Common Neurological Conditions

Question 1

What are other common neurological conditions?

Answer 1

Common neurological disorders
* Tension headaches
* Cluster headaches
* Tinnitus
* Temporal arteritis
* Meniere’s
* Labyrinthitis
* Benign paroxysmal positional vertigo
* Macular degeneration

Question 2

What are tension headaches?

Answer 2

• Most common type of headache, esperienced by the majority of people
• Not fully understood - perhaps a milder version of migraine, and stress, caffeine and so on are likely triggers
• Women are twice as likely to experience
• Pain presents as dull, tight or pressure
• Pain is constant & generalised
• No associated symptoms like nausea or disabling
• Women are twice as likely to experience

Question 3

What are cluster headaches?

Answer 3

• Cause unknown
• Possible abnormal hypothalamic activity
• Cluster lasts weeks to months
• Headaches usually daily, sometimes several times a day
• 1 or several attacks can occur within 24 hrs
• Lasts 15 minutes to 3 hours
• Often woken at night
• Severe unilateral periorbital pain (around the eye) with autonomic features but may readiate elsewhere - can cause eye to droop, and may get sweaty face and flushing,

Risk factors - More frequent in men, onset usually in 3rd decade, smoking, ↑ ETOH

Question 4

What is tinnitus?

Answer 4

• Involved auditory & non-auditory systems
• Abnormal neuronal activity in auditory complex
• Ringing or other noises not due to external sound
• Can cause fatigue, sleep disturbances, concentration, memory & mental health
  issues
• Experienced by 15-20% of population, so common, especially in older adults
• Variety of causes, commonly due to hearing loss, ear infection, head/neck injury - usually only in one ear, plus some conditions and medications

Risk factors - Loud noise, age, sex (men more likley than women), smoking & ↑ ETOH use, pre-existing health conditions

Question 5

What is temporal arteritis?

Answer 5

Temporal arteritis (Giant cell arteritis)
* Cause is unknown - but Inflammation affecting medium & large sized arteries around head - activated by immune system
* Genetic
* Environmental
* Main symptoms are severe & frequent headaches, Pain/tenderness over temples, Jaw pain when eating or talking, Visual disturbances

Risk factors - can overlap with Polymyalgia rheumatica, plus age (only in older adults), sex, ethnicity - more common in women and in Scandi ancestory

Question 6

What is Ménière’s disease?

Answer 6

Ménière’s disease
* This is caused by an abnormality of endolymph
* It can cause episodes of vertigo or Tinnitus, Sense of pressure in ear, Hearing loss

Risk factors - Age, Family History, allergies,
pressure changes in atmosphere, dietary changes and more

Question 7

What is Labyrinthitis (acute vestibular failure)?

Answer 7

Labyrinthitis (acute vestibular failure)
* Inflammation of labyrinth
* Usually due to viral or bacterial infection
* Usually self limiting, and reveals itself with dizziness, hearing loss, vertigo

Risk factors - Viral infection, allergies, smoking, ↑ ETOH (alcohol consumption), head injury, vascular disorder, immune disorder, medications, age

Question 8

What is Benign paroxysmal positional vertigo?

Answer 8

Benign paroxysmal positional vertigo
* Occurs when otoconia (calcium carbonate particles) move into semicircular canals which control balance, and get trapped there
* Disrupts flow of endolymph
* Otoconia move & stimulate cilia causing vertigo
* Most common inner ear disorder
* Symptoms - Dizziness, light-headedness, balance issues, nausea, vomiting, blurred vision, nystagmus

Risk factors - Injury, inner ear disorders, age (most common over 60)

Question 9

What is Macular degeneration?

Answer 9

Macular degeneration
* Late-onset, neurodegenerative retinal
disease that shares some features with Alzeimers
* There are 2 types; Dry & wet
* Dry - parts of the macula get thinner with age and tiny clumps of protein (drusen) grow.
* Wet is less common- abnormal blood vessels grow under the retina. These vessels may leak blood or other fluids, causing scarring of the macula.

Signs and symptoms:
* Mild symptoms might be blurriness central vision, trouble seeing in low light
* In late MD, straight lines look wavy, blank spots, colours dimmer
* Loss of vision - blurry area grows
* Most common cause of visual impairment in high income countries
* Affects approximately 1.5 million people in UK

Risk factors - Age, FH, smoking, CVD, HYPTN, obesity, sun exposure, diet