Degenerative Brain Disease Flashcards
Give 3 degenerative brain diseases
Parkinson’s
MS
Motor neurone disease
What is MS?
Demyelinating condition, most common one in young
Affects CNS only
Progressive functional loss
Demyelination occurs due to inflammatory processes
What is the cause of ms?
- suspected to be acquired during childhood
- altered host reaction to infective agent
- genetic factors play a huge role, as more common in identical twins and amongst immediate family members
Give some symptoms and signs of MS
Symptoms
- muscle weakness
- paraesthesia
- dysarthria
- pain
Signs
- altered reflexes
- tremor
- spasticity (UMN disease)
- optic atrophy (shine light in eye and optic constriction will be slower than usual)
How can one investigate for MS?
MRI
History and exam
CSF analysis
- decreased lymphocytes
- increased igG protein
What are the types of MS?
Relapsing and remitting
- acute periods, damage builds with each episode, eventually becomes progressive
Primary progressive
- cumulative, slow, neurological damage
Treatment for MS?
Antibiotics
Antispasmodics for muscle spasms
Analgesia for pain
Physiotherapist And occupational therapy
What drugs may an MS patient be on?
Cladribine
Siponomod
What dental implications can an MS patient have?
Limited mobility can be an issue with oral hygiene
Always use LA as GA can damage brain further
Enhanced trigeminal neuralgia risk
Chronic orofacial pain is possible
What is motor neurone disease?
Degeneration of motor nerves in spinal cord (anterior horns / corticospinal tract)
Death within 3 years of diagnosis
Signs of motor neurone disease?
Progressive loss of motor function of
- limbs
- intercostals
- diaphragm
- motor cranial nerves
Death due to
- ventilation failure
- aspiration pneumonia
What might a patient notice when MND first developing?
Weak ankle or leg
Slurred speech
Weak grip
Muscle cramps and twitches
Weight loss due to muscle atrophy
Emotional lability - cry or laugh in inappropriate situations
What are the dental implications of MND?
Difficulty in acceptance of dental care due to muscle weakness in head and neck
Drooling and swallowing difficulties
- use medication to reduce this e.g. Botox into salivary glands or anticholinergics
What is the cause of Parkinsons?
Degeneration of dopaminergic neurones in Brain
- causing dopamine shortage
Makes neurone transmission from cortex (thinking) to cerebellum (doing), difficult
Clinical signs of Parkinson’s?
Bradykinesia
- slow movement and initiation of movement
Rigidity
- of movement due to increased muscle tone
Tremor
Impaired gait
Lack of facial muscle expression
