Neurological Disorders Flashcards
Gene that makes people more vulnerable to AD and CTE
APOE e4 variant
Outside the cell protein build up. AD
Amyloid B plaques
Inside brain
Intracerebral
When immune system overreacts to virus in other parts of body such as herpes, chickenpox, measles, or polio. Brain gets hit in crossfire, more common
Secondary encephalitis
Aneurysms (bursting of a blood vessel)
Cerebral hemorrhage
A neurodegenerative condition associated with aging that results in dementia
Alzheimers
Clear edges. Easier to remove
Non-gliomas (meningioma)
Always fatal, caused by prions, holes in the brain that shouldn’t be there
CJD
80% of infected show no symptoms
West nile virus
Ischemia and transient ischemic attacks, infarct/penumbra, thrombosis vs embolism
Sudden blockage of a blood vessel
Higher risk for migraines in men or women?
Women
2 things that are sign of AD and contribute strongly to it
Amyloid B plaques and neurofibrillary tau tangles
What is Kuru?
Creutzfeldt jakob disease in Papua New Guinea tribe
Virtual reality therapy
Patients participate without expensive staff
Spread through mosquitos
West nile virus
Demyelination of axons that starts slow and gets more and more and affects white matter in different locations
Multiple sclerosis
What causes TSEs?
Prions
What limits chemo therapy for brain tumors?
The blood brain barrier
Blockage of CNS vasculature leads to this, or low oxygen levels
Ischemia
What causes physical damage to the brain
Open head injuries: penetration of the skull
Can withstand sterilization, long incubation period, no inflammation
Prion
Inflammation of the brain caused by viral infection
Encephalitis
Symptoms of fever, headache, body aches, nausea, vomiting
West nile virus
When virus directly invades CNS (West Nile virus)
Primary encepahlitis
AD treatments
Experimental antibodies targeting amyloid B clear plaques, increasing seafood/omega 3 fatty acid intake, acetylcholinesterase inhibitors, antipsychotics (dopamine antagonists)
Repetitive unprovoked seizures
Epilepsy
How can the APOE e4 allele be inherited?
As a dominant trait due to mutations in either the APP, PSEN1, or PSEN2 genes
3 stages of CJD (kuru)
- ambulant followed by laughing
- sedentary (sitting/laying)
- terminal (organ systems shut down)
In middle of meninges
Subarachnoid
Inside the cell protein clumps. Causes the cell to lose function and die. AD
Neurofibrillary tau tangles
Tumors that are rare, have unknown causes, radiation is a risk
Primary brain tumor
When do AD patients start to need care?
Moderate AD
Pain is like a band squeezing the head. Linked to stress
Tension headache
What causes 50-75% of all dementia?
Alzheimers
Excitotoxicity in ischemia
Oxygen starved neuron releases excessive glutamate that creates an overexcited injured neuron
Pain behind brow bone and or cheekbones. Linked to environment
Sinus headache
Flu like symptoms defined by neck stiffness, photophobia, and drowsiness
Meningitis
Causes increased nervousness and aggression, abnormal posture, incoordination, difficulty rising, decreased milk production, loss of body condition despite appetite
Bovine spongiform encephalopathy
Blockage of blood vessels; lack of blood flow to affected area. 80% of strokes
Ischemic stroke
This is more common in higher altitudes due to lack of vitamin D due to lack of sunlight
MS
What are antipsychotics associated with in AD?
Earlier death
May lead to death of neural tissue, or infarct
Ischemia
Treatments for migraines
OTC pain relief (excedrin), SSRIs and triptans, botox injections, behavioral changes and avoid triggers
These work together to increase blood flow and pain in migraines
Trigeminovasuclar system (5HT) and calcitonin gene related peptide (CGRP)
Don’t have clear boundaries/edges. Difficult removal
Gliomas
Treatments for traumatic brain injuries
Glutamate inhibitors, dopamine activity enhancers, NE reuptake inhibitors, patient and family education, virtual reality
Risk increases with age
Alzheimers
How does a stroke occur?
When the brains blood supply is interrupted by either a cerebral hemorrhage or the sudden blockage of a blood vessel
Types of seizure onset
Focal onset (has a specific place), generalized onset (spreads to whole hemisphere or Brian), unknown onset
Between dura and skull
Epidural
Inflammation of membranes that cover and protect the nervous system
Meningitis
Area of neural tissue susceptible to secondary damage that surround an infarct. Delayed damage. Ischemia
Penumbra
Clot floating in the blood that causes ischemia
Embolus
How do epilepsy medications work?
GABA agonists increase inhibition to try to bring excitation and inhibition back into balance
How do prions take over?
Abnormal form takes over and becomes dominant
How does ultrasound therapy help remove brain tumors?
Sound waves create gaps in BBB for chemo meds to get in
Where is the migraine generator located?
Brainstem
Causes atrophy of the cerebral cortex and neurodegeneration
Alzheimers
How do strokes effect the face?
