{"id":348,"date":"2019-11-19T16:58:42","date_gmt":"2019-11-19T16:58:42","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/8-3-disorders-of-the-cns-system\/"},"modified":"2025-01-16T22:29:15","modified_gmt":"2025-01-16T22:29:15","slug":"8-3-disorders-of-the-cns-system","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/8-3-disorders-of-the-cns-system\/","title":{"raw":"8.3 Disorders of the CNS System","rendered":"8.3 Disorders of the CNS System"},"content":{"raw":"<div class=\"1.3-disorders-of-the-cns-system\">\n\nNow that we have reviewed basic concepts of neurotransmitters and their function, let\u2019s review common central nervous system (CNS) disorders.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/wtcs.pressbooks.pub\/nursingmhcc\/\" target=\"_blank\" rel=\"noopener\">Nursing: Mental Health &amp; Community Concepts<\/a> by <a href=\"https:\/\/www.cvtc.edu\/landing-pages\/grants\/open-rn\" target=\"_blank\" rel=\"noopener\">Open RN\u00a0<\/a>licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>[\/footnote]<\/sup>\n<div class=\"textbox\">\n<p class=\"arrow\">Read additional information about mental health disorders in Open RN <a href=\"https:\/\/wtcs.pressbooks.pub\/nursingmhcc\/\" target=\"_blank\" rel=\"noopener\"><em>Nursing: Mental Health &amp; Community Concepts<\/em><\/a>.<\/p>\n\n<\/div>\n<h2><a id=\"_1mx1797t7cs2\" href=\"\"><\/a>Anxiety<\/h2>\nAnxiety disorders are a group of conditions marked by pathological or extreme anxiety or dread. People with anxiety experience disturbances of mood, behavior, and body systems, making it difficult to complete everyday activities. Many feel anxious most of the time for no apparent reason.\n\nAnxiety is different from fear. Fear is a person's response to an event or object. The psychiatric disorder of anxiety occurs when the intensity and duration of anxiety does not match the potential for harm or threat to the affected person. Anxiety can be expressed behaviorally or experienced with physical symptoms.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals With Intellectual Disability &amp; Mental Illness<\/a> by Sheri Melrose licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>[\/footnote]<\/sup>\n<h3>Signs and Symptoms of Anxiety<\/h3>\n<ul>\n \t<li>Aches<\/li>\n \t<li>Pains<\/li>\n \t<li>Stomachaches<\/li>\n \t<li>Headaches<\/li>\n \t<li>Heart racing or pounding<\/li>\n \t<li>Trembling<\/li>\n \t<li>Sweating<\/li>\n \t<li>Difficulty concentrating (see Figure 8.5)<sup>[footnote]\u201c<a href=\"https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/\" target=\"_blank\" rel=\"noopener noreferrer\">stress-2902537_960_720.jpg<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/users\/TheDigitalArtist-202249\/\" target=\"_blank\" rel=\"noopener noreferrer\">TheDigitalArtist<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0 1.0<\/a> [\/footnote]<\/sup><\/li>\n \t<li>Increased agitation<\/li>\n \t<li>Crying<\/li>\n<\/ul>\n[caption id=\"attachment_347\" align=\"aligncenter\" width=\"645\"]<img class=\"wp-image-345\" title=\"&quot;stress-2902537_960_720.jpg&quot; by TheDigitalArtist is licensed under CC0 1.0 Access for free at https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/ \" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537.jpg\" alt=\"Mixed media image of woman looking worried, stressed, or overwhelmed\" width=\"645\" height=\"430\"> Figure 8.5 Many Clients With Anxiety Experience Difficulty Concentrating[\/caption]\n\nTreatment can include nonpharmacological interventions, as well as medications. Nonpharmacological interventions to decrease anxiety include relaxation techniques such as deep breathing, exercise, psychotherapy, support groups, or cognitive behavioral therapy. Antianxiety medications can also be used to help both verbal and nonverbal clients feel a much-needed sense of peace.\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about anxiety on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/anxiety-disorders\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<\/div>\n<h2><a id=\"_rehswqokrj9s\" href=\"\"><\/a>Major Depressive Disorder<\/h2>\nMajor depressive disorder affects up to 5% of the U.S. population. To be diagnosed with major depressive disorder, five of the following symptoms must be present during the same two-week period and represent a change from previous functioning. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms of depression cannot be due to effects of a substance or from bereavement.\n<h3>Signs and Symptoms of Depression<\/h3>\n<ul>\n \t<li>Depressed mood<\/li>\n \t<li>Diminished interest<\/li>\n \t<li>Weight loss when not dieting or weight gain<\/li>\n \t<li>Insomnia or hypersomnia<\/li>\n \t<li>Agitation<\/li>\n \t<li>Fatigue or loss of energy<\/li>\n \t<li>Feeling of worthlessness<\/li>\n \t<li>Inappropriate guilt<\/li>\n \t<li>Diminished ability to concentrate<\/li>\n \t<li>Recurrent thoughts of death, suicidal ideation, or suicide attempt<\/li>\n<\/ul>\nTreatment of depression may include medication, psychotherapy, cognitive therapy, electroconvulsive therapy (ECT), and group therapy. Clients who are depressed may not report symptoms unless specifically asked, and they may be suicidal. Using assessment techniques to gather information about the history of each client\u2019s depression, support system, specific triggering events, psychosocial assessment, and risk for harm to self or others is imperative. Each client\u2019s response to medication is unpredictable, and often medications will need to be adjusted based on reported symptoms.\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about depression on the <a href=\"http:\/\/www.nimh.nih.gov\/health\/topics\/depression\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<\/div>\n<h2><a id=\"_kgqk93qnul73\" href=\"\"><\/a>Bipolar Disorder<\/h2>\nBipolar disorder is marked by serious mood swings. Typically, clients experience extreme highs (called mania or hypomania) alternating with extreme lows (depression). See the \"Major Depressive Disorder\" subsection for signs and symptoms of depression. Bipolar disorder and major depression disorder are also referred to as \"<strong>affective mood disorders<\/strong>.\" For some people, the cycles occur so rapidly that they hardly ever feel a sense of control over their mood swings.