Neurological Disorders Flashcards
What does the central nervous system consist of?
The brain and the spinal cord
What does the peripheral nervous system consist of?
The nerves which connect the central nervous system to the rest of the body
Which specialised cells make up the nervous system?
Neurons
What is the gap between neurons called?
The synapse
Which pathways are affected within Parkinsons disease?
Dopamine pathways within the brain
Neurones that use dopamine as a neurotransmitter are described as:
Dopaminergenic
Name 4 monoamine neurotransmitters:
Adrenaline, dopamine, serotonin and noradrenline
Which amino acid is dopamine synthesized from?
L-tyrosine
L-tyroxine must be converted into levodopa before it can be further converted into dopamine. Which enzyme converts l-tyroxine into levodopa?
Tyrosine hydroxylase
Which enzyme converts tyrosine hydroxylase into dopamine?
Dopa decarbonoxylase
Which enzyme deactivates dopamine?
Mono-amine oxydase
Which two risk factors are thought to be involved with the development of Parkinsons disease?
Previous infection and exposure to neurotoxins
What is meant by Parkinsons as a neurodegenerative disorder?
It leads to the progressive loss of neurons or loss of neuron functionality
What are the three most common symptoms of Parkinsons disease?
Tremor, rigidity and hypokinesia.
What is meant by hypokinesia in Parkinsons?
Reduced movement of the body.
What is meant by bradykinesia in Parkinsons?
Slowed movements within the body.
What is meant by akinesia in Parkinsons?
Difficulty in initiating movements within the body.
Describe further symptoms which an individual may develop due to tremor:
Reduced facial expressions, difficulty in communicating, difficulty chewing and swallowing, loss of balance.
Which part of the brain is affected by Parkinsons disease?
The basil ganglia.
What is the primary function of the basil ganglia?
To control learned and voluntary movement.
Which specific part of the basil ganglia is affected in Parkinsons disease due to the death of doperminergenic neurons?
The substantia nigra.
Where does the substantia nigra send signals to coordinate cognition, action planning and motivation?
The stranium
What appears in the place of doperminergenic neurons in Parkinsons Disease?
Lewy bodies.
What are Lewy bodies?
Microscopic collections of protein.
Name three causes of seizures:
Diabetes, epilepsy and heart conditions
What happens to the electrical activity of neurons within epilepsy?
Neurons spontaneously fire electrical activity in a non coordinated way which results in an epileptic seizure. Where the impulse begins and whether the impulse spreads determines the symptoms an individual experiences as a part of their epilepsy.
Elaborate on the two phases within a tonic-clonic seizure.
Tonic phase- refers to the rigidity experienced as a result of electrical impulses causing muscles to contract.
Clonic phase- refers to rhythmic jerking (fitting) which occurs when muscles contract and relax in quick succession.
How is breathing affected in a tonic clonic seizure?
Breathing may become obstructed causing cyanosis.
Give 10 causes of epilepsy:
- low sodium levels
- low oxygen levels
- low glucose levels
- low calcium levels
- drug and alcohol abuse
- fever
- stroke
- traumatic head injury
- meningitis
- brain tumour
How many unprovoked seizures must an individual have before they are diagnosed with epilepsy?
2
Give two triggers which can bring on epileptic seizures:
Lack of sleep, flashing lights
What can be used to diagnose epilepsy?
An EEG (electroencephalogram) which can be used to view the electrical activity within the brain
The part of the brain where the disruptive electrical signal begins within epilepsy is referred to as:
The epileptic focus point
What is a simple focal seizure?
Electrical signal starts in a localised part of the brain and does not impair conciousness. Symptoms include strange, unsettled feeling, feeling of impending doom, minor twitching. The individual is aware of what is happening and often just needs reassurance.
What is a complex focal seizure?
Electrical signal starts in a localised part of the brain and consciousness is impaired. Patient will have a loss of awareness. May make abnormal noises, move body around, chew or swallow excessively.
What is a focal seizure which evolves to a secondary generalised seizure?
Electrical signal starts in a localised part of the brain but then spreads to the whole brain. Consciousness is also impaired. Patients may experience an ‘aura’ before seizure progresses.
