When Things Go Wrong

Question 1

What are the symptoms of a seizure?

Answer 1

A person loses consciousness and may fall to the ground, become stiff and shake

Question 2

What happens during a seizure?

Answer 2

There is an increase in the firing of action potentials by neurons followed by a period of reduced excitability

Question 3

What is the cyclical process of a seizure modulated by?

Answer 3

Inhibitory (GABA) and excitatory (glutamate) neurotransmitters

Question 4

What is seizure triggered by?

Answer 4

When the reduction in excitatory is incomplete, seizures may be triggered by uncontrolled recruitment of neighbouring neurons

Question 5

When is a seizure partial?

Answer 5

When the recruitment of neighbouring neurons is localized

Question 6

When is the seizure generalised?

Answer 6

When the recruitment of neighbouring neurons spread to the entire cortex

Question 7

What is the EEG like during a generalised seizure?

Answer 7

Normal alpha rhythm of the EEG is replaced by large, slow, synchronous waves of electrical activity in both cerebral hemispheres

Question 8

What is epilepsy?

Answer 8

Recurring seizures

Question 9

What is the treatment for epilepsy like?

Answer 9

1. Drugs that dampen down abnormal seizure activity without damping down normal brain activity
2. Use brain imaging to localise source of seizures accurately and for neurosurgeon to cut out this brain tissue

Question 10

What is meninges?

Answer 10

Lining of the brain

Question 11

What are the symptoms of meningitis?

Answer 11

Fever, headache, neck stiffness, confusion, vomiting, rash for some cases of meningitis like those caused by meningococcal disease

Question 12

What are the symptoms of migraine?

Answer 12

Feel sick, find bright lights or noises discomforting, experience migrainous aura consisting of flashing lights or jagged lines

Question 13

Do migrainous aura come before or after the headache?

Answer 13

Before

Question 14

Which part of the brain does migraine start?

Answer 14

The part that processes pain sensations coming from cerebral blood vessels

Question 15

What causes symptoms like flashing lights in migraine?

Answer 15

Thee is increase activity in regions that process pain sensations that cause an increase in local blood supply

Question 16

What causes the temporary weakness in migraines?

Answer 16

After the brief increase in local blood supply, it is immediately followed by reduced blood flow

Question 17

What drugs that effective at stopping migraine headaches?

Answer 17

Triptans

Question 18

How do triptans work?

Answer 18

They activate a particular group of serotonin receptors

Question 19

What causes stroke?

Answer 19

Interruption of energy supply that the brain needs to function

Question 20

How are fuels delivered to neurons and gila?

Answer 20

Through the four major blood vessels that supply the brain

Question 21

What are the raw materials to make ATP?

Answer 21

Oxygen and carbohydrate in the form of glucose

Question 22

What is energy provided used to do?

Answer 22

Driving the flow of charged ions that underlie the electrical activity of neurons, about two thirds of a neuron’s energy is used to fuel an enzyme called Sodium/ Potassium ATPase which recharges the ionic gradients of sodium and potassium after an action potential has occurred

Question 23

What happens during a transient ischaemic attack (TIA)?

Answer 23

Blood supply to a part of the brain fails and the supply of ATP is interrupted, neurons cannot recharge their ionic gradients and can no longer conduct action potentials

Question 24

How long does TIA last?

Answer 24

Typically last few minutes and under 24h

Question 25

Does TIA cause permanent damage?

Answer 25

No

Question 26

How does TIA pass?

Answer 26

Obstruction passes quickly, neurons can make ATP again, recharge their membranes and normal function will resume

Question 27

What happens in the absence of ATP?

Answer 27

Cells cannot maintain homeostasis and they may swell up and burst, neurons may also spontaneously depolarise, releasing potentially toxic neurotransmitters such as glutamate and glial cells that mop up excess glutamate through ATP-dependent pump also stops working

Question 28

What are most strokes caused by?

Answer 28

Blood clots blocking vessels

Question 29

How to treat strokes caused by blood clots?

Answer 29

“clot-busting” drug called tissue plasminogen activator (TPA) that can break up clot and restore blood flow

Question 30

What is the condition where people have problem with fine control of movements that make them increasingly unsteady of their feet as years go by?

Answer 30

Spinocerebellar ataxia

Question 31

What is a neurodegenerative disease associated with abnormal involuntary movements of the body?