\n<h3>Signs and Symptoms of a Manic Episode<\/h3>\n<ul>\n \t<li>Rapid speech<\/li>\n \t<li>Hyperactivity<\/li>\n \t<li>Reduced need for sleep<\/li>\n \t<li>Flight of ideas<\/li>\n \t<li>Grandiosity<\/li>\n \t<li>Poor judgement<\/li>\n \t<li>Aggression\/hostility<\/li>\n \t<li>Risky sexual behavior<\/li>\n \t<li>Neglect basic self-care<\/li>\n \t<li>Decreased impulse control<\/li>\n<\/ul>\nTreatment for a client diagnosed with bipolar may include medication, safety initiatives during acute mania, ECT, psychotherapy, and support groups. The severity of manic and depressive episodes varies for each client. Assessing if a client is a danger to others or themselves is the priority. People with bipolar may need assistance with impulse control during times when they are in a manic state.\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about bipolar disorder on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/bipolar-disorder\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<\/div>\n<h2><a id=\"_sqzswoqbn6n1\" href=\"\"><\/a>Schizophrenia<\/h2>\nSchizophrenia affects people from all walks of life and typically first appears between the ages of 15 and 30.\u00a0Schizophrenia refers to a group of severe, disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, delusions (fixed false beliefs that cannot be changed through reasoning), hallucinations (hearing, seeing, smelling, tasting, or feeling touched by things that are not there), and flat affect (lack of observable expressions of emotions, monotone voice, expressionless face, immobile body).\n<h3><a id=\"_l40g23sko056\" href=\"\"><\/a>Signs and Symptoms of Schizophrenia<\/h3>\nThere are three categories of symptoms related to schizophrenia: positive, negative, and cognitive.\n<h4><a id=\"_4ov879eqs0oc\" href=\"\"><\/a>Positive Symptoms<\/h4>\nNote that in this context, the term \"positive\" does not refer to \"good.\" Positive symptoms refer to how the individual has lost touch with reality. Positive symptoms include the following:\n<ul>\n \t<li>Delusions<\/li>\n \t<li>Hallucinations<\/li>\n \t<li>Disorganized thinking and behavior<\/li>\n<\/ul>\nDelusions fall into several categories. Individuals with a persecutory delusion may believe they are being tormented, followed, tricked, or spied on. Individuals with a grandiose delusion may believe they have special powers. Individuals with a reference delusion may believe that passages in books, newspapers, television shows, song lyrics, or other environmental cues are directed toward them. In delusions of thought withdrawal or thought insertion, individuals believe others are reading their mind, their thoughts are being transmitted to others, or outside forces are imposing their thoughts or impulses on them.\n<h4><a id=\"_v4znq6hwkpxx\" href=\"\"><\/a>Negative Symptoms<\/h4>\nNegative symptoms refer to a lack of characteristics that should be present. Negative symptoms are as follows:\n<ul>\n \t<li>Apathy (lack of interest in people, things, activities)<\/li>\n \t<li>Lack of motivation<\/li>\n \t<li>Blunted affect (lack of display of emotion)<\/li>\n \t<li>Poverty of speech (brief replies)<\/li>\n \t<li>Anhedonia (lack of interest in activities once enjoyed)<\/li>\n \t<li>Avoidance of relationships<\/li>\n<\/ul>\nKeep in mind that the inability to show emotion does not reflect an inability to feel emotion. Similarly, it is helpful to understand that withdrawing from others is a coping mechanism for an individual with schizophrenia and not a rejection of those who initiate contact.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals With Intellectual Disability &amp; Mental Illness<\/a> by Sheri Melrose licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>[\/footnote]<\/sup>\n<h4><a id=\"_drisa7gvgse\" href=\"\"><\/a>Cognitive<\/h4>\nCognitive symptoms refer to altered thought patterns and include these behaviors:\n<ul>\n \t<li>Poor decision-making<\/li>\n \t<li>Loss of memory<\/li>\n \t<li>Distraction<\/li>\n \t<li>Difficulty focusing<\/li>\n<\/ul>\n<h3>Treatment<\/h3>\nTreatment for a client diagnosed with schizophrenia may include medications to control positive and\/or negative signs and symptoms and nonpharmacological interventions such as limit setting, therapeutic communication, ECT, and psychotherapy. Key assessments for a client with schizophrenia focus on safety with examination for hallucinations and delusions, identifying a support system, and reviewing medication with a focus on adherence to their prescribed therapeutic regimen.\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about schizophrenia on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/schizophrenia\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<\/div>\n<h2><a id=\"_pfz1vlo0zacj\" href=\"\"><\/a>Attention-Deficit\/Hyperactivity Disorder<\/h2>\nAttention-deficit\/hyperactivity disorder (ADHD) is characterized by hyperactivity, lack of impulse control, and\/or lack of attention that interferes with how a person functions. ADHD is often diagnosed during childhood, but signs and symptoms can last through adulthood.\n<h3>Signs and Symptoms of ADHD<\/h3>\n<ul>\n \t<li>Hyperactivity<\/li>\n \t<li>Inability to concentrate<\/li>\n \t<li>Difficulty with self-control<\/li>\n \t<li>Lack of emotional control<\/li>\n<\/ul>\nA child with ADHD may have difficulty sitting still and focusing at school or have emotional outbursts. See Figure 8.6 for an illustration of the inability to focus on details.<sup>[footnote]\u201c<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:RightBrainDominant.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">RightBrainDominant.jpg<\/a>\u201d by Elisa Riva is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a>[\/footnote]<\/sup>\n\nMedication, psychotherapy, behavior management, and family support all play a large part in helping an individual with ADHD. Providing resources for parents is also helpful.\n\n[caption id=\"attachment_347\" align=\"aligncenter\" width=\"558\"]<img class=\"wp-image-346\" title=\"&quot;RightBrainDominant.jpg&quot; by ElisaRiva is licensed under CC0\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-300x228.jpg\" alt=\"Illustration showing psychological division of the cerebral brain hemispheres.