Nervous System Pathologies Flashcards
What is the carpal tunnel?
An anatomical space that runs through the anterior region of the wrist.
Which nerve becomes compressed in Carpal Tunnel Syndrome?
The median nerve
List 4 causes of carpal tunnel syndrome
- Fluid retention in the body (i.e, pregnancy)
- Overuse (vibrating tools, desk use)
- Rheumatoid arthritis, hypothyroidism
- Trauma
List 3 signs/symptoms of carpal tunnel syndrome.
- Pain, tingling and/or numbness in the hand
- Weak grip strength
- Symptoms worse at night
- Weak thumb opposition & dropping things
How would you diagnose Carpal Tunnel Syndrome?
- Tinel’s test (tapping over median nerve)
- Phalen’s test
What’s the allopathic treatment for Carpal Tunnel Syndrome?
Anti-inflammatories, steroid injection, wrist splint at night
Describe Bell’s Palsy.
A condition where the facial nerve becomes inflamed / compressed.
What is the most common cause of Bell’s Palsy?
Virus (usually herpes simplex virus)
Can also be trauma/injury/side effect of facial surgery.
What do cold sores and Bell’s Palsy have in common?
Herpes simplex virus involvement
List 2 signs / symptoms of Bell’s Palsy.
- Sudden unilateral weakness / paralysis of the facial muscles.
- Can’t close affected eye
What is the allopathic treatment for Bell’s Palsy?
Anti-viral drugs, cortisone
Describe Guillain-Barre Disease
A form of post-infectious, de-myelinating disease of peripheral nerves, with neuritis
It is an auto-immune disease.
What is neuritis?
Inflamed nerves
List 2 similarities between Guillain-Barre Disease and Multiple Sclerosis.
- Both autoimmune diseases
2. Both de-myelinating
Which nervous system pathology causes ascending paralysis, usually starting at the feet and making its way upwards?
Guillain Barre Disease
What is the main cause/trigger of Guillain Barre Disease?
A recent respiratory or GIT infection (75% of cases)
Explain the pathophysiology of Guillain Barre Disease.
Around 3 weeks after a respiratory/GIT virus, the antibodies to the virus cross-react with the lipids in myelin around peripheral nerves. A case of mistaken identity.
Which neurological pathology might someone develop after vaccination?
Guillain Barre Syndrome
List 2 possible complications of Guillain Barre Syndrome
Heart failure and respiratory failure (& death) due to ascending paralysis.
List 4 signs/symptoms of Guillain Barre Syndrome.
- Ascending paralysis
- Tingling & pain in the legs
- Pins and needles
- Sensory changes
How is Guillain Barre Syndrome diagnosed?
Via nerve conduction tests down into the legs, and/or via lumbar puncture.
What is the allopathic treatment for Guillain Barre Syndrome?
- Emergency care
- Blood plasma exchange (to rid the body of the antibodies causing the issue)
Intensive care & respirator
Name 2 nervous system pathologies that are auto-immune.
- Guillain Barre Syndrome
2. Multiple Sclerosis (MS)
Describe Multiple Sclerosis
An autoimmune, inflammatory disease associated with de-myelination of axons in the CNS.
Describe the pathophysiology of MS
T-lymphocytes attack myelin antigens, causing multiple areas of sclerosis along axons, which disrupts conduction.
Who is most at risk of MS?
People between 20 - 50 yrs old.
Women twice as likely to get MS.
There are 2 common patterns of MS. What are they?
- Relapsing-remitting pattern (85%)
2. Progressive
List 4 causes behind (the aetiology of) MS
- Vitamin D deficiency
- Vitamin B12 deficiency
- Genetic susceptibility, with environmental trigger
- EBV - Epstein Barr Virus
What is the biggest single risk factor for Multiple Sclerosis? Why is this?
Vitamin D deficiency
Vit D helps to produce myelin
List 5 signs/symptoms of MS
- Blindness / loss of vision
- Blurred vision, unilateral loss of vision
- Deafness
- Loss of balance
- Weakness
- Burning pain sensations
- Bladder urgency & incontinence
Which highly myelinated nerve is often affected in MS?
The optic nerve
What is the most definitive way/method to diagnose MS?
MRI scan.
But, there is no one definitive test.
Why do T-cells tend to attack the optic nerve, in MS?
Because the optic nerve is so densely myelinated.
How is MS treated, allopathically?
- Steroids and other immune modulating therapies
- Pain killers
- Physiotherapy
How might you treat MS naturally?
- Ketogenic diet
- Anti-inflammatory diet
- Vit D and Vit B12 supplementation
What is Motor Neuron Disease?
The progressive degeneration of motor neurons in the spinal cord, motor cortex and brain stem.
So basically, the degeneration of any motor pathway in the CNS.
Which pathology do we think is associated with oxidative stress and subsequent damage to mitochondria in motor neurons?
Motor Neuron Disease
Do patients with motor neuron disease present with any sensory symptoms?
No
How do patients with motor neuron disease usually present?
With paralysis and weakness
Who are the at risk age and gender groups for motor neuron disease?
