13. Nervous System I - Pathologies Flashcards
Carpal Tunnel Syndrome: definition
Compression of the median nerve in the carpal tunnel
What does the median nerve do?
Provides sensory information to the hand
Controls movements in the hand and fingers
Carpal Tunnel Syndrome: aetiology
Fluid retention - pregnancy
Overuse - vibrating tools, desk posture
Other pathologies - RA, hypothyroidism, acromegaly
Trauma (swelling), tumour or fracture in wrist
Carpal Tunnel Syndrome: signs and symptoms
Tingling, numbness, pain in median nerve distribution
Worse at night
Weakness of grip and weak thumb opposition
Carpal Tunnel Syndrome: diagnostics
Tinel’s test
Phalen’s test
Nerve conduction studies
Carpal Tunnel Syndrome: complications
In chronic/untreated cases, muscles around base of thumb may degenerate
Carpal Tunnel Syndrome: allopathic treatment
Anti-inflammatory drugs Corticosteroid injection Physiotherapy Wrist splinting Surgery
Carpal Tunnel Syndrome: natural treatments
Treat the cause.
Herbs and nutrition for pain and inflammation.
Acupuncture,
homeopathy (arnica, ruta)
Vitamin B6 helps in pain pathway
Osteopathy - ‘biscuit breaking’ exercise
Bell’s Palsy: definition
Inflammation or compression of the facial nerve
Specifically compressed in facial canal
Bell’s Palsy: aetiology
Viral (Herpes simplex*)
Surgery (secondary to a procedure)
Injury
*same as for cold sores
Bell’s Palsy: signs and symptoms
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
Bell’s Palsy: allopathic treatment
Cortisone (steroid)
Acyclovir (antiviral)
Bell’s Palsy: natural treatment
Acupuncture most effective at early stage
Herbs and nutrients (antiviral, support for nerve function)
Anti-inflammatory diet
Homeopathy.
Guillain-Barre Syndrome: definition
Acute, ascending, progressive inflammation and demyelination of peripheral nerves
Guillain-Barre Syndrome: aetiology
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
Guillain-Barre Syndrome: pathophysiology
Starting with the most peripheral neurons
Feet, lower limbs and progressive ascending paralysis
Causes neuritis (inflammation of the nerve cells)
Guillain-Barre Syndrome: signs and symptoms
Sudden, progressive, bilateral, ascending paralysis (starts in the feet)
Paraesthesia (‘pins and needles’) and sensory changes
Neuropathic pain into legs
Guillain-Barre Syndrome: complications
Death by heart or respiratory failure
Guillain-Barre Syndrome: diagnostics
Nerve conduction studies
Lumbar puncture
Guillain-Barre Syndrome: allopathic treatment
Emergency care (respirator, intensive care)
Plasma exchange
Intravenous antibodies
Corticosteroids
Multiple Sclerosis (MS): definition
Autoimmune inflammatory diseases causing demyelination of axons in CNS neurons
Multiple Sclerosis (MS): aetiology
Vitamin D deficiency* Vitamin B12 deficiency Genetic susceptibility Environmental triggers: > Dietary risk factors > Viruses - EBV, measles etc
*Vit D activates oligodendrocytes
Multiple Sclerosis (MS): signs and symptoms
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
Multiple Sclerosis (MS): pathophysiology
T-lymphocytes attack antigens in the myelin sheath
Multiple areas of sclerosis (scar tissue)
Creates leisons of damaged myelin along axons disrupting conduction
Multiple Sclerosis (MS): diagnostics
No definitive test - based on clinical findings
MRI
Ophthalmoscopy (retinal examination of optic nerve)
CSF analysis
At what age is multiple sclerosis likely to occur?
Between 20-50 years
Who is more likely to be affected by multiple sclerosis?
Women (2:1 to men)