\" width=\"558\" height=\"424\"> Figure 8.6 Clients With ADHD May Have Difficulty Focusing on Details[\/caption]\n\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about ADHD on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/attention-deficit-hyperactivity-disorder-adhd\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health's website.<\/a><\/p>\n\n<\/div>\n&nbsp;\n<div class=\"textbox\">\n\n<a class=\"video\" href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">View supplementary videos on mental health disorders at Khan Academy.<\/a><sup>[footnote]<a href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">Introduction to Mental Disorders<\/a> by Khan Academy is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 3.0<\/a>[\/footnote]<\/sup>\n\n<\/div>\n<h2><a id=\"_b1j9ixk4rb22\" href=\"\"><\/a>Seizures<\/h2>\nThe official definition of a seizure is \"a transient occurrence of signs and\/or symptoms due to an abnormal excessive or synchronous neuronal activity in the brain.\" This means that during a seizure, large numbers of brain cells are activated abnormally at the same time. It is like an electrical storm in the brain. They may alter consciousness and produce abnormal motor activity. There are different classifications of seizures based on severity of symptoms.<sup>[footnote]Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a>[\/footnote]<\/sup>\n<h3><a id=\"_j4nawyehl3ma\" href=\"\"><\/a>Signs and Symptoms of Seizures<\/h3>\n<h4><a id=\"_vxsx3zm0wodf\" href=\"\"><\/a>Motor Symptoms<\/h4>\n<ul>\n \t<li>Jerking (clonic)<\/li>\n \t<li>Muscles becoming limp or weak (atonic)<\/li>\n \t<li>Tense or rigid muscles (tonic)<\/li>\n \t<li>Brief muscle twitching (myoclonus)<\/li>\n \t<li>Epileptic spasms<\/li>\n<\/ul>\n<h4><a id=\"_134p9jb9ypzt\" href=\"\"><\/a>Non-motor Symptoms<\/h4>\n<ul>\n \t<li>Changes in sensation, emotions, thinking, or autonomic functions<\/li>\n \t<li>Lack of movement<\/li>\n<\/ul>\n<h3><a id=\"_44itdmpo0xdl\" href=\"\"><\/a>Classification of Seizures<\/h3>\nSeizures are classified in many ways, beginning with whether they are partial or generalized seizures.\n<h4><a id=\"_6i2iq8hlg1xo\" href=\"\"><\/a>Partial Seizures<\/h4>\nPartial seizures have focal onset on one side of the brain. They are further classified into simple, complex, or secondarily generalized:\n<ul>\n \t<li>Simple partial seizures are most common. They may also affect sensory and autonomic systems.<\/li>\n \t<li>Complex partial seizures include impairment of consciousness, with or without motor activity or other signs.<\/li>\n \t<li>Simple or complex partial seizures may become secondarily generalized, producing a tonic-clonic seizure.<\/li>\n<\/ul>\n<h4><a id=\"_3bzwa0io53jg\" href=\"\"><\/a>Generalized Seizures<\/h4>\nGeneralized seizures have bilateral onset on both sides of the brain and are typified by petit mal seizures, which can be recognized by clinical characteristics, as well as interictal EEG abnormalities.<sup>[footnote]Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a>[\/footnote]<\/sup>\n<h4><a id=\"_mtjf2zjihnlo\" href=\"\"><\/a>Status Epilepticus<\/h4>\n<strong>[pb_glossary id=\"611\"]Status epilepticus[\/pb_glossary]<\/strong> is a state of repeated or continuous seizures. It is often defined operationally as a single seizure lasting more than 20 minutes or repeated seizures without recovery of consciousness. Prolonged status epilepticus leads to irreversible brain injury and has a very high rate of mortality. The goal of therapy should be to achieve control of a seizure within 60 minutes or less. Pharmacological treatment of seizures is very successful in the majority of cases, but it requires accurate diagnosis and classification of seizures. Medication management of seizures may include CNS depressants, benzodiazepines or barbiturates, or anticonvulsants such as phenytoin.\n<h2><a id=\"_qrybvf2hnd8z\" href=\"\"><\/a>Parkinson\u2019s Disease<\/h2>\nParkinson\u2019s disease is a progressive disease of the nervous system that impairs one\u2019s ability to move. The typical onset for Parkinson\u2019s disease is middle to later stages of life. This disease worsens over time and has no cure. The cause of this disease is unknown, but it is known that it is characterized by a loss of dopaminergic neurons.\n<h3>Signs and Symptoms of Parkinson\u2019s Disease<\/h3>\n<ul>\n \t<li><strong>[pb_glossary id=\"656\"]Tremor[\/pb_glossary]<\/strong> at rest<\/li>\n \t<li><strong>[pb_glossary id=\"612\"]Bradykinesia[\/pb_glossary]<\/strong><\/li>\n \t<li>Muscle <strong>[pb_glossary id=\"657\"]rigidity[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"655\"]Postural instability[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"613\"]Gait disturbance[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"614\"]Dystonia[\/pb_glossary]<\/strong><\/li>\n \t<li><strong>[pb_glossary id=\"615\"]Ophthalmoplegia[\/pb_glossary]<\/strong><\/li>\n \t<li>Active mood disorders<\/li>\n<\/ul>\nSee Figure 8.7 for a typical posture associated with clients with Parkinson\u2019s disease.<sup>[footnote]\u201c<a href=\"https:\/\/en.wikipedia.org\/wiki\/File:Paralysis_agitans_(1907,_after_St._Leger).png\" target=\"_blank\" rel=\"noopener noreferrer\">Paralysis agitans (1907, after St. Leger).png<\/a>\u201d by <a href=\"https:\/\/en.wikipedia.org\/wiki\/William_Richard_Gowers\" target=\"_blank\" rel=\"noopener noreferrer\">William Richard Gowers<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a>[\/footnote]<\/sup> Treatment for a client with Parkinson\u2019s disease often includes medication to increase dopamine in the brain to slow the progression of the disease.\n\n[caption id=\"\" align=\"aligncenter\" width=\"462\"]<img title=\"&quot;Paralysis agitans (1907, after St. Leger).png&quot; by William Richard Gowers is licensed under CC0 \" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2025\/01\/image7-11.png\" alt=\"Illustration of man with stooped posture, shown from front and profile views\" width=\"462\" height=\"487\"> Figure 8.7 Typical Stooping Posture of Parkinson\u2019s Disease[\/caption]\n\n&nbsp;\n<div class=\"textbox textbox--learning-objectives\">\n<p style=\"color: #333333\"><strong>Potential New Treatment of Proteins in Alzheimer\u2019s and Parkinson\u2019s Disease<\/strong><\/p>\n<p style=\"color: #333333\">The underlying cause of some neurodegenerative diseases, such as Alzheimer\u2019s and Parkinson\u2019s, appears to be related to proteins\u2014specifically, to proteins behaving badly. One of the strongest theories of what causes Alzheimer\u2019s disease is based on the accumulation of beta-amyloid plaques, dense conglomerations of a protein that is not functioning correctly. Parkinson\u2019s disease is linked to an increase in a protein known as alpha-synuclein that is toxic to the cells of the substantia nigra nucleus in the midbrain.