Degenerative Brain Disease

Question 1

What are examples of conditions that are a result of degenerative brain disease?

Answer 1

• multiple sclerosis
• motor neuron disease
• parkinson’s disease

Question 2

what is the most common CNS disorder of the young?

Answer 2

Multiple Sclerosis

Question 3

What is multiple sclerosis?

Answer 3

DEMYELINATION of axons in the CNS only

Question 4

What is the aetiology of multiple sclerosis?

Answer 4

• susceptibility acquired during childhood
• background genetic/immune factors
• altered host reaction to an infective agent

Question 5

who is multiple sclerosis more common in?

Answer 5

identical twins

Question 6

what are the symptoms of multiple sclerosis?

Answer 6

• muscle weakness
• visual disturbances
• paraesthesia
• autonomic dysfunction
• dysarthria
• pain
• balance/hearing loss

Question 7

what are the signs of multiple sclerosis?

Answer 7

• muscle weakness
• spasticity
• altered reflexes
• tremor
• optic atrophy
• proprioceptive loss
• loss of touch

Question 8

what investigations are used if a patient is thought to have multiple sclerosis?

Answer 8

• history & exam
• magnetic resonance imagine (MRI)
• CSF analysis
• visual evoked potentials

Question 9

In the CSF of an MS patient, how would it look?

Answer 9

• reduced lymphocytes
• increased IgG protein

Question 10

how is the symptomatic management of MS patients carried out?

Answer 10

• antibiotics
• antispasmodics
• analgesia
• steroids
• physiotherapy
• occupational therapy

Question 11

what are the dental aspects of patients that suffer with MS?

Answer 11

• limited mobility & psychological disorders
• treat under LA
• orofacial motor & sensory disturbance
• chronic orofacial pain possible
• enhanced trigeminal neuralgia risk

Question 12

what is motor neurone disease?

Answer 12

degeneration in the spinal cord
- progressive loss of motor function

Question 13

what age are motor neuron disease patients typically?

Answer 13

30-60 yrs

Question 14

what sex is more likely to suffer from motor neurone disease?

Answer 14

Males
- 2.5:1

Question 15

what causes death in motor neurone disease patients?

Answer 15

• ventilation failure
• aspiration pneumonia

Question 16

what might MND patients notice occurring to their body?

Answer 16

• weakness in ankle or leg
• slurred speech & difficulty swallowing
• a weak grip
• muscle cramps & twitches
• weight loss
• emotional lability

Question 17

how are motor neuron disease patients treated?

Answer 17

• physiotherapy & occupational therapy
• riluzole
• aspiration prevention

Question 18

what are the dental aspects of treating motor neurone disease patients?

Answer 18

• difficulty in acceptance of dental care
• drooling & swallowing difficulties
• realistic treatment planning required

Question 19

what is the cause of Parkinson’s disease?

Answer 19

Degeneration of dopaminergic neurones in the basal ganglia of the brain (substantia nigra)
- dopamine shortage results in difficult of message passaging from thinking to doing

Question 20

what are the clinical signs of Parkinson’s?

Answer 20

• bradykinesia
• rigidity
• tremor

Question 21

what doers BRADYKINESIA mean?

Answer 21

slow movement & slow initiation of movement

Question 22

what are the clinical manifestations of parkinson’s?

Answer 22

• impaired gait and falls
• impaired use of upper limbs
• mask-like face
• swallowing problems

Question 23

how is parkinson’s disease treated?

Answer 23

• physiotherapy & occupational therapy
• dopamine medications
• surgery

Question 24

what medical treatments are involved in parkinson’s patients?

Answer 24

Dopamine
- levadopa

Dopamine analogues
- tablets (promipexole)
- injection (apomorphine)
- infusion (duodopa)

Question 25

what surgery is used to treat parkinson’s patients?

Answer 25

Stereotactic surgery
- deep brain stimulation

Question 26

what are the dental aspects of treating parkinson’s patients?

Answer 26

• difficulty accepting treatment (facial tremor etc)
• dry mouth due to anticholinergic effects of the drugs