- Predominantly affects men
- Age 50-70yrs (but any age over 40)
List 3 signs/symptoms of early motor neuron disease.
- Weakness in upper limbs (i.e, dropping things, weak grip)
- Wasting of hand muscles
- At-rest tremor in limbs
List 3 signs/symptoms of late-stage motor neuron disease.
- Tripping over
- Slurred speech
- Dyspnoea
- Difficulty swallowing
What is the prognosis of motor neuron disease?
Patients usually die within 3-5yrs of prognosis (usually via respiratory failure).
There is currently no cure.
Name a well-known person who had Motor Neuron Disease
Stephen Hawking. He lived well beyond his prognosis.
What is Dementia?
A syndrome caused by a number of brain disorders.
What are the classic 3 signs of Dementia?
- Memory loss
- Decline in cognition
- Difficulty performing daily activities
What is the most common type of Dementia (accounting for approximately 50% of cases)?
Alzheimer’s Disease
What is Alzheimer’s Disease?
A degenerative condition, affecting the cerebral cortex, coupled with low levels of acetylcholine and the deposition of protein plaques (beta-amyloid plaques)
Which part of the brain is affected by Alzheimers Disease?
The cerebral cortex
Which form of dementia is associated with low acetylcholine production?
Alzheimers Disease
Alzheimers Disease is associated with the deposition of _______ ________ plaques.
Beta amyloid plaques
List 2 types of dementia.
- Vascular Dementia
2. Alzheimers Disease
Which type of dementia can be caused by multiple strokes / reduced oxygen delivery to areas of the brain?
Vascular dementia
What is the umbrella term given to disorders affecting brain cognition?
Dementia
Can cognitive decline be reversed?
Yes
Which pathology primarily involves the emotional and memory areas of the brain (amygdala and hippocampus)?
Alzheimers Disease
In what pathology would you see shrinking of the cerebral cortex and atrophy of neurons?
Alzheimers Disease
In which area of the brain do we store and ingrain memories?
The hippocampus
What percentage of the population are affected by Alzheimers Disease by 80yrs of age?
20%
List 4 causes associated with Alzheimers Disease.
- Heavy metal toxicity (excessive copper, mercury & aluminium)
- Polysorbate 80 (in vaccines)
- Genetics - AopE4 gene (<1% cases)
- Chronic inflammation
- Insulin resistance
- Leaky gut (dairy & gluten)
- Oral bacteria (P.gingivalis)
- Herpes Simplex virus
- Nutritional deficiencies (B vits, Omega 3)
- Lack of oestrogen
- Underactive thyroid
- Stress & high cortisol
- Hypertension / CV disease (high levels of Homocysteine)
List 3 signs and symptoms of early-stage Alzheimers Disease.
- Slight. short term memory loss
- Confusion / repeated questions
- Loss of interest in hobbies
- Decline in hygiene motivation
List 3 signs and symptoms of late-stage Alzheimers Disease
- Significant memory loss
- Long term memory loss
- Mood disturbances
- Confusion, struggle to understand jokes
- Difficulty with language
- Unsteady, disorientated
- Depression
List 3 ways in which you could investigate a diagnosis for Alzheimers Disease.
- The mini mental state exam (MMSE)
- MRI
- CT Scan
Which (largely ineffective) drug is often used allopathically in Alzheimers Disease?
Acetylcholinesterase Inhibitors
How long do Alzheimers patients live with the disease, following onset of symptoms?
5 - 20 years
What is Parkinsons Disease?
A progressive, neurological disorder affecting movement.
What is the pathophysiology of Parkinsons Disease (2 things)?
- The degeneration of dopaminergic neurons in the substantia nigra area of the brain.
- Accumulation of abnormal proteins (‘Lewy bodies’)
List 3 proposed causes of Parkinsons Disease.
- Oxidative stress
- Prolonged exposure to toxins (i.e, chemicals, herbicides, pesticides)
- Mitochondrial dysfunction/damage
- Diets low in polyunsaturated fats
- Constipation
List 3 signs / symptoms of Parkinsons Disease.
- Short, shuffling gait
- Resting “pill rolling” hand tremor
- Stooped / flexed posture
- Muscle rigidity, ‘masked’ face
- Deep / low voice
Why does degeneration of dopaminergic neurons lead to the classic movement-centred symptoms in Parkinsons Disease?
Because dopamine is a neurotransmitter involved in control of body movement.
Less dopamine = less control over body movement.
Name the allopathic medication often given to Parkinsons Disease patients.
Levodopa (dopamine replacement)
Describe Huntingtons Disease
An inherited (genetic), neurodegenerative disorder affecting the basal ganglia of the brain.
Which area of the brain is affected in Huntingtons Disease?
The basal ganglia
Which genetic neurological disease is associated with a defect on Chromosome 4?
Huntingtons Disease
Which neurological disease is associated with excessive, uncontrolled jerky body movements (called ‘chorea’)?
Huntingtons Disease
How would a patient with Huntingtons Disease present?
- Uncontrolled jerky body movements
- Loss of intellect
- Cognitive impairment
- Poor mood & emotions regulation