<\/p>\nFor proteins to function correctly, they are dependent on their three-dimensional shape. The linear sequence of amino acids folds into a three-dimensional shape that is based on the interactions between and among those amino acids. When the folding is disturbed and proteins take on a different shape, they stop functioning correctly. But the disease is not necessarily the result of functional loss of these proteins; rather, these altered proteins start to accumulate and may become toxic. For example, in Alzheimer\u2019s the hallmark of the disease is the accumulation of these amyloid plaques in the cerebral cortex. The term coined to describe this sort of disease is \u201cproteopathy,\u201d and it includes other diseases. Creutzfeld-Jacob disease, the human variant of the disease known as mad cow disease, also involves the accumulation of amyloid plaques, similar to Alzheimer\u2019s. Diseases of other organ systems can fall into this group as well, such as cystic fibrosis or type 2 diabetes. Recognizing the relationship between these diseases has suggested new therapeutic possibilities. Interfering with the accumulation of the proteins, and possibly as early as their original production within the cell, may unlock new ways to alleviate these devastating diseases.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/openstax.org\/details\/books\/anatomy-and-physiology\" target=\"_blank\" rel=\"noopener noreferrer\">Anatomy and Physiology<\/a> by <a href=\"https:\/\/openstax.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenStax<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. Access for free at <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction<\/a>[\/footnote]<\/sup>\n\n<\/div>\n<\/div>","rendered":"<div class=\"1.3-disorders-of-the-cns-system\">\n<p>Now that we have reviewed basic concepts of neurotransmitters and their function, let\u2019s review common central nervous system (CNS) disorders.<sup><a class=\"footnote\" title=\"This work is a derivative of Nursing: Mental Health &amp; Community Concepts by Open RN\u00a0licensed under CC BY 4.0\" id=\"return-footnote-348-1\" href=\"#footnote-348-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/sup><\/p>\n<div class=\"textbox\">\n<p class=\"arrow\">Read additional information about mental health disorders in Open RN <a href=\"https:\/\/wtcs.pressbooks.pub\/nursingmhcc\/\" target=\"_blank\" rel=\"noopener\"><em>Nursing: Mental Health &amp; Community Concepts<\/em><\/a>.<\/p>\n<\/div>\n<h2><a id=\"_1mx1797t7cs2\" href=\"\"><\/a>Anxiety<\/h2>\n<p>Anxiety disorders are a group of conditions marked by pathological or extreme anxiety or dread. People with anxiety experience disturbances of mood, behavior, and body systems, making it difficult to complete everyday activities. Many feel anxious most of the time for no apparent reason.<\/p>\n<p>Anxiety is different from fear. Fear is a person&#8217;s response to an event or object. The psychiatric disorder of anxiety occurs when the intensity and duration of anxiety does not match the potential for harm or threat to the affected person. Anxiety can be expressed behaviorally or experienced with physical symptoms.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals With Intellectual Disability &amp; Mental Illness by Sheri Melrose licensed under CC BY 4.0\" id=\"return-footnote-348-2\" href=\"#footnote-348-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/sup><\/p>\n<h3>Signs and Symptoms of Anxiety<\/h3>\n<ul>\n<li>Aches<\/li>\n<li>Pains<\/li>\n<li>Stomachaches<\/li>\n<li>Headaches<\/li>\n<li>Heart racing or pounding<\/li>\n<li>Trembling<\/li>\n<li>Sweating<\/li>\n<li>Difficulty concentrating (see Figure 8.5)<sup><a class=\"footnote\" title=\"\u201cstress-2902537_960_720.jpg\u201d by TheDigitalArtist is licensed under CC0 1.0\" id=\"return-footnote-348-3\" href=\"#footnote-348-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/sup><\/li>\n<li>Increased agitation<\/li>\n<li>Crying<\/li>\n<\/ul>\n<figure id=\"attachment_347\" aria-describedby=\"caption-attachment-347\" style=\"width: 645px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-345\" title=\"&quot;stress-2902537_960_720.jpg&quot; by TheDigitalArtist is licensed under CC0 1.0 Access for free at https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537.jpg\" alt=\"Mixed media image of woman looking worried, stressed, or overwhelmed\" width=\"645\" height=\"430\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537.jpg 960w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-300x200.jpg 300w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-768x512.jpg 768w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-65x43.jpg 65w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-225x150.jpg 225w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2019\/11\/Depression-Problem-Stress-Anxiety-Worried-Unhappy-2902537-350x233.jpg 350w\" sizes=\"auto, (max-width: 645px) 100vw, 645px\" \/><figcaption id=\"caption-attachment-347\" class=\"wp-caption-text\">Figure 8.5 Many Clients With Anxiety Experience Difficulty Concentrating<\/figcaption><\/figure>\n<p>Treatment can include nonpharmacological interventions, as well as medications. Nonpharmacological interventions to decrease anxiety include relaxation techniques such as deep breathing, exercise, psychotherapy, support groups, or cognitive behavioral therapy. Antianxiety medications can also be used to help both verbal and nonverbal clients feel a much-needed sense of peace.