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BioMed S2 > 13. Nervous System I - Pathologies > Flashcards

13. Nervous System I - Pathologies Flashcards

1
Q

Carpal Tunnel Syndrome: definition

A

Compression of the median nerve in the carpal tunnel

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2
Q

What does the median nerve do?

A

Provides sensory information to the hand
Controls movements in the hand and fingers

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3
Q

Carpal Tunnel Syndrome: aetiology

A

Fluid retention - pregnancy
Overuse - vibrating tools, desk posture
Other pathologies - RA, hypothyroidism, acromegaly
Trauma (swelling), tumour or fracture in wrist

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4
Q

Carpal Tunnel Syndrome: signs and symptoms

A

Tingling, numbness, pain in median nerve distribution
Worse at night
Weakness of grip and weak thumb opposition

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5
Q

Carpal Tunnel Syndrome: diagnostics

A

Tinel’s test
Phalen’s test
Nerve conduction studies

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6
Q

Carpal Tunnel Syndrome: complications

A

In chronic/untreated cases, muscles around base of thumb may degenerate

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7
Q

Carpal Tunnel Syndrome: allopathic treatment

A 
Anti-inflammatory drugs
Corticosteroid injection
Physiotherapy
Wrist splinting
Surgery
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8
Q

Carpal Tunnel Syndrome: natural treatments

A

Treat the cause.
Herbs and nutrition for pain and inflammation.
Acupuncture,
homeopathy (arnica, ruta)
Vitamin B6 helps in pain pathway
Osteopathy - ‘biscuit breaking’ exercise

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9
Q

Bell’s Palsy: definition

A

Inflammation or compression of the facial nerve

Specifically compressed in facial canal

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10
Q

Bell’s Palsy: aetiology

A

Viral (Herpes simplex*)
Surgery (secondary to a procedure)
Injury

*same as for cold sores

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11
Q

Bell’s Palsy: signs and symptoms

A

Sudden, unilateral weakness or paralysis of the facial muscles
Cannot close affected eye*
Loss of taste
Intolerance to loud noise

*patients advised to protect cornea with eye patch

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12
Q

Bell’s Palsy: allopathic treatment

A

Cortisone (steroid)
Acyclovir (antiviral)

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13
Q

Bell’s Palsy: natural treatment

A

Acupuncture most effective at early stage
Herbs and nutrients (antiviral, support for nerve function)
Anti-inflammatory diet
Homeopathy.

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14
Q

Guillain-Barre Syndrome: definition

A

Acute, ascending, progressive inflammation and demyelination of peripheral nerves

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15
Q

Guillain-Barre Syndrome: aetiology

A

Autoimmune
75% triggered by a recent infection
(1-3 wks after respiratory/GIT infection eg. Flu or EBV)

Associated with post-vaccination (linked to Flu and HPV vaccines

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16
Q

Guillain-Barre Syndrome: pathophysiology

A

Starting with the most peripheral neurons
Feet, lower limbs and progressive ascending paralysis
Causes neuritis (inflammation of the nerve cells)

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17
Q

Guillain-Barre Syndrome: signs and symptoms

A

Sudden, progressive, bilateral, ascending paralysis (starts in the feet)
Paraesthesia (‘pins and needles’) and sensory changes
Neuropathic pain into legs

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18
Q

Guillain-Barre Syndrome: complications

A

Death by heart or respiratory failure

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19
Q

Guillain-Barre Syndrome: diagnostics

A

Nerve conduction studies
Lumbar puncture

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20
Q

Guillain-Barre Syndrome: allopathic treatment

A

Emergency care (respirator, intensive care)
Plasma exchange
Intravenous antibodies
Corticosteroids

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21
Q

Multiple Sclerosis (MS): definition

A

Autoimmune inflammatory diseases causing demyelination of axons in CNS neurons

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22
Q

Multiple Sclerosis (MS): aetiology

A 
Vitamin D deficiency*
Vitamin B12 deficiency
Genetic susceptibility
Environmental triggers:
> Dietary risk factors
> Viruses - EBV, measles etc

*Vit D activates oligodendrocytes

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23
Q

Multiple Sclerosis (MS): signs and symptoms

A 
Blindness, loss of vision in one eye and occasional pain (neuritis)
Double vision and nystagmus (jerking of eyeball)
Deafness
Loss of balance
Spinal tract symptoms: 
> Burning pain, pulling sensations
> Tingling, loss of sensation
Bladder urgency, incontinence
Cognitive changes, depression
Weakness
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24
Q

Multiple Sclerosis (MS): pathophysiology

A

T-lymphocytes attack antigens in the myelin sheath
Multiple areas of sclerosis (scar tissue)
Creates leisons of damaged myelin along axons disrupting conduction

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25
Q

Multiple Sclerosis (MS): diagnostics

A

No definitive test - based on clinical findings
MRI
Ophthalmoscopy (retinal examination of optic nerve)
CSF analysis

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26
Q

At what age is multiple sclerosis likely to occur?

