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Neurological System Case Study

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Neurological System Case Study
A thirty-five-year-old male is admitted to a hospital following a minor car accident. He was driving home and fell asleep at the wheel. This is the third accident he has had in the past year. He also falls asleep regularly at work, at the dinner table, at church, and, in fact, anywhere. When he becomes excited or enraged, he suddenly becomes weak and falls. At night, he often has bizarre, terrifying dreams. During these dreams, he feels as if he were paralyzed.
Based on the scenario given above, answer the following questions:
• Describe how a nerve impulse is transmitted from one neuron to the next.
The neuron is the primary structural, functional unit and information/communication cell of the nervous system …show more content…

NREM (non-rapid eye movement) sleep is the light and deep stages of sleep “initiated by withdrawal of neurotransmitters from the reticular formation and by the inhibition of arousal mechanisms in the cerebral cortex.” The reticular formation found in the brainstem is primarily responsible for generating REM sleep, and NREM sleep is produced by projections from the reticular formation and other areas of the mesencephalon (midbrain). Normal sleep happens in cycles of NREM and REM sleep. When a person falls asleep, he first enters into a light sleep and then progresses into increasingly deeper stages of sleep (NREM cycle) for about 90 mins, followed by the initial stage of REM sleep, the two cycles alternating throughout the night. For people suffering from narcolepsy, sleep begins immediately with REM sleep and portions of REM happens involuntarily throughout the waking hours. As mentioned earlier, REM sleep is when muscles are paralyzed and when dreams take place, explains the associated symptoms of cataplexy, paralysis and hallucinations (McCance & Huether, 2014; "National Sleep Foundation," …show more content…

It typically combines medication with behavioral therapy. A combination of drugs is prescribed. Stimulants such as such as modafinil and methylphenidate to promote daytime alertness and reduce excessive daytime sleepiness, antidepressants such as tricyclics (imipramine, desipramine, clomipramine, and protriptyline) and selective serotonin and noradrenergic reuptake inhibitors (venlafaxine, fluoxetine and atomoxetine) to treat cataplexy, hallucinations and sleep paralysis and a potent sleep-inducing drug such as sodium oxybate or gamma hydroxybutyrate, that’s taken at night to improve nighttime sleep and reduce cataplexy and daytime sleepiness. All these drugs have undesirable side effects and careful consideration should be taken to balance the therapeutic effects and side effects. The objective is to attain normal alertness with minimal side effects. Lifestyle changes includes short frequent 10-15 minute naps to fight excessive sleepiness, maintaining a regular sleep and meal schedule, regular exercise, and avoiding heavy meals, alcohol, caffeine and nicotine which can disturb or induce sleep. Counseling is very important even with treatment because the symptoms of narcolepsy are not widely understood by the general population and can be quite scary and embarrassing to the patient. Narcolepsy can be debilitating, interfering with daily activities and personal relationships (Perry, 2016;

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