CONDITIONS OF THE NERVOUS SYSTEM

Meningitis is an inflammation of the meninges, or membranes, that surround the spinal cord and brain. Cause: infection, usually from the meningococcus bacteria Bacteria may enter the central nervous system through the nose or throat following infections of the ear, throat, or respiratory tract. The bacteria get into the arachnoid or pia mater, and inflammation spreads to the adjacent nervous tissue, causes swelling of the brain, enlargement of the ventricles, and hemorrhage of the brain stem. 1.Meningitis

Meningitis is a serious disease in children; it usually occurs between the ages of 3 months and 2 years. Signs/Sx: Symptoms include a high fever, stiff neck, intense headache, and sensitivity to light and sound, and progress to vomiting, convulsions, and coma. 1.Meningitis

Tx: The cerebrospinal (CSF) fluid must be analyzed for bacteria and the presence of white blood cells. CSF is taken through a puncture in the lumbar area, or spinal tap. If meningococcus bacteria are identified, isolation is necessary for at least 24 hours because of the contagious nature of the disease. IV antibiotics must be started immediately, and the patient is usually cared for in an ICU (Intensive Care Unit). 1.Meningitis

2.Multiple Sclerosis Cause: Multiple Sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system that causes deterioration and permanent damage to the myelin sheath that surrounds the nerve cell axon. It can attach the spinal cord, optic nerve, or white matter of the brain. Nerve conduction is disrupted, causing diverse symptoms. MS most often affects people between the ages of years. The exact cause is unknown, and but there appears to be an association with a genetic factor called HLA-DR2.

Signs/Sx: The patient will usually present with a history of dizziness, numbness, tingling, or weakness that resolved over a few days. Specific signs depend on the part of the nervous system that is affected. Blurred vision with blind spots, speech defects, tremors, and muscle weakness and numbness in the extremities is common. Some people experience tremor, spacticity, and neurotic behavior involving mood swings. The disease may progress steadily, or there may be acute attacks followed by partial or complete temporary remission of symptoms. 2.Multiple Sclerosis

Tx: Management involves dealing with the symptoms as they appear and disappear. The individual should avoid overexertion and fatigue, exposure to extreme temperatures, and stressful situations. A regular plan for daily activity and exercise should be established. There is some research suggesting that dietary factors such as polyunsaturated fatty acids and antioxidants may help somewhat. Corticosteroids can be helpful during acute symptomatic episodes. Several new drugs have been developed that appear to slow the progression of the disease, but as of now there is no cure. 2.Multiple Sclerosis

3.Amyotrophic Lateral Sclerosis (a.k.a. Lou Gehrig’s Disease) Cause: Amyotrophic Lateral Sclerosis (ALS) involves sclerosis, or hardening, of the lateral regions of the spinal cord along with degeneration of motor neurons and significant atrophy of muscles. The disorder occurs between the ages of years, and does not seem to have a genetic predisposition.

Signs/Sx: The patient is usually an adult who complains of muscle weakness and cramping in the hands. Symptoms include difficulty in speaking, swallowing, chewing, and use of the hands. Sensory and intellectual function remain intact. There is rapid progression of muscle atrophy, usually resulting in paralysis and confinement to a wheelchair. 3.Amyotrophic Lateral Sclerosis (a.k.a. Lou Gehrig’s Disease)

Tx: Although there is no cure for this terrible disease, it should be remembered that the person who is totally incapacitation still has normal intellectual capacity, but is unable to communicate feelings or ideas. The disease usually progresses to death over a period of 2-2 ½ years in most patients. The 5-year survival rate is only 20%. 3.Amyotrophic Lateral Sclerosis (a.k.a. Lou Gehrig’s Disease)

4.Bell’s Palsy Cause: The cause of this condition is unknown, but it is believed to be due to a viral infection that causes an inflammatory reaction in the facial nerve. Signs/Sx: The patient complains of facial weakness and distortion and is unable to close one eye. They do not recall any cause, they just “woke up with it.” There may also be associated ear pain and a possible unilateral loss of taste. The face will appear expressionless on the involved side.

4.Bell’s Palsy

Tx: There is still a debate as to whether or not the condition should be treated initially. The general belief, as about 60% of patients recover completely without any treatment, is that corticosteroids should be given if the symptoms are severe. (Although, the corticosteroids have only been proven to reduce pain.) Eye drops and/or a patch may be required until eye closure is possible. 4.Bell’s Palsy

5.Parkinson’s Disease (a.k.a. Paralysis Agitans) Cause: Parkinson’s disease is caused by a dopamine depletion. (Dopamine is a neurotransmitter formed in the brain.) This leads to an imbalance between dopamine and acetylcholine, which affects the body system responsible for the smoothness of movement (the Extrapyramidal System).

5.Parkinson’s Disease (a.k.a. Paralysis Agitans)

Signs/Sx: The patient is older (45-65 years) and complains of difficulty with movement and associated tremors. The patient may have no specific complaint, but the cardinal signs of parkinsonism are present. These include rigidity, bradykinesia (excessively slow movement), resting tremor, and asymmetrical onset. As the disease progresses, the patient will appear to have a blank, emotionless facial expression. Muscle strength remains intact, but the patient is slow to react. The patient’s walk may demonstrate a classic festinating gait, in which the patient takes many small, shuffling steps and has trouble stopping. 5.Parkinson’s Disease (a.k.a. Paralysis Agitans)

Tx: Treatment is aimed at either blocking the effects of acetylcholine or restoring dopamine levels. Parkinson’s is not usually treated in the initial stages. With progression, a drug called Levadopa is effective in treating many of the associated symptoms. 5.Parkinson’s Disease (a.k.a. Paralysis Agitans)

6.Muscular Dystrophy Cause: Muscular dystrophy (MD) is a group of inherited myopathic disorders, each of which presents differently. The most common is the Duchene type (pseudohypertrophic), which is an X-linked recessive gene disorder. The defective gene leads to a significant reduction, or even absence of, an important protein called dystrophin. Symptoms begin to develop as a result of fatty replacement of muscle tissue. The patient is usually between the ages of 1-5 years when the diagnosis is made.

6.Muscular Dystrophy

Signs/Sx: The parents of a child with MD usually notice that he/she has difficulty in rising from a bent-over position, has a waddling gait, and falls often. A characteristic sign is when the child is rising from a bent-over position and appears to “walk up the legs with his/her hands.” Proximal muscle testing may indicate weakness. The disease will affect the limbs first, then the shoulders. Mild mental retardation may be present, and laboratory studies will reveal a significant elevation in creatine kinase levels. 6.Muscular Dystrophy

Tx: There is no treatment for this disease. Progression is rapid, leading to the need for a wheelchair. Patients will progressively decline, and usually die before the age of 20. As the disease is genetically passed, females on the maternal side of an affected side are often checked for elevated CK levels. There is potential hope for gene therapies as research on this condition continues. 6.Muscular Dystrophy