DEGENERATIVE BRAIN DISEASE Flashcards
MULTIPLE SCLEORSIS
Demyelination of axons that connects parts of brain that progresses to functional loss
What genetics are more susceptible
twins
MS symptoms
muscle weakness
visual disturbance
paraesthesia
autonomic dysfunction
dysarthria (difficulty speaking)
pain
balance/ hearing loss
MS signs to a clinician
muscle weakness
spasticity
altered reflexes
tremor
optic atrophy
proprioceptive loss
loss of touch
MS investigations
magnetic resonance imaging
CSF (cerebro fluid) analysis
visual evoked potentials
what is the result of a CSF analysis in someone with MS
reduced lymphocytes
increased IgG protein
is there a cure for MS
NO
how do you systemically manage MS
antibiotics
antispasmodics
analgesia; physiotherapy and occupational therapy
the 2 types of MS
relapsing and remitting
primary progressive
describe the relapsing and remitting type of MS
acute exacerbations and periods of respite
damage builds up with each episode and then develops to progressive form
describe the primary progressive type of MS
slow and steady progressive deterioration
cumulative neurological damage
what drugs can slow down the progressive form on MS
disease modifying therapies:
- cladribine
- siponomod
- ocrelizumab
what treatment can ‘reboot’ the immune system
stem cell transplant
dental aspects of MS
limited mobility
orofacial motor and sensory disturbance
chronic orofacial pain
enhanced risk of trigeminal neuralgia
degeneration of anterior horns of the corticospinal tracts in the spinal cord
motor neurone disease
common age to have motor neurone disease
30-60
motor neurone disease mortality
3 years after diagnosis
symptoms of motor neurone disease
progressive loss of motor function in the:
- limbs
- intercostal
- diagphragm
- motori CNVII - XII
signs of motor neurone disease
weakness in ankle/ leg
slurred speech
difficulty swallowing food
weak grip
muscle cramps and twitches
weight loss in arms and leg muscles
emotional liability
treatment for motor neurone disease
physiotherapy and occupational therapy
riluzole: 6-9 months life extension
aspiration prevention with PEG tube feed
dental aspects of motor neurone disease
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
Degeneration of dopaminergic neurons in the basal ganglia of the brain (lack of dopamine)
parkinsons disease
what does parkinsons result in
difficulty of message passing from thinking to doing
clinical features of parkinsons
bradykinesia; slow movement and slow initiation of movement
rigidity; increased muscle tone
tremor; slow amplitude - common in mandible
key feature of parkinsons
rest tremor
parkinsons manifestations
impaired gait (unsteady walking) and falls
mask-like face (flat looking)
swallowing problems
medical treatment of parkinsons
dopaminergic drugs; direct replacement of dopamine or agonists
medical form of dopamine
levodopa
dopamine analogues (tablets)
promipexole
selegilline
dopamine analogues (subcutaneous injection)
apomorphine
dopamine analogues (infused directly into gut)
duodopa
surgical tx for parkinsons
stereotactic surgery - deep brain stimulation; electrode into the brain
stem cell transplant
dental aspects of parkinsons
difficulty accepting tx
tremor at rest; reduces mouth opening
dry mouth; from anticholinergics
potential drug interactions