<\/p>\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about anxiety on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/anxiety-disorders\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<\/div>\n<h2><a id=\"_rehswqokrj9s\" href=\"\"><\/a>Major Depressive Disorder<\/h2>\n<p>Major depressive disorder affects up to 5% of the U.S. population. To be diagnosed with major depressive disorder, five of the following symptoms must be present during the same two-week period and represent a change from previous functioning. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms of depression cannot be due to effects of a substance or from bereavement.<\/p>\n<h3>Signs and Symptoms of Depression<\/h3>\n<ul>\n<li>Depressed mood<\/li>\n<li>Diminished interest<\/li>\n<li>Weight loss when not dieting or weight gain<\/li>\n<li>Insomnia or hypersomnia<\/li>\n<li>Agitation<\/li>\n<li>Fatigue or loss of energy<\/li>\n<li>Feeling of worthlessness<\/li>\n<li>Inappropriate guilt<\/li>\n<li>Diminished ability to concentrate<\/li>\n<li>Recurrent thoughts of death, suicidal ideation, or suicide attempt<\/li>\n<\/ul>\n<p>Treatment of depression may include medication, psychotherapy, cognitive therapy, electroconvulsive therapy (ECT), and group therapy. Clients who are depressed may not report symptoms unless specifically asked, and they may be suicidal. Using assessment techniques to gather information about the history of each client\u2019s depression, support system, specific triggering events, psychosocial assessment, and risk for harm to self or others is imperative. Each client\u2019s response to medication is unpredictable, and often medications will need to be adjusted based on reported symptoms.<\/p>\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about depression on the <a href=\"http:\/\/www.nimh.nih.gov\/health\/topics\/depression\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<\/div>\n<h2><a id=\"_kgqk93qnul73\" href=\"\"><\/a>Bipolar Disorder<\/h2>\n<p>Bipolar disorder is marked by serious mood swings. Typically, clients experience extreme highs (called mania or hypomania) alternating with extreme lows (depression). See the &#8220;Major Depressive Disorder&#8221; subsection for signs and symptoms of depression. Bipolar disorder and major depression disorder are also referred to as &#8220;<strong>affective mood disorders<\/strong>.&#8221; For some people, the cycles occur so rapidly that they hardly ever feel a sense of control over their mood swings.<\/p>\n<h3>Signs and Symptoms of a Manic Episode<\/h3>\n<ul>\n<li>Rapid speech<\/li>\n<li>Hyperactivity<\/li>\n<li>Reduced need for sleep<\/li>\n<li>Flight of ideas<\/li>\n<li>Grandiosity<\/li>\n<li>Poor judgement<\/li>\n<li>Aggression\/hostility<\/li>\n<li>Risky sexual behavior<\/li>\n<li>Neglect basic self-care<\/li>\n<li>Decreased impulse control<\/li>\n<\/ul>\n<p>Treatment for a client diagnosed with bipolar may include medication, safety initiatives during acute mania, ECT, psychotherapy, and support groups. The severity of manic and depressive episodes varies for each client. Assessing if a client is a danger to others or themselves is the priority. People with bipolar may need assistance with impulse control during times when they are in a manic state.<\/p>\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about bipolar disorder on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/bipolar-disorder\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<\/div>\n<h2><a id=\"_sqzswoqbn6n1\" href=\"\"><\/a>Schizophrenia<\/h2>\n<p>Schizophrenia affects people from all walks of life and typically first appears between the ages of 15 and 30.\u00a0Schizophrenia refers to a group of severe, disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, delusions (fixed false beliefs that cannot be changed through reasoning), hallucinations (hearing, seeing, smelling, tasting, or feeling touched by things that are not there), and flat affect (lack of observable expressions of emotions, monotone voice, expressionless face, immobile body).<\/p>\n<h3><a id=\"_l40g23sko056\" href=\"\"><\/a>Signs and Symptoms of Schizophrenia<\/h3>\n<p>There are three categories of symptoms related to schizophrenia: positive, negative, and cognitive.<\/p>\n<h4><a id=\"_4ov879eqs0oc\" href=\"\"><\/a>Positive Symptoms<\/h4>\n<p>Note that in this context, the term &#8220;positive&#8221; does not refer to &#8220;good.&#8221; Positive symptoms refer to how the individual has lost touch with reality. Positive symptoms include the following:<\/p>\n<ul>\n<li>Delusions<\/li>\n<li>Hallucinations<\/li>\n<li>Disorganized thinking and behavior<\/li>\n<\/ul>\n<p>Delusions fall into several categories. Individuals with a persecutory delusion may believe they are being tormented, followed, tricked, or spied on. Individuals with a grandiose delusion may believe they have special powers. Individuals with a reference delusion may believe that passages in books, newspapers, television shows, song lyrics, or other environmental cues are directed toward them. In delusions of thought withdrawal or thought insertion, individuals believe others are reading their mind, their thoughts are being transmitted to others, or outside forces are imposing their thoughts or impulses on them.<\/p>\n<h4><a id=\"_v4znq6hwkpxx\" href=\"\"><\/a>Negative Symptoms<\/h4>\n<p>Negative symptoms refer to a lack of characteristics that should be present. Negative symptoms are as follows:<\/p>\n<ul>\n<li>Apathy (lack of interest in people, things, activities)<\/li>\n<li>Lack of motivation<\/li>\n<li>Blunted affect (lack of display of emotion)<\/li>\n<li>Poverty of speech (brief replies)<\/li>\n<li>Anhedonia (lack of interest in activities once enjoyed)<\/li>\n<li>Avoidance of relationships<\/li>\n<\/ul>\n<p>Keep in mind that the inability to show emotion does not reflect an inability to feel emotion. Similarly, it is helpful to understand that withdrawing from others is a coping mechanism for an individual with schizophrenia and not a rejection of those who initiate contact.