A

Between 20-50 years

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27
Q

Who is more likely to be affected by multiple sclerosis?

A

Women (2:1 to men)

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28
Q

What patterns can MS follow?

A 
Relapsing-remitting pattern (85% of cases)
Other patterns are progressive
Primary (progressive from onset)
Secondary (relapse-remitting > progressive)
29
Q

What is the prognosis for MS?

A

Depends on disease pattern - 15% only suffer one episode
Progressive types have a poor prognosis

30
Q

Multiple Sclerosis (MS): allopathic treatment

A

Immunomodulatory therapies:
* corticosteroids
* interferon-beta
Physiotherapy
Symptom management

31
Q

Multiple Sclerosis (MS): natural treatment

A 
Lifestyle and diet are important in prolonging remission
Anti-inflammatory diet
Ketogenic diet (increasing ketones)
Herbal medicine for autoimmune and antiviral conditions
Low-grade exercise 
Alpha-lipoic acid (antioxidant)
Vitamin D and Vitamin B12
32
Q

Motor Neuron Disease (MND): definition

A

Progressive degeneration of motor neurons in the spinal cord, motor cortex and brain stem

Degeneration of any motor pathway of CNS

33
Q

At what age does MND usually occur?

A

> 40 yrs (50-70 yrs)

34
Q

Who does MND usually affect?

A

More commonly affects men

35
Q

Motor Neuron Disease (MND): pathophysiology

A

Abnormal mitochondrial function causing oxidative stress in motor neurons

36
Q

Motor Neuron Disease (MND): aetiology

A

Unknown - suspected link with genetics, environmental toxins, oxidative stress

37
Q

Motor Neuron Disease (MND): signs and symptoms

A 
Weakness in upper limbs*
Weak grip, dropping/difficulty manipulating objects
Wasting of hand muscles
Tremor of limbs at rest
Later stages can affect legs (tripping) 
Slurred speech
Dyspnoea, difficulty swallowing

Deterioration begins in upper limbs

38
Q

Motor Neuron Disease (MND): complications

A

Death by respiratory failure Typically 3-5 yrs after diagnosis*

Stephen Hawking exception (very young at diagnosis)

39
Q

Motor Neuron Disease (MND): allopathic treatment

A

No cure
Specialist care

40
Q

Motor Neuron Disease (MND): natural treatment

A

An anti-inflammatory diet
Herbs and nutrients to support nerve function
Homeopathy and acupuncture.

41
Q

Dementia: definition

A

Syndrome caused by a number of brain disorders which cause
* Memory loss
* Decline in other aspects of cognition
* Difficulty performing daily activities

42
Q

What are the two main categories of dementia?

A

Alzheimer’s disease (50%)
Vascular dementia (25%)

43
Q

What is vascular dementia?

A

Due to cerebrovascular disease e.g. stroke/strokes and poor oxygen delivery

44
Q

Alzheimer’s Disease: definition

A

Neurodegenerative disease of the cerebral cortex

45
Q

Alzheimer’s Disease: pathophysiology

A

Abnormal protein plaque deposition (beta amyloid plaques*)
Atrophy of neurons
Estimated loss of 1000 synapses/day
Less acetylcholine

*Key diagnostic feature

46
Q

Which area of the brain is usually first affected by Alzheimer’s?

A

Hippocampus
Short term memories affected

47
Q

What is the hippocampus important for developing?

A

Memories

48
Q

Which area of the brain is usually affected later by Alzheimer’s?

A

Amygdala

49
Q

What is the amygdala important for?

A

Emotions
Memories

50
Q

Alzheimer’s: Beta-amaloid hypothesis
|Verbal, not on slide

A

The subject of extensive research and drug development efforts with little to no effect

Suggests that the accumulation of beta-amyloid plaques plays a central role in the development and progression of Alzheimer’s disease

51
Q

Alzheimer’s Disease: aetiology

A 
Heavy metal toxicity (degeneration of the blood brain barrier)
* Mercury
* Excessive copper
* Aluminium toxicity (vaccines, cans, foil)

Genetic links (<1%) - ApoE4 gene

Chronic inflammation
* Sugar (insulin resistance), dairy
* Gluten and leaky gut (molecules/bacteria entering blood which can travel to brain)

Pathogens (micro-organisms) 
* Oral bacteria e.g. P. gingivalis
* Herpes simplex virus

Increased risk if cardiovascular disease
(CVD) present and with high homocysteine.

