a walker, removing loose rugs from flooring, and keeping a home well lit reduce the risk of falling. Architectural modifications in bathtubs and showers (such as grab-bars) may prevent falls in these wet and slippery environments. Maintaining familiar visual and auditory cues helps patients ...

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