<sup><a class=\"footnote\" title=\"This work is a derivative of Supporting Individuals With Intellectual Disability &amp; Mental Illness by Sheri Melrose licensed under CC BY 4.0\" id=\"return-footnote-348-4\" href=\"#footnote-348-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/sup><\/p>\n<h4><a id=\"_drisa7gvgse\" href=\"\"><\/a>Cognitive<\/h4>\n<p>Cognitive symptoms refer to altered thought patterns and include these behaviors:<\/p>\n<ul>\n<li>Poor decision-making<\/li>\n<li>Loss of memory<\/li>\n<li>Distraction<\/li>\n<li>Difficulty focusing<\/li>\n<\/ul>\n<h3>Treatment<\/h3>\n<p>Treatment for a client diagnosed with schizophrenia may include medications to control positive and\/or negative signs and symptoms and nonpharmacological interventions such as limit setting, therapeutic communication, ECT, and psychotherapy. Key assessments for a client with schizophrenia focus on safety with examination for hallucinations and delusions, identifying a support system, and reviewing medication with a focus on adherence to their prescribed therapeutic regimen.<\/p>\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about schizophrenia on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/schizophrenia\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<\/div>\n<h2><a id=\"_pfz1vlo0zacj\" href=\"\"><\/a>Attention-Deficit\/Hyperactivity Disorder<\/h2>\n<p>Attention-deficit\/hyperactivity disorder (ADHD) is characterized by hyperactivity, lack of impulse control, and\/or lack of attention that interferes with how a person functions. ADHD is often diagnosed during childhood, but signs and symptoms can last through adulthood.<\/p>\n<h3>Signs and Symptoms of ADHD<\/h3>\n<ul>\n<li>Hyperactivity<\/li>\n<li>Inability to concentrate<\/li>\n<li>Difficulty with self-control<\/li>\n<li>Lack of emotional control<\/li>\n<\/ul>\n<p>A child with ADHD may have difficulty sitting still and focusing at school or have emotional outbursts. See Figure 8.6 for an illustration of the inability to focus on details.<sup><a class=\"footnote\" title=\"\u201cRightBrainDominant.jpg\u201d by Elisa Riva is licensed under CC0\" id=\"return-footnote-348-5\" href=\"#footnote-348-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a><\/sup><\/p>\n<p>Medication, psychotherapy, behavior management, and family support all play a large part in helping an individual with ADHD. Providing resources for parents is also helpful.<\/p>\n<figure id=\"attachment_347\" aria-describedby=\"caption-attachment-347\" style=\"width: 558px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-346\" title=\"&quot;RightBrainDominant.jpg&quot; by ElisaRiva is licensed under CC0\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-300x228.jpg\" alt=\"Illustration showing psychological division of the cerebral brain hemispheres.\" width=\"558\" height=\"424\" srcset=\"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-300x228.jpg 300w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-1024x780.jpg 1024w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-768x585.jpg 768w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-1536x1170.jpg 1536w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-65x49.jpg 65w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-225x171.jpg 225w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant-350x267.jpg 350w, https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-content\/uploads\/sites\/219\/2025\/01\/RightBrainDominant.jpg 1920w\" sizes=\"auto, (max-width: 558px) 100vw, 558px\" \/><figcaption id=\"caption-attachment-347\" class=\"wp-caption-text\">Figure 8.6 Clients With ADHD May Have Difficulty Focusing on Details<\/figcaption><\/figure>\n<div class=\"textbox\">\n<p class=\"arrow\">Read more about ADHD on the <a href=\"https:\/\/www.nimh.nih.gov\/health\/topics\/attention-deficit-hyperactivity-disorder-adhd\/index.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute of Mental Health&#8217;s website.<\/a><\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"textbox\">\n<p><a class=\"video\" href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">View supplementary videos on mental health disorders at Khan Academy.<\/a><sup><a class=\"footnote\" title=\"Introduction to Mental Disorders by Khan Academy is licensed under CC BY-NC-SA 3.0\" id=\"return-footnote-348-6\" href=\"#footnote-348-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a><\/sup><\/p>\n<\/div>\n<h2><a id=\"_b1j9ixk4rb22\" href=\"\"><\/a>Seizures<\/h2>\n<p>The official definition of a seizure is &#8220;a transient occurrence of signs and\/or symptoms due to an abnormal excessive or synchronous neuronal activity in the brain.&#8221; This means that during a seizure, large numbers of brain cells are activated abnormally at the same time. It is like an electrical storm in the brain. They may alter consciousness and produce abnormal motor activity. There are different classifications of seizures based on severity of symptoms.<sup><a class=\"footnote\" title=\"Epilepsy Foundation. (2016, December 22). 2017 Revised classification of seizures. https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" id=\"return-footnote-348-7\" href=\"#footnote-348-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a><\/sup><\/p>\n<h3><a id=\"_j4nawyehl3ma\" href=\"\"><\/a>Signs and Symptoms of Seizures<\/h3>\n<h4><a id=\"_vxsx3zm0wodf\" href=\"\"><\/a>Motor Symptoms<\/h4>\n<ul>\n<li>Jerking (clonic)<\/li>\n<li>Muscles becoming limp or weak (atonic)<\/li>\n<li>Tense or rigid muscles (tonic)<\/li>\n<li>Brief muscle twitching (myoclonus)<\/li>\n<li>Epileptic spasms<\/li>\n<\/ul>\n<h4><a id=\"_134p9jb9ypzt\" href=\"\"><\/a>Non-motor Symptoms<\/h4>\n<ul>\n<li>Changes in sensation, emotions, thinking, or autonomic functions<\/li>\n<li>Lack of movement<\/li>\n<\/ul>\n<h3><a id=\"_44itdmpo0xdl\" href=\"\"><\/a>Classification of Seizures<\/h3>\n<p>Seizures are classified in many ways, beginning with whether they are partial or generalized seizures.<\/p>\n<h4><a id=\"_6i2iq8hlg1xo\" href=\"\"><\/a>Partial Seizures<\/h4>\n<p>Partial seizures have focal onset on one side of the brain. They are further classified into simple, complex, or secondarily generalized:<\/p>\n<ul>\n<li>Simple partial seizures are most common. They may also affect sensory and autonomic systems.<\/li>\n<li>Complex partial seizures include impairment of consciousness, with or without motor activity or other signs.<\/li>\n<li>Simple or complex partial seizures may become secondarily generalized, producing a tonic-clonic seizure.<\/li>\n<\/ul>\n<h4><a id=\"_3bzwa0io53jg\" href=\"\"><\/a>Generalized Seizures<\/h4>\n<p>Generalized seizures have bilateral onset on both sides of the brain and are typified by petit mal seizures, which can be recognized by clinical characteristics, as well as interictal EEG abnormalities.