High levels of oxidative stress
High cortisol

Nutritional deficiency
* B1, B3, B6, B12, folate*
* Omega 3 fatty acids

Hormonal deficiencies
* Oestrogen, testosterone
* Thyroid hormone

*Help with conversion of homocysteine to methionine

52
Q

Alzheimer’s Disease: signs and symptoms - early stages

A

Slight memory loss (especially short term - forgetting recent conversations)
Repeated questions and confusion
Decreased initiative - reduction in hobbies/hygiene

53
Q

Alzheimer’s Disease: signs and symptoms - later stages

A

Significant memory loss (long term, forget who people are)
Subtle changes in higher order functions i.e. not understanding jokes
Mood disturbances - agitation, aggression
Loss of sense of self
Difficulty with language
Unsteady, disorientated
Depression

54
Q

Alzheimer’s Disease: diagnostics

A

Mini mental state exam (MMSE)
MRI/CT scans

55
Q

Alzheimer’s Disease: allopathic treatment

A

Drugs - acetylcholinesterase inhibitors (to encourage Ach to increase) - ineffective

Psychological treatments - cognitive behavioural therapy (usually not offered)

56
Q

Alzheimer’s Disease: natural treatment

A

Nutrition is essential in prevention and
disease management
Ketogenic diet
Deficiencies to be addressed: antioxidants, anti-inflammatory and other
nerve supporting nutrients:
- Beta-carotene
- Omega-3 fatty acids
- Medium-chain triglycerides (MCTs support neuron functions)
- B vitamins

Herbs such as ginkgo and turmeric
Regular exercise and good quality sleep
Addressing metal toxicity
Managing stress
MEND protocol

57
Q

What is the prognosis for Alzheimer’s?

A

People typically live for anywhere between 5 and 20 yrs after the onset of symptoms

58
Q

What is the most common cause of death in people with Alzheimer’s?

A

Infection

59
Q

Parkinson’s Disease: definition

A

Progressive neurological disorder affecting movement

60
Q

What is the prevalence of Parkinson’s

A

Affects 1% of individuals over 60

61
Q

Parkinson’s Disease: aetiology

A

Mitochondrial dysfunction (oxidative stress)

Constipation and diet low in polyunsaturated fats

Genetics

Toxic environmental factors :
industrial chemicals
carbon monoxide
manganese poisoning
exposure to pesticides and herbicides

62
Q

Parkinson’s Disease: pathophysiology

A

Degeneration of the dopaminergic neurons in the *substantia nigra** (area of brain that regulates movement)

Causes dopamine deficiency, leaving patients less able to direct or control their movement

Accumulation of abnormal protein (Lewy bodies) within neurons

*‘black substance’, darker appearance due to high levels of neuromelanin

63
Q

Parkinson’s Disease: signs and symptoms

A

Bradykinesia - short shuffling steps, difficulty stopping/starting

Resting tremor (pill rolling)

Stopped/flexed posture

Lack of normal subconscious movements - swinging arms

Muscle rigidity, mask like face, low voice

64
Q

Parkinson’s Disease: allopathic treatment

A

Dopamine replacement - Levodopa (L-dopa)

Deep brain stimulation - electrodes in brain

65
Q

Parkinson’s Disease: natural treatment

A

Anti-inflammatory, anti-oxidant and
mitochondrial support through diet (i.e.
Mediterranean), herbs. B vitamins.

Exercise (30–45 mins of aerobic 3–5 x per week).
- Cycling: reduces symptoms
- Dance: music and colours are stimulatory

Dietary protein intake at dinner to prevent competitive uptake between amino acids and L-dopa.

66
Q

Huntington’s Disease: definition

A

Inherited neurodegenerative disorder affecting the basal ganglia

67
Q

Huntington’s Disease: pathophysiology

A

A genetic (autosomal dominant) disease with a defect on chromosome 4

68
Q

Huntington’s Disease: signs and symptoms

A 
Loss of muscle co-ordination (chorea)
Cognitive impairment
Loss of intellect
Depression
Aggression
69
Q

What are the involuntary jerky movements seen in Huntington’s disease called?

A

Chorea

BioMed S2 (34 decks)

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