What is an absence generalised seizure?
Widespread activity across the whole brain. Patient loses consciousness for a short amount of time. May look black and is unresponsive. Normally lasts for between 10 and 15 seconds and has an immediate recovery.
What is a myoclonic generalised seizure?
Patient may or may not lose consciousness. Muscles jerk (fitting). Sometimes can occur several times in quick succession.
What is a tonic- clonic generalised seizure?
Electrical signal effects the whole brain. Characterised by two phases- muscle rigidity followed by fitting. Patient may have a very low mood and feel very tired following seizure occurrence.
What is the most common type of dementia?
Altzheimers disease
Give three general symptoms of dementia
Memory loss, personality changes and difficulty communicating needs.
Give examples of cognitive functions affected in dementia.
Intellectual activities which involve planning and coordination such as problem solving, memory and language.
What are the two main risk factors for developing dementia?
Increased age and family history.
Name the three most common problems found with defunctioning semantic memory within dementia.
Inability to find words.
Inability to recognise faces.
Inability to orientate familair surroundings.
Give the 5 types of degenerative dementia:
- Alzheimer’s disease
- frontotemporal dementia
- parkinsons disease with dementia
- dementia with lewy bodies
- huntington diease
Other than degenerative dementia, give the 7 other types of dementia:
- Vascular dementia (caused by damage to blood supply to the brain)
- Metabolic dementia (caused by metabolic disturbances such as liver failure)
- Toxic dementia (caused by alcohol or drug abuse)
- Vitamin deficiency dementia (caused by a lack of B-12 and thiamine)
- Infectious dementia (caused by viral infections such as HIV
- Endocrine induced dementia (caused by hypothyroidism)
- Psychiatric dementia (caused by pseudo-dementia within depression)
The pathology of advanced Alzheimer’s diseases can be characterised by:
Extensive neuron death throughout the brain.
Which two distinctive brain lesions are found in Alzheimer’s disease?
Amyloid plaques and neurofibrillary tangles.
What is a febrile seizure?
A seizure occuring dur to fever or high temperature typically occuring in children between 6 months and 5 years old.
Define the focal features of a simple febrile seizure:
Typically the same as a generalised tonic-clonic seizure. Occur once within 24 hours.
Define the focal features of a complex febrile seizure:
Focal seizures with or without generalisation. Typically occur more than once in 24 hours and can continue for an extended period of time.
Why is high temperature thought to contribute to seizure activity?
A sudden increase in the temperature of the brain combined with release of cytokines and other inflammatory mediators.
What is meant by ‘status epilepticus’:
An ongoing tonic clonic seizure which lasts for longer than 10 minutes or occurs in a succession of 3 seizures without a period of recovery. Status epilepticus is a medical emergency.
What is an organic seizure?
A seizure with a physical or medical cause often related to a metabolic cause for example hypoglycaemia. Seizure is resolved when the medical cause is found and treated.
What is a factitious seizure?
A seizure which is ‘put on’- the individual has some control over the seizure and may exaggerate symptoms.
Give 6 psychosocial implications of seizures:
- Social isolation
- emmaressment
- injury
- depression and/or anxiety
- relationship breakdown
- stigma
- difficulty finding employment
What first aid should be administered to somebody having a seizure:
Do not restrain the patient. Time the seizure. Remove any potential dangers. Protect the head and neck if possible. Protect the airway if possible.
Which examination is used to determine dementia?
Addenbrookes cognitive examination
Which neurochemical changes occur in Alzheimer’s patients?
Reduction in acytycholine, reduction in GABA, reduction in noradrenaline and reduction in 5HT (serotonin).
Which factors put individuals at risk of developing vascular dementia?
Hypertension, high cholesterol, diabetes, smoking, lack of exercise, atrial fibrillation.
Give characteristics of lewy body dementia:
Fluctuating cognition, visual hallucinations, falls, sensitivity to medications, tremor presence.
What is an acute confusional state?
A rapid onset of confusion caused by a toxic, vascular or metabolic defect such as urine infection, fluctuating blood glucose levels or ingestion of toxic substances (e.g. alcohol/drug use).
