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Nursing the neuromuscular patient

02 April 2018
11 mins read
Volume 9 · Issue 3


Neuromuscular disorders are a group of diseases affecting the peripheral nervous system (lower motor neurons, neuromuscular junction and/or muscle) causing weakened, reduced or absent voluntary movement. Neuromuscular patients are challenging yet rewarding to nurse as they require intensive rehabilitation and nursing care, especially if complications arise. It is important to understand the pathophysiology of these diseases to help facilitate the best possible outcome.

Neuromuscular diseases can affect; the peripheral nerve (neuropathy), neuromuscular junction (junctionopathy) or muscle (myopathy) (Figure 1). They affect not only an animal's ability to walk, but their ability to swallow and sometimes breathe in the most severe cases. Some disorders can exist alongside existing conditions which can cause complications in patient management. There are three main neuromuscular disorders seen in dogs: polyradiculoneuritis, myasthenia gravis and polymyositis.

Polyradiculoneuritis is the most common peripheral neuropathy in dogs (Cuddon, 2002) and is described as the equivalent of Guillian-Barre Syndrome in humans (Northington et al, 1981). The exact pathogenesis of disease is still unclear however it is thought to be an immunemediated mechanism targeting the myelin and/or axons of the peripheral nerves (Añor, 2014), leading to axonal degeneration and demyelination. It has been shown that lumbosacral nerve roots are often affected more severely than thoracic or cervical ones, meaning clinical signs are usually worse in the pelvic than thoracic limbs (Cummings and Haas, 1967).

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