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BDS3 DISEASES OF HUMAN SYSTEMS > 7 - Degernative brain disease > Flashcards

7 - Degernative brain disease Flashcards

1
Q

What is MS?

A
  • multiple sclerosis
  • affects CNS only
  • demyelination of axons due to inflammatory changes
  • progressive functional loss
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2
Q

What are the causes of MS?

A
  • aetiology is widely unknown
  • susceptibility can be acquired during childhood
  • genetic and immune factors play a role
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3
Q

What are the symptoms of MS?

A
  • muscle weakness
  • visual disturbance
  • paraesthesia
  • autonomic dysfunction
  • pain
  • balance or hearing loss
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4
Q

What are the signs of MS?

A
  • muscle weakness
  • spasticity (UMN)
  • altered reflexes
  • tremor
  • optic atrophy
  • proprioceptive loss
  • loss of touch
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5
Q

What investigations can be conducted for MS?

A
  • history and exam
  • MRI
  • CSF analysis (reduced lymphocytes and increased IgG proteins)
  • visual evoked potential (reduced after optic neuritis)
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6
Q

What are the different types of MS?

A
  • relapsing and remitting
  • primary progressive
  • secondary progressive
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7
Q

Describe relapsing and remitting MS.

A
  • acute exacerbation and periods of respite
  • damage builds up with every episode
  • most eventually develop secondary progressive MS and become disabled
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8
Q

Describe primary progressive MS.

A
  • slow and steady progressive deterioration
  • no exacerbations
  • cumulative neurological damage
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9
Q

How is MS managed?

A
  • antibiotics, antispasmodics, analgesia and steroids
  • physiotherapy and OT
  • relapsing and remitting can use disease modifying therapies to slow progression
  • stem cell transplant (existing disability not reversed)
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10
Q

What disease modifying drugs can be used to treat MS?

A
  • cladribine
  • siponomod
  • ocrelizumab
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11
Q

What are the dental aspect of MS?

A
  • limited mobility for OH
  • cannot be treated under GA
  • orofacial motor and sensory disturbance can be sign
  • chronic orofacial pain
  • increased trigeminal neuralgia risk
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12
Q

What is MND?

A
  • motor neurone disease
  • degeneration in spinal cord that affects corticospinal tracts, anterior horns and the bulbar motor nuclei
  • more common in males
  • patients aged 30-60
  • usually die within 3 years
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13
Q

Describe MND effects.

A
  • progressive loss of motor function affecting the limbs, intercostal muscles, diaphragm and cranial nerves VII-XII
  • death due to ventilation failure or aspiration pneumonia as protective reflex is lost
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14
Q

What are symptoms of MND?

A
  • weakness in ankle or leg
  • slurred speech
  • weak grip
  • muscle cramps and twitches
  • weight loss
  • emotional lability (cry/laugh at wrong things)
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15
Q

What is the treatment of MND?

A
  • no treatment
  • physiotherapy and OT to preserve function
  • riluzole can extend life by 6-9 months
  • aspiration prevention via PEG feed or reduced salivation
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16
Q

What are the dental aspects of MND?

A
  • difficult to accept care due to muscle weakness in head and neck
  • OH difficult
  • realistic treatment planning due to short life expectancy
  • drooling and swallowing problems can be treated with botox into glands
17
Q

What is Parkinson’s disease?

A
  • disabling and progressive disease of older people
  • caused by lack of dopamine in substantia nigra
  • shortage of dopamine results in difficulty of message passing atom thinking to doing
18
Q

What are clinical signs of Parkinson’s?

A
  • bradykinesia (slow movement/initiation)
  • rigidity due to increased muscle tone
  • tremor with rest, intentional movement smooth
19
Q

How does Parkinson’s manifest?

A
  • impaired gait and increased falls
  • impaired use of upper limbs
  • mask-like face
  • swallowing problems
  • cognitive function is lost
20
Q

What is the treatment for Parkinson’s?

A
  • physiotherapy and OT
  • dopamine replacement (levadopa)
  • dopamine analogue (mimics) eg promipexole, selegiline
  • stereotactic surgery for deep brain stimulation
  • stem cell transplant (?)
21
Q

What are the risks with Parkinson’s medications?

A

Gambling problems

22
Q

What are the dental aspects of Parkinson’s?

A
  • difficulty accepting treatment due to tremor or delayed compliance
  • dry mouth due to anticholinergic effect of drugs
  • drug interactions
  • ability to conduct OH impaired

BDS3 DISEASES OF HUMAN SYSTEMS (16 decks)

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