Lateralization. They usually effect one side
Autoimmune condition that causes immune system to attack oligodendrocytes (myelin sheath) of CNS and Schwann cells of PNS
Multiple sclerosis
Bacterial (worst, has a vaccine), fungal, or viral
Meningitis
Clot attached to vessel wall that causes ischemia
Thrombus
Rupture of blood vessels; leakage of blood. 20% of strokes, more fatal
Hemorrhagic stroke
What are people with two copies of the e4 version of the APOE gene more likely to develop?
15 times more likely to develop AD than people without it
How can amyloid B plaques be found?
PET scans
Force can rip axons that causes problems with the vestibular system and problems walking
Axonal shear injuries
Two causes of ischemia
Thrombus and embolus
Injury at the primary site of impact
Coup
Core region of tissue death due to lack of oxygen. Less than 6 minutes. Ischemia
Infarct
Progressive cerebellar ataxia (loss of coordination/movement control) leading to death
CJD (kuru)
What is cognitive reserve?
People are impacted by brain injuries differently. Some people have more room for error due to brain size, synapses, IQ, education etc
Pain is in and around one eye. Linked to circadian rhythm
Cluster headache
Changes due to learning that is the target of rehabilitation. Timeline can span many years
Experience dependent neuroplasticity
3 types of injuries occurring to the brain
Direct impact injury, shock wave injury, and acceleration-deceleration injury (brain gets whipped around)
Seizures caused by flashing lights of specific intensity and frequency (3-30 Hz) that often originate in occipital lobe
Photosensitve epilepsy
Results in slurred speech, memory impairment, personality changes, lack of coordination, and Parkinson like symptoms
CTE/dementia pugilistica
Creates deeper sulci and ventricle enlargement due to loss of tissue filling in space
AD
Injury on opposite side from impact (the bouncing back from primary site)
Countercoup
Locations of hemorrhages
Intracerebral, subarachnoid, subdural, epidural
Pain, nausea, and visual changes are typical of classic form. Linked to neurovascular pressure/5HT
Migraine headache
Possible cause of multiple sclerosis
Exposure to viruses (especially Epstein-barr (mono))
Factors to address in neurocognitive rehabilitation
Changes to cognitive abilities, emotional changes, physical changes
Two types of traumatic brain injuries
Physical damage to the brain or closed head injuries
Surgery to treat epilepsy
Corpus callostomy
What is dementia?
A symptom caused by many different diseases (most often Alzheimers)
Free living microscopic amoeba. Brain eating amoeba
Naegleria fowleri
Brain tumor treatments
Surgical removal, radiation, stereotaxic radio surgery, chemo, ultrasound, thalidomide to starve tumors of blood, stem cells with anticancer genes
Between dura and brain
Sub dural
What causes closed head injuries (concussions)
Blow to the head, coup, countercoup, subdural hematoma, white matter damage
Diagnosed by autopsy (after death), biomarkers in CSF and blood, and PET and MRI scans
Alzheimers
This is more common in female but more severe in males
Multiple sclerosis
Treatments for epilepsy
Vagus nerve stimulation or deep brain stimulation, anti epileptic drugs, surgery, diet
Brain damage from repeated concussions
CTE (chronic traumatic encephalopathy)
APOE e4 gene and AD
Most people with AD don’t have it but if you have it, its likely you will get AD
New treatments for ischemia
Block glutamate (antagonist or Mg) and slight hypothermia for 49-72 hours. Goal is to reduce excitotoxicity to decrease penumbra
Tumors that are typically encapsulated and generally do not recur following surgery (meningioma, medulloblastoma, CNS lymphoma)
Non-gliomas
Methods for improving cognitive function
Cognitive (top down) approach (find things that will generalize) and functional (specific tasks) approach (specific skills to help in daily life)
An infectious agent composed of protein in a misfolded form
Prions
General disturbance before migraine hits
Aura
Transmissible spongiform encephalopathies
Humans = Creutzfeldt Jakob, kuru Animals = scrapie, mad cow, chronic wasting
What is the Kennard principle?
Younger brains more likely to be plastic than than older brains
Standard treatments for ischemia
Blood thinners and exercise/diet changes
Type of multiple sclerosis with continuous decline
Primary progressive MS
Tumors that arise from glial cells, meninges, and ependymal cells. Most common type of tumor until age 19
Secondary tumors
Ingestion of T. sodium eggs in contaminated pork products. Eggs hatch in stomach then larvae lodge in skin, muscle, eye and brain
Neurocysticercosis
Progression of Alzheimers
Mild cognitive impairment to mild AD to moderate AD to severe AD
Type of multiple sclerosis with periods of relief
Relapse remitting MS
EEG of focal onset and generalized onset in epilepsy
Focal = specific times of bursts Generalized = all times of bursts
Biggest risk for vascular events
High blood pressure
Tumors that develop in glial cells and are about 70% of brain tumors (astrocytoma, oligodendroglioma, epyndymoma)
Gliomas
What do approved AD treatments do?
Slow down but don’t revers the course of the disease
