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MD4001 - Public Health etc. > Long term effects of Chronic Neurological Conditions > Flashcards

Long term effects of Chronic Neurological Conditions Flashcards

1
Q

How many people in the UK are living with a neurological condition?

A

10 million

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2
Q

How many people in the UK are disabled by their neurological condition?

A

1 million (2%)

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3
Q

How many people in the UK require help for most of their daily activities due to a neurological condition?

A

350,000

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4
Q

What conditions are the most common cause of serious disability?

A

Neurological conditions

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5
Q

What percentage of GP consultations are for neuro symptoms?

A

17%

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6
Q

What percentage of hospital admissions are for neurological problem requiring treatment from a neurologist or neurosurgeon

A

19%

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7
Q

What percentage of disabled people living in residential care have a nerological condition?

A

33%

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8
Q

How many children have an acquired brain injury?

A

200,000

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9
Q

How many people in the UK care for someone with a neurological condition?

A

~ 850,000

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10
Q

What percentage of people aged 16-24 with chronic disability have a neurological condition?

A

25%

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11
Q

What is spina bifida?

A
  • Developmental abnormality in utero
  • Incomplete development or covering of the brain and/or spinal cord, caused by a failure of the foetal spine to close normally in the first month of pregnancy
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12
Q

How common is spina bifida?

A

1-1.5 / 2000 births

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13
Q

What condition is spina bifida linked with?

A

Hydrocephalus

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14
Q

What are the proposed factors the contribute to spina bifida?

A
  • Folate deficiency
  • Multi-factorial inheritance
  • Potato blight
  • Vitamin deficiency
  • Maternal fever
  • Zinc deficiency
  • High sound intensity
  • Viral infection
  • Alcohol
  • Mineral deficiency
  • Medication - phenytoin, epillim etc.
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15
Q

When does the neural plate close over?

A

20-29 days

  • Anterior neuropore closes at 26 days
  • Posterior neuropore closes at 29 days
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16
Q

What is spina bifoda called if it is not apparent?

A

Spina Bifida occulta - small cleft sacral dimble - almosr zero clinical consequences

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17
Q

What is anencephalus?

A

Neural tube defect that occurs when the rostral (head) end of the neural tube fails to close, usually between the 23rd and 26th day following conception

18
Q

What are the neurological consequences of severe spina bifida?

A
  • Paralysis, loss of sensation and reflexes distal to the abnormality
  • High risk of meningitis
  • Hydrocephalus in 70-90% because of the interuption of the circulation of CSF
19
Q

How is hydrocephalus treated?

A
  • Neurosurgeon will put a small shunt in which will drain it from the ventricular system into the peritoneum or chest which will drain the CSF
20
Q

What are the problems associated with shunts?

A

They can become blocked or infected (associated with dizziness, cognitive decline, headaches in those with shunts)

21
Q

How can spina bifida be diagnosed antenatally?

A

Ultrasound
- Spinal anomalies identifiable at 16-18 wks
Alpha fetoprotein raised in neural tube defects
- Maternal serum at 16-20 wks amniocentesis

22
Q

What are the associated conditions of spina bifida?

A
  • Renal anomalies
  • Sphincter function
  • Intellectual impairments
  • Musculoskeletal
23
Q

What are conditions are associated with spina bifida?

A
  • Renal anomalies
  • Sphincter function
  • Intellectual impairments
  • Musculoskeletal
24
Q

WHat are the deformaties of the feet called in individuals with spina bifida?

A

Paralytic deformaties of feet

  • Difficulties with shoe wear
  • Plantar ulceration
25
Q

What is scoliosis though to be due to?

A

Combination of congenital abnormalities of the spine and spinal muscle weakness

26
Q

If surgery is required for scoliosis when is it done?

A

Usually after the age of 10 years to allow sufficient spinal growth beforehand
Rods put through vertebral bodies

27
Q

What are the consequences of an L4 lesion on the lower limbs?

A
  • Paralysed calf muscles result in excess ankle dorsiflexion
  • Muscle fatigue
  • Energy inefficient gait
  • Knee pain
28
Q

What are charcot joints?

A
  • Loss of cartilage and and therefore joint destruction

- In an L4 lesion there is a loss of protective sensation and proprioception resulting in these joints

29
Q

What are the expectations of lower urinary tracts?

A
  • That bladder should fill to good capacity
  • Should wmpty to completion
  • Emptying should be under voluntary control
  • That filling and emptying should not be detrimental to renal function
30
Q

What does incomplete bladder emptying lead to?

A

Back pressure on ureters and eventual renal parenchymal damage and failure, if left untreated

31
Q

Why is permenant bladder catheterisation not a satisfactoy long term solution to urinary incontinance?

A

High risk of UTIs

- Clean intermittent catheterisation often the best option - carer or patient self catheterisation

32
Q

Damage to what spinal cord levels cause urinary incontinance?

A

S2-4

33
Q

What levels of the spinal cord control sexual sensation?

A

S2-4

34
Q

How can serections be made possible in tose with spinal injuries?

A

Through a spinal reflex

35
Q

What factors lead to an optimal outcome for adults living independantly?

A
  • Normal intellect
  • Social continance stable
  • Independantly mobile, can drive an adapted vehicle and use walking aids
  • Independant living - household adaptations, telecare and other technologies
  • Employed
36
Q

What are the challenges to independant living as an adult?

A
  • Learning difficulties
  • Behavioural difficulties
  • Social continance not achieved
  • Cannot transfer independantly
  • Ageing parents
  • Some parents will live in a sheltered/residential facility and be looked after by a team of carers - options for community living are limited though in reality
37
Q

What is cerebral palsy?

A
  • Spectrum of motor disorders affecting posture, movement and co-ordination
  • Caused by brain lesion resulting in abnormal development of CNS
  • Higher risk in oremature birth, twins
38
Q

How common is Cerebral Palsy in the UK?

A

2-3 per 1000 live births

39
Q

Do older or younger individuals with crebral palsy feel less socially integrated?

A

Older people with CP feel less socially integrated

  • Vocational status
  • Living situation
  • Musculoskeletal pain
40
Q

What is spastic diplegia?

A
  • Type of cerebral palsy

- Hypertonia and spasticity in lower limbs

MD4001 - Public Health etc. (6 decks)

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