Degenerative neurological disorders Flashcards
Define a neurodegenerative disease
Progressive loss of structure or function of neurones including death of neurones
Know the commonly encountered neurodegenerative diseases
Dementia
(Alzheimer’s)
Motor disorders
(Parkinson’s)
Demyelinating diseases
(MS and Guillain-Barre syndrome)
Describe generally, dementia, and what causes it.
- Chronic disorder characterised by memory disorders, personality changes and impaired reasoning
- Caused by build up of protein deposits in the brain which kills neurones
- Leads to neurofibrillary tangles and amyloid plaques
Describe generally, demyelinating diseases (MS and Guillain-Barre syndrome) in terms of causes and symptoms
MS
• Autoimmune disease which causes loss of myelin sheath around axons in CNS
Guillain-Barré syndrome
• Demyelination of peripheral NS.
Symptoms • Visual impairment • Weakness and/or paraesthesia • Heat sensitivity • Electrical sensation down the spine on neck flexion • Fatigue
Describe generally, motor disorders (Parkinson’s), and what causes it.
- Results in abnormal and involuntary movements and being underweight due to excessive energy expenditure
- Caused by genetic mutations in cerebrum
- Also caused by the degeneration of centres that inhibit movement = less inhibition of unwanted movement
Know the risk factors for dementia
- 65+ yrs age
- CVD
- Diabetes
- Obesity
- Family history (Amyloid protein, ApoE4 proteins, Presenilin)
- Head injury
- Smoking
- High alcohol intake
Know the risk factors for motor disorders
- 50+ age or younger
- Males
- FHx
- Declining oestrogen levels
- Hysterectomies
- Exposure to pesticide or herbicides that inhibit dopamine production and promote free radical damage
- Low level of vit B folate
- Head trauma
Know the risk factors for demyelinating diseases
- 15 - 60 age
- Women
- FHx
- Infection (Epstein- Barr virus)
- Race: Caucasians, esp. Scandinavian
- Climate: more common in countries with temperate climates
- Smoking
- Autoimmune disease: thyroid disorders, type 1 diabetes
Know the effect of dementia on orofacial structures
- Forget appointments
- Neglect oral care
- Losing control of dentures/oral appliances
- Side effects of medication eg. Postural hypotension, xerostomia, drug interaction with adrenaline
- Issues with consent
Know the effect of motor disorders on orofacial structures
- Tremors and rigidity of orofacial muscles
- Facial pain
- Angular cheilosis due to dysphagia
- Poor OH due to dexterity issues
- Medication induced xerostomia
Involuntary mandibular movements (parafunction) that may lead to:
• TMJ discomfort,
• Cracked teeth
• Dental attrition
• Difficulties in controlling and retaining dentures
Know the effect of demyelinating diseases on orofacial structures
- Intermittent facial numbness or pain
- Facial palsy or spasm
- Difficulty in speaking, swallowing
- Headaches
- Medication-induced xerostomia
Know the dental management of dementia patients
- Tailor daily oral care to person’s ability eg. self-care or carer; daily reminders eg. scheduling alarms
- Preventive measures eg. CHX, F rinse, frequent recalls
- Difficult to adapt to new dentures
- Realistic treatment planning eg. need for complex work?
Know the dental management of motor disorder patients
- Short <45min appt
- Early morning appt – less symptoms in AM & medications most effective
- Use bite blocks; rubber dam
- Incline chair <45
- Implant-retained denture for stability
- Preventive measures eg. CHX, F & frequent recalls
- Reduce stress; explain procedures and reassure
Know the dental management of demyelinating disease patients
- Issues with poor OH due to dexterity or pain
- Smaller appts
- Use bite blocks; rubber dam
- Incline chair <45
- Preventive measures eg. CHX, F & frequent recalls
List risk markers for Alzheimer’s
• Presence of Amyloid protein, ApoE4 proteins, Presenilin
