neurologic disorders
Overview of Peripheral Nervous System Disorders
Treatment
Treatment of underlying disorder Supportive care, often by a multidisciplinary team Treatment of a peripheral nerve disorder is directed at the underlying disorder when possible. Otherwise, treatment is supportive. A multidisciplinary team approach helps patients cope with progressive neurologic disability: Physical therapists may help patients maintain muscle function. Occupational therapists can recommend adaptive braces and walking devices to help with activities of daily living. Speech and language therapists may provide alternative communication devices. If pharyngeal weakness develops, a speech therapist or a multidisciplinary team that specializes in swallowing problems can help assess risk of aspiration and recommend measures for prevention (eg, precautions for oral feeding and/or need for tube feedings). A gastroenterologist may recommend percutaneous endoscopic gastrostomy. If respiratory weakness develops, forced vital capacity is measured, and pulmonary or intensive care specialists help assess whether intensive care, noninvasive respiratory support (eg, bilevel positive airway pressure), and tracheostomy with full ventilatory support are needed. Early in fatal disorders, health care practitioners must talk frankly with patients, family members, and caregivers to determine the level of intervention acceptable. Patients are encouraged to put their decisions in writing ( Advance Directives ) before they become incapacitated. These decisions should be reviewed and confirmed at various stages of the disorder. 