Degenerative brain diseases

Question 1

What is multiple sclerosis

Answer 1

a central nervous system disorder that sees demyelination of axons in a patchy distribution
aetiology is unknown
most common CNS disorder in the young

Question 2

Symptoms and signs of multiple sclerosis

Answer 2

muscle weakness
pain
balance / hearing loss
proprioceptive loss
spasticity (UMN damage)
optic atrophy (vision problems)
fatigue

Question 3

What tests investigations can be done for multiple sclerosis

Answer 3

MRI scans
CSF analysis - will be reduced lymphocytes

Question 4

What are the 2 forms of multiple sclerosis

Answer 4

Relapsing and remitting
primary progressive

Question 5

Relapsing and remitting multiple sclerosis

Answer 5

mix of acute exacerbations and periods of respite
damage builds with each episode and may develop into progressive form (secondary progressive)

Question 6

primary progressive multiple sclerosis

Answer 6

slow steady deterioration with cumulative neurological damage

Question 7

treatment of multiple sclerosis

Answer 7

disease modifying therapy drugs which may slow progression - cladribine , siponomod
stem cell transplant- aims to reboot immune system

Question 8

dental implications of multiple sclerosis

Answer 8

limited mobility - think access and OH
enhanced trigeminal neuralgia risk
avoid GA
if a pt presents with sudden motor and sensory orofacial disturbance - MS could be a cause

Question 9

how do people die from motor neurone disease

Answer 9

ventilation failure or aspiration pneumonia

Question 10

early symptoms of motor neurone disease

Answer 10

weakness in ankle/ leg
slurred speech
weak grip

Question 11

dental aspects of motor neurone disease

Answer 11

drooling / swallowing difficulties
realistic tx planning (3 year prognosis)
muscle weakness of head and neck

Question 12

what is parkinsons disease

Answer 12

progressive condition caused by lack of dopamine production in substantia nigra of brain - results in delay between thinking and doing
usually affects older people

Question 13

clinical signs of parkinsons

Answer 13

Bradykinesia - slow movement and slow initiation of movement
rigidity
tremor - possible in mandible

Question 14

treatment for parkinsons

Answer 14

dopamine - body develops sensitivity so dose must be increased fairly regularly however at some point intolerable symptoms/side effects will occur
dopamine agonists
surgery

Question 15

dental implications of parkinsons

Answer 15

potential mandible tremor (this should disappear when mouth open as it is a rest tremor)
dry mouth - anticholinergic drugs