Answer 31

Huntington’s disease

Question 32

What is Huntington’s disease caused by?

Answer 32

Repeat mutation in one of the largest gene in the human genome called huntingtin

Question 33

What are some early onset forms of Parkinson’s disease caused by?

Answer 33

Problems in gene coding for Parkin

Question 34

What is a disease characterised by repeated episodes of weakness, numbness, double vision or poor balance that last for a few weeks before recovery?

Answer 34

Multiple sclerosis

Question 35

What is multiple sclerosis caused by?

Answer 35

Inflammation in the nervous system that flares up and settles down again

Question 36

What causes demyelination?

Answer 36

When immune system attacks the myelin that wraps around neurons, resulting in a local area of inflammation

Question 37

What is an autoimmune disease?

Answer 37

When your body’s immune system mistakenly attacks your body

Question 38

What are the symptoms of demyelination?

Answer 38

Neurological deficits such as vision changes, weakness, altered sensations or behavioural and cognitive problems

Question 39

What is the relationship between demyelination, autoimmune disease and multiple sclerosis?

Answer 39

Multiple sclerosis is a type of memyelination is a type of autoimmune disease

Question 40

What can multiple sclerosis attacks be made shorter?

Answer 40

Through drugs like steroids that dampen down the immune system

Question 41

What are some treatment methods for patients with severe multiple sclerosis?

Answer 41

Permanently dampening down certain parts of immune system with drugs like azathioprine or beta interferon

Question 42

What causes myasthenia gravis?

Answer 42

Immune system attacking junctions where nerves connect with muscles

Question 43

What causes Guillaume Barre syndrome?

Answer 43

Immune system attacking the nerves as they emerge from the spinal cord

Question 44

What is Alzheimer’s disease a form of?

Answer 44

Dementia

Question 45

What happens as Alzheimer’s disease develop?

Answer 45

Brain cells die, the cortex thins and ventricles enlarge

Question 46

How can Alzheimer’s disease be confirmed?

Answer 46

Post-mortem during microscopic examination of brain which reveals cell loss and widespread abnormal deposition of an amyloid protein in scattered small degenerating amyloid plagues and fibrillary tangles

Question 47

What are fibrillary tangles?

Answer 47

Tangled mess of rod-like proteins that are normal constituents of brain cells

Question 48

What genetic factors can increase the risk of getting Alzheimer’s?

Answer 48

Mutations in genes that encode amyloid precursor protein and presenilins and inheritance of a particular variation of apolipoprotein E (apoE) gene, apoE-4

Question 49

What does amyloid precursor protein do?

Answer 49

Where amyloid is made

Question 50

What do presenilins do?

Answer 50

Encode enzymes that break precursor protein down

Question 51

What has a modest treatment effect on Alzheimer’s?

Answer 51

Nerve cells utilising the chemical transmitter acetylcholine are particularly vulnerable to attack, drugs that block the effect of enzymes that destroy this neurotransmitter boosts the action of the remaining acetylcholine

Question 52

What are symptoms of depression?

Answer 52

Disturbed sleep, lowered appetite, failing concentration and memory and loss of interest in life

Question 53

What is the treatment for depression?

Answer 53

Antidepressants that enhance the effect of neuromodulatory transmitters such as serotonin and noradrenaline can treat the disease within weeks, psychological treatments can also be helpful

Question 54

What is the effect of being chronically stressed?

Answer 54

Unbalancing effect on the control of stress hormones like cortisol which when chronically activated can damage brain cells, particularly in the frontal and temporal lobe

Question 55

What has been found as an effect of antidepressant drugs?

Answer 55

They promote integrity of brain cells and increase the rate at which new neurons are produced in the hippocampus

Question 56

What are the symptoms of schizophrenia?

Answer 56

Delusions and hallucinations

Question 57

What happens to a person’s brain when they have schizophrenia?

Answer 57

Ventricles of the brain enlarge and the activity of frontal lobes becomes impaired

Question 58

What is treatment is helpful in reducing the frequency and impact of schizophrenia symptoms?

Answer 58

Drugs that block dopamine receptors

Question 59

What is the result when the brain is activated with drugs like amphetamine?

Answer 59

It is possible to detect abnormalities in the release of dopamine

Question 60

What does post-mortem studies suggest about schizophrenia?

Answer 60

The way neurons have connected up during development may be abnormal and other neurotransmitter systems like glutamate may be malfunctioning