NEUROLOGICAL PATHOLOGIES - Parkinson's and MS

Question 1

What is MULTIPLE SCLEROSIS (MS) ?

Answer 1

MS is a chronic demyelinating disease of the CNS characterised by an Inflammatory Process and causing wide spread degeneration of the CNS, gradually resulting in severe Neurological Deficit.

Question 2

What is the Pathophysiology of MS ?

Answer 2

1. ) Disruption of blood- brain barrier.
2. ) Leakage of Inflammatory Cells
3. ) Destruction of OLIGODENDROCYTES & MYELIN SHEATH
4. ) Disruption of nerve signals ( rate of conduction of nerve slow down )

Question 3

What causes MS ?

What’s triggering the immune response

Answer 3

• IMMUNOLOGY ( Immune system )
• ENVIRONMENT ( obesity / smoking increases the risk )
• GENETICS ( not heredity but increases chance )
• VIRAL ( B & T - CELLS can be triggered )

Question 4

What are the different types of MS ?

Answer 4

1. ) BENIGN MS
   - normally happen 2x lifetime
2. ) RELAPSING REMITTING MS (85% = most common)
   - Its stable then relapse over time ( disability increases over time )
3. ) SECONDARY PROGRESSIVE
   - similar to relapsing remitting but disability increases exponentially
   - more scarring.
4. ) PRIMARY PROGRESSIVE
   - No sudden relapsed / gradual increase ( exponentially )

Question 5

What are some common signs and symptoms of MS.

Answer 5

• FATIGUE
• DIFFICULTY WALKING
• VISION PROBLEMS
• PROBLEMS CONTROLLING BLADDER
• SENSORY DEFICITS
• INCREASED MUSCLE TONE
• REDUCED BALANCE

Question 6

What are the process of diagnosing someone with MS ?

Answer 6

1,) Clinical history

2. ) Neurological examination by a specialist
3. ) Evoke potential Test
4. ) MRI SCAN AND BLOOD TEST

Question 7

What are some medical treatment of symptoms for MS ?

Answer 7

• Anti-spasticity Agents and relaxants ( Baclofen / Tizadine )
• Neuropathic pain medication ( Gabapentin )
• Anti-depressant
• analgesia ( pain reliever )

DISEASE MODIFYING DRUGS (DMD)
- fewer relapse meaning reduces the build up of disability.

Question 8

What is PARKINSON’S DISEASE ?

Answer 8

PD is a chronic progressive neurodegenerative disorder resulting from the degeneration of DOPAMINE producing neurone in the SUBSTANTIA NIGRA of the basal Ganglia.

(Its IDIOPATHIC)

Question 9

What are the clinical criteria for diagnosing PARKINSONS DISEASE ?
( WHAT ARE THE CARDINAL SIGNS )

Answer 9

BRAIN EXAMINATION MUST OCCUR

1.) BRADYKINESIA
(slowness of the movement)

2.) RIGIDITY
(resistance to passive movement in unidirectional Resistance)

3.) RESTING TREMOR
(pill rolling Tremor)

4.) POSTURAL INSTABILITY
(decreased balance on different posture)

Question 10

What are some other signs and symptoms of Parkinson’s Disease

Answer 10

• Cardinal signs
• Difficulty initiating and terminating movement
• Sleep Disorders
• Dysphagia ( swallow dysfunction )
• FESTINATING GAIT PATTERN
• Anxiety & Depression

Question 11

Name the 5 main Nuclei of the basal ganglia and state each Nuclei’s Function ?

Answer 11

1. ) GLOBUS PALLIDUS
   - Responsible for learning motor skills & movement sequence.
2. ) CAUDATE
   - Responsible for Preparation and Planning.
3. ) PUTAMEN
   - Responsible for Initiating and Terminating movement
4. ) SUBTHALAMIC NUCLEI
   - Responsible for sequencing and Timing
5. ) SUSTANTIA NIGRA
   - Responsible for regulating muscle tone and inhibition of unnecessary movement.

Question 12

Name some Medication used to treat the symptoms of Parkinson’s Disease ?

Answer 12

1.) DOPAMINE REPLACEMENT ( madopor / Sinemet )
- aims to replace lost dopamine but it cant cross the brain barrier so it contains drugs
that facilitate the crossing to the brain.

2.) DOPAMINE COPY CATS

3. ) DOPAMINE PROTECTORS
   - protects current level of Dopamine by blocking enzymes that breaks it down.

Question 13

How the Basal Ganglia control the body ?

Answer 13

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