<sup><a class=\"footnote\" title=\"Epilepsy Foundation. (2016, December 22). 2017 Revised classification of seizures. https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" id=\"return-footnote-348-8\" href=\"#footnote-348-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><\/sup><\/p>\n<h4><a id=\"_mtjf2zjihnlo\" href=\"\"><\/a>Status Epilepticus<\/h4>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_611\">Status epilepticus<\/a><\/strong> is a state of repeated or continuous seizures. It is often defined operationally as a single seizure lasting more than 20 minutes or repeated seizures without recovery of consciousness. Prolonged status epilepticus leads to irreversible brain injury and has a very high rate of mortality. The goal of therapy should be to achieve control of a seizure within 60 minutes or less. Pharmacological treatment of seizures is very successful in the majority of cases, but it requires accurate diagnosis and classification of seizures. Medication management of seizures may include CNS depressants, benzodiazepines or barbiturates, or anticonvulsants such as phenytoin.<\/p>\n<h2><a id=\"_qrybvf2hnd8z\" href=\"\"><\/a>Parkinson\u2019s Disease<\/h2>\n<p>Parkinson\u2019s disease is a progressive disease of the nervous system that impairs one\u2019s ability to move. The typical onset for Parkinson\u2019s disease is middle to later stages of life. This disease worsens over time and has no cure. The cause of this disease is unknown, but it is known that it is characterized by a loss of dopaminergic neurons.<\/p>\n<h3>Signs and Symptoms of Parkinson\u2019s Disease<\/h3>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_656\">Tremor<\/a><\/strong> at rest<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_612\">Bradykinesia<\/a><\/strong><\/li>\n<li>Muscle <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_657\">rigidity<\/a><\/strong><\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_655\">Postural instability<\/a><\/strong><\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_613\">Gait disturbance<\/a><\/strong><\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_614\">Dystonia<\/a><\/strong><\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_348_615\">Ophthalmoplegia<\/a><\/strong><\/li>\n<li>Active mood disorders<\/li>\n<\/ul>\n<p>See Figure 8.7 for a typical posture associated with clients with Parkinson\u2019s disease.<sup><a class=\"footnote\" title=\"\u201cParalysis agitans (1907, after St. Leger).png\u201d by William Richard Gowers is licensed under CC0\" id=\"return-footnote-348-9\" href=\"#footnote-348-9\" aria-label=\"Footnote 9\"><sup class=\"footnote\">[9]<\/sup><\/a><\/sup> Treatment for a client with Parkinson\u2019s disease often includes medication to increase dopamine in the brain to slow the progression of the disease.<\/p>\n<figure style=\"width: 462px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" title=\"&quot;Paralysis agitans (1907, after St. Leger).png&quot; by William Richard Gowers is licensed under CC0\" src=\"https:\/\/pressbooks.ccconline.org\/accdigitalmarketing\/wp-content\/uploads\/sites\/219\/2025\/01\/image7-11.png\" alt=\"Illustration of man with stooped posture, shown from front and profile views\" width=\"462\" height=\"487\" \/><figcaption class=\"wp-caption-text\">Figure 8.7 Typical Stooping Posture of Parkinson\u2019s Disease<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<p style=\"color: #333333\"><strong>Potential New Treatment of Proteins in Alzheimer\u2019s and Parkinson\u2019s Disease<\/strong><\/p>\n<p style=\"color: #333333\">The underlying cause of some neurodegenerative diseases, such as Alzheimer\u2019s and Parkinson\u2019s, appears to be related to proteins\u2014specifically, to proteins behaving badly. One of the strongest theories of what causes Alzheimer\u2019s disease is based on the accumulation of beta-amyloid plaques, dense conglomerations of a protein that is not functioning correctly. Parkinson\u2019s disease is linked to an increase in a protein known as alpha-synuclein that is toxic to the cells of the substantia nigra nucleus in the midbrain.<\/p>\n<p>For proteins to function correctly, they are dependent on their three-dimensional shape. The linear sequence of amino acids folds into a three-dimensional shape that is based on the interactions between and among those amino acids. When the folding is disturbed and proteins take on a different shape, they stop functioning correctly. But the disease is not necessarily the result of functional loss of these proteins; rather, these altered proteins start to accumulate and may become toxic. For example, in Alzheimer\u2019s the hallmark of the disease is the accumulation of these amyloid plaques in the cerebral cortex. The term coined to describe this sort of disease is \u201cproteopathy,\u201d and it includes other diseases. Creutzfeld-Jacob disease, the human variant of the disease known as mad cow disease, also involves the accumulation of amyloid plaques, similar to Alzheimer\u2019s. Diseases of other organ systems can fall into this group as well, such as cystic fibrosis or type 2 diabetes. Recognizing the relationship between these diseases has suggested new therapeutic possibilities. Interfering with the accumulation of the proteins, and possibly as early as their original production within the cell, may unlock new ways to alleviate these devastating diseases.