DEGENERATIVE BRAIN DISEASE

Question 1

MULTIPLE SCLEORSIS

Answer 1

Demyelination of axons that connects parts of brain that progresses to functional loss

Question 2

What genetics are more susceptible

Answer 2

twins

Question 3

MS symptoms

Answer 3

muscle weakness
visual disturbance
paraesthesia
autonomic dysfunction
dysarthria (difficulty speaking)
pain
balance/ hearing loss

Question 4

MS signs to a clinician

Answer 4

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

Question 5

MS investigations

Answer 5

magnetic resonance imaging
CSF (cerebro fluid) analysis
visual evoked potentials

Question 6

what is the result of a CSF analysis in someone with MS

Answer 6

reduced lymphocytes
increased IgG protein

Question 7

is there a cure for MS

Answer 7

NO

Question 8

how do you systemically manage MS

Answer 8

antibiotics
antispasmodics
analgesia; physiotherapy and occupational therapy

Question 9

the 2 types of MS

Answer 9

relapsing and remitting
primary progressive

Question 10

describe the relapsing and remitting type of MS

Answer 10

acute exacerbations and periods of respite
damage builds up with each episode and then develops to progressive form

Question 11

describe the primary progressive type of MS

Answer 11

slow and steady progressive deterioration
cumulative neurological damage

Question 12

what drugs can slow down the progressive form on MS

Answer 12

disease modifying therapies:
- cladribine
- siponomod
- ocrelizumab

Question 13

what treatment can ‘reboot’ the immune system

Answer 13

stem cell transplant

Question 14

dental aspects of MS

Answer 14

limited mobility
orofacial motor and sensory disturbance
chronic orofacial pain
enhanced risk of trigeminal neuralgia

Question 15

degeneration of anterior horns of the corticospinal tracts in the spinal cord

Answer 15

motor neurone disease

Question 16

common age to have motor neurone disease

Answer 16

30-60

Question 17

motor neurone disease mortality

Answer 17

3 years after diagnosis

Question 18

symptoms of motor neurone disease

Answer 18

progressive loss of motor function in the:
- limbs
- intercostal
- diagphragm
- motori CNVII - XII

Question 19

signs of motor neurone disease

Answer 19

weakness in ankle/ leg
slurred speech
difficulty swallowing food
weak grip
muscle cramps and twitches
weight loss in arms and leg muscles
emotional liability

Question 20

treatment for motor neurone disease

Answer 20

physiotherapy and occupational therapy
riluzole: 6-9 months life extension
aspiration prevention with PEG tube feed

Question 21

dental aspects of motor neurone disease

Answer 21

difficulty to accept dental care
muscle weakness of head and neck
medication that reduces saliva (anticholinergics)
may have Botox in salivary glands
drooling and swallowing difficulties

Question 22

Degeneration of dopaminergic neurons in the basal ganglia of the brain (lack of dopamine)

Answer 22

parkinsons disease

Question 23

what does parkinsons result in

Answer 23

difficulty of message passing from thinking to doing

Question 24

clinical features of parkinsons

Answer 24

bradykinesia; slow movement and slow initiation of movement
rigidity; increased muscle tone
tremor; slow amplitude - common in mandible

Question 25

key feature of parkinsons

Answer 25

rest tremor

Question 26

parkinsons manifestations

Answer 26

impaired gait (unsteady walking) and falls
mask-like face (flat looking)
swallowing problems

Question 27

medical treatment of parkinsons

Answer 27

dopaminergic drugs; direct replacement of dopamine or agonists

Question 28

medical form of dopamine

Answer 28

levodopa

Question 29

dopamine analogues (tablets)

Answer 29

promipexole
selegilline

Question 30

dopamine analogues (subcutaneous injection)

Answer 30

apomorphine

Question 31

dopamine analogues (infused directly into gut)

Answer 31

duodopa

Question 32

surgical tx for parkinsons

Answer 32

stereotactic surgery - deep brain stimulation; electrode into the brain

stem cell transplant

Question 33

dental aspects of parkinsons

Answer 33

difficulty accepting tx
tremor at rest; reduces mouth opening
dry mouth; from anticholinergics
potential drug interactions