Diseases of Human Systems - Neurology: Degenerative Brain Disease Flashcards

1
Q

What is MS?

A

Demyelination of axons due to inflammatory changes which lead to permanent loss of function.

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2
Q

Who is affected by MS?

A

Disorder of the young

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3
Q

What causes MS?

A

Genetic link

Environmental triggers - the further away from the equator the higher the incidence

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4
Q

What are the signs of MS?

A
muscle weakness/spasticity 
visual disturbances 
Paraesthesia 
autonomic dysfunction 
dysarthria 
pain 
balance/hearing loss
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5
Q

What are the types of MS?

A

Relapsing and remitting - patient will eventually become disabled from the accumulation of all the damage during acute episodes

Primary progressive - slow, steady degeneration

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6
Q

What are the dental implications of MS?

A

Limited mobility

Orofacial motor and sensory disturbances

Chronic orofacial pain

Enhanced risk of trigeminal neuralgia

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7
Q

What is motor neurone disease?

A

degeneration of motor nerves in the anterior horn of the corticospinal tracts in the spinal chord and the motor nuclei in the brain stem.

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8
Q

What do most patients with MND die of?

A

Type 2 respiratory failure
or
aspiration pneumonia

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9
Q

What are the effects of MND?

A

Progressive loss of motor function in the limbs, intercostal muscles, diaphragm and motor cranial nerves

= hypoxia

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10
Q

What are the symptoms of MND?

A

Weakness in the legs - hard to climb stairs

slurred speech and trouble swallowing

weak grip

muscle cramps and twitches

Emotional liability

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11
Q

What are the dental implications of MND?

A

Limited mobility - problems with access and tooth brushing

Difficulty in maintaining head posture

Drooling - dentist may be asked to prescribe anticholinergics and administer botox in order to reduce the saliva

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12
Q

What patients are at risk of MDN? age + sex

A

Commonly males (females can develop too) from 30-60 y/o

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13
Q

What age range of patients are more at risk of developing Parkinson’s disease?

A

> 50 y/o’s

However some forms can affect younger people

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14
Q

What is Parkinson’s?

A

Progressive and disabling disorder cause by a lack of the neurotransmitter domaine in the substance nigra basal ganglia of the brain

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15
Q

What are the signs of Parkinson’s? (5)

A

Bradykinesia - slow movement, slow initiation of movement

Rigidity - from increased muscle tone

Tremor at rest which disappears when making a conscious muscle movement

Unsteady/unusual walking

Mask like facial expression

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16
Q

How is Parkinson’s treated (3 + named examples)?

A

Dopamine replacement - levodopa

Dopamine analogues - duodopa and apomorphine

Surgery - stereostatic surgery (deep brain stimulation)

17
Q

What are the limitations of dopamine replacements such as levodopa?

A

These medications will be effective initially and the dosage has to be continually increased to have an effect. Eventually the dose is too high and the side effects are intolerable and then the medication has to be stopped.

Can also give the patients weird compulsions such as gambling.

18
Q

What are the considerations in terms of dental treatment in those with Parkinson’s? (5)

A

difficult to comply with treatment as the patients capacity deteriorates.

Difficulty in communication

Dry mouth from anticholinergic drugs used to treat symptoms

Drug interactions

mask like appearance = unable to identify visual cues in terms of how patient is tolerating treatment/feeling