<sup><a class=\"footnote\" title=\"This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction\" id=\"return-footnote-348-10\" href=\"#footnote-348-10\" aria-label=\"Footnote 10\"><sup class=\"footnote\">[10]<\/sup><\/a><\/sup><\/p>\n<\/div>\n<\/div>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-348-1\">This work is a derivative of <a href=\"https:\/\/wtcs.pressbooks.pub\/nursingmhcc\/\" target=\"_blank\" rel=\"noopener\">Nursing: Mental Health &amp; Community Concepts<\/a> by <a href=\"https:\/\/www.cvtc.edu\/landing-pages\/grants\/open-rn\" target=\"_blank\" rel=\"noopener\">Open RN\u00a0<\/a>licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a> <a href=\"#return-footnote-348-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-348-2\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals With Intellectual Disability &amp; Mental Illness<\/a> by Sheri Melrose licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a> <a href=\"#return-footnote-348-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-348-3\">\u201c<a href=\"https:\/\/pixabay.com\/photos\/stress-anxiety-depression-unhappy-2902537\/\" target=\"_blank\" rel=\"noopener noreferrer\">stress-2902537_960_720.jpg<\/a>\u201d by <a href=\"https:\/\/pixabay.com\/users\/TheDigitalArtist-202249\/\" target=\"_blank\" rel=\"noopener noreferrer\">TheDigitalArtist<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0 1.0<\/a>  <a href=\"#return-footnote-348-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-348-4\">This work is a derivative of <a href=\"https:\/\/opentextbc.ca\/caregivers\/chapter\/chapter-three-an-overview-of-mental-illness\/\" target=\"_blank\" rel=\"noopener noreferrer\">Supporting Individuals With Intellectual Disability &amp; Mental Illness<\/a> by Sheri Melrose licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a> <a href=\"#return-footnote-348-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-348-5\">\u201c<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:RightBrainDominant.jpg\" target=\"_blank\" rel=\"noopener noreferrer\">RightBrainDominant.jpg<\/a>\u201d by Elisa Riva is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a> <a href=\"#return-footnote-348-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-348-6\"><a href=\"https:\/\/www.khanacademy.org\/test-prep\/mcat\/behavior\/psychological-disorders\/v\/introduction-to-mental-disorders\" target=\"_blank\" rel=\"noopener noreferrer\">Introduction to Mental Disorders<\/a> by Khan Academy is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 3.0<\/a> <a href=\"#return-footnote-348-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-348-7\">Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a> <a href=\"#return-footnote-348-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-348-8\">Epilepsy Foundation. (2016, December 22). <em>2017 Revised classification of seizures.<\/em> <a href=\"https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.epilepsy.com\/article\/2016\/12\/2017-revised-classification-seizures<\/a> <a href=\"#return-footnote-348-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><li id=\"footnote-348-9\">\u201c<a href=\"https:\/\/en.wikipedia.org\/wiki\/File:Paralysis_agitans_(1907,_after_St._Leger).png\" target=\"_blank\" rel=\"noopener noreferrer\">Paralysis agitans (1907, after St. Leger).png<\/a>\u201d by <a href=\"https:\/\/en.wikipedia.org\/wiki\/William_Richard_Gowers\" target=\"_blank\" rel=\"noopener noreferrer\">William Richard Gowers<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/cc0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC0<\/a> <a href=\"#return-footnote-348-9\" class=\"return-footnote\" aria-label=\"Return to footnote 9\">&crarr;<\/a><\/li><li id=\"footnote-348-10\">This work is a derivative of <a href=\"https:\/\/openstax.org\/details\/books\/anatomy-and-physiology\" target=\"_blank\" rel=\"noopener noreferrer\">Anatomy and Physiology<\/a> by <a href=\"https:\/\/openstax.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenStax<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY 4.0<\/a>. Access for free at <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-introduction<\/a> <a href=\"#return-footnote-348-10\" class=\"return-footnote\" aria-label=\"Return to footnote 10\">&crarr;<\/a><\/li><\/ol><\/div><div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_348_611\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_611\"><div tabindex=\"-1\"><p>A state of repeated or continuous seizures.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_348_656\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_656\"><div tabindex=\"-1\"><p>Usually tremor at rest; When person sits, arm shakes; tremor stops when person attempts to grab something (pill rolling tremor).<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_348_612\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_612\"><div tabindex=\"-1\"><p>Slowness in initiation and execution of voluntary movements.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_348_657\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_657\"><div tabindex=\"-1\"><p>Increase muscle tone and increase resistance to movement (Arms and Legs Stiff) \u2013 as severity increases cogwheel rigidity.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_348_655\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_655\"><div tabindex=\"-1\"><p>Abnormal fixation of posture (stoop when standing), problems with equilibrium, and righting reflex.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_348_613\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_613\"><div tabindex=\"-1\"><p>An abnormal way of walking, such as shuffling feet.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_348_614\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_614\"><div tabindex=\"-1\"><p>Inappropriate and continuous muscle contraction.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_348_615\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_348_615\"><div tabindex=\"-1\"><p>Weakness in eye muscles.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":83,"menu_order":3,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-348","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":336,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/348","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/users\/83"}],"version-history":[{"count":2,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/348\/revisions"}],"predecessor-version":[{"id":762,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/348\/revisions\/762"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/336"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/348\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/media?parent=348"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=348"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/contributor?post=348"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/license?post=348"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}