Degenerative brain disease Flashcards
Multiple Sclerosis features
- Demyelination of axons
- progressive functional loss
- women with 4th decade onset most severe
multiple sclerosis aetiology
- susceptibility acquired during childhood
- more common in indentical twins
- more common amongst immediate family members
ms signs and symptoms
- muscle weakness
- visual disturbance
- parasthesia
- autonomic dysfunction
- dysarthria
- pain
- balance/hearing loss
- spasticity
- altered reflexes
- tremor
- optic atrophy
- proprioceptive loss
- loss of touch
ms investigations
history and examination
magnetic resonance imaging
CSF analysis
- reduced lymphocytes
- increased IgG protein
visual evoked potentials
ms - outcome (relapsing and remitting type )
- acute exacerbations and periods of respite
- damage builds up with each episode
- many will eventually develop progressive form (secondary progressive)
ms - primary progressive type - outcome
- slow steady progressive deterioration
- cumulative neurological damage
ms - management
- antibiotics, antispasmodics, analgesia, steroids
- physiotherapy and occupational therapy
MS- dental aspects
- limited mobility and psychological disorders
- treat under LA
- chronic orofacial pain posible
- enhanced trigeminal neuralgia risk
motor neurone disease features
- degeneration in spinal cord
- patients aged 30-60 years
- death with 3 years of diagnosis
- male 5:1 female
- no good family history - most are sporadic
progressive loss of motor function
death due to ventilation failure or aspiration pneumonia
MND - what the patient might notice
- weakness in ankle or leg
- slurred speech
- weak grip
- muscle cramps and twitches
- weight loss
- emotional lability
MND - treatment
- NONE effective
- physiotherapy and occupational therapy
- Riluzole - some get 6-9 months life extension
- aspiration prevention - PEG tube feed
MND - dental aspects
difficulty in acceptance of dental care
realistic treatment planning
drooling and swallowing difficulties
Parkinson’s disease features
- quite common
- disabling
- progressive
- usually older people
Parkinson’s disease - cause
- degeneration of dopaminergic neurones in basal ganglia of brain
- shortage of dopamine results in difficulty of message passing from ‘thinking’ to ‘doing’ brain
Parkinson’s disease - clinical signs
Bradykinesia
- slow movement and slow initiation of movement
Rigidity
- increased muscle tone
tremor
- slow amplitude
Parkinson’s disease - manifestations
- impaired gait and falls
- impaired use of upper limbs
- mask-like face
- swallowing problems
Parkinson’s medical treatment
dopamine
- levadopa
dopamine agonists
- tablets
- injection
- infusion
Parkinson’s disease - dental aspects
difficulty accepting treatment
- tremor at rest of body
dry mouth
- anticholinergic effects of drugs
drug interactions?
