1. The Nervous System Lesson 2: The Pathology of the Nervous System25
The Nervous System
Lesson 2:
The Pathology of the Nervous System

2. Lesson Objectives
Upon completion of this lesson, students should be able to …
Define and spell the terms to learn for this chapter.
Identify and explain common disorders associated with the nervous system.

3. Alzheimer’s Disease
Progressive, degenerative disease that attacks the brain and its cognitive function
No known cure
Family history often plays a role in the development of this disease along with activity and age
Onset is generally in the later stages of life. The ages between 65 and 70 seem to be when Alzheimer’s most frequently develops.

4. Signs and Symptoms of Alzheimer’s
Mild forgetfulness of recent events marks first symptoms
Ability to think and rationalize diminishes
Thought processes are interrupted
Speech may become difficult to understand
Reading and writing skills dissipate
Behavioral patterns change during the later stages

5. Signs and Symptoms of Alzheimer’s
Patients (may) become agitated, depressed, aggressive or violent
Eventually, patients are unable to speak, eat, or care for themselves

6. Treatment of Alzheimer’s Disease
Medications to slow the progression in the early stages
Medication must continue throughout the patient’s life to avoid regression

7. Amyotrophic Lateral Sclerosis
Unknown etiology
Breaks down the nerves that are responsible for movement
Disease is also known as motor neuron disease as well as Lou Gehrig’s disease

8. Signs, Symptoms, and Treatment of Amyotrophic Lateral Sclerosis
Signs and Symptoms include:
Loss of control of voluntary muscle movement including that of the arms, legs, and trunk
Involuntary muscle movement such as that associated with the contraction of the heart and the smooth muscle of the internal organs are not generally affected
Depending on the form of ALS the loss of intellectual function (dementia) or sensory symptoms may occur

9. Signs, Symptoms, and Treatment of Amyotrophic Lateral Sclerosis
Treatment includes
No known cure
Use of medications can help to lessen symptoms

10. Bell’s Palsy
Generally not a serious condition, but does affect the appearance of the face
Caused by damage to a facial nerve, one of which runs beneath each ear to the muscles on the same side of the face
Also known as facial palsy
Named after Dr. Charles Bell who first documented the disorder in 1882

11. Signs, Symptoms, and Treatment for Bell’s Palsy
Signs and symptoms include:
Unilateral paralysis of the face
Facial drooping and lack of expression on afflicted side
Treatment includes:
Corticosteroids at onset ensures good recovery. Without treatment, it may resolve on its own in a few weeks or months.

12. Disk Disorders
Painful deterioration of disks that support the spinal vertebrae
Signs and symptoms include:
Severe pain around or near the location of the problematic disk
Neck, back, and leg pain
Leg and other muscle weakness
Incontinence

13. Treatment for Disk Disorders
Bed rest
Heat or cold
Muscle relaxers
Analgesics
Physical therapy for ruptured or slipped disks

14. Encephalitis Infection of the brain often caused by a virus
Primarily affects infants and the elderly
Signs and symptoms include:
Headache
Sudden fever
Vomiting
Sensitivity to light
Stiff neck and back
Confusion
Drowsiness
Clumsiness
Irritability

15. Treatment for Encephalitis
Emergency care required if patient exhibits
Loss of consciousness
Poor responsiveness
Seizures
Muscle weakness
Impaired judgment
Treatment includes:
Hospitalization
Antibiotics
Antiviral medications
Anticonvulsants
Steroids to decrease inflammation
Sedatives to control irritability and agitation

16. Epilepsy and Seizures Epilepsy Seizures
Disorder associated by misfiring or interference of electrical impulses within the brain
Cause is unknown
Often the result of another condition, such as head injury, stroke, brain infection, or brain tumor
Seizures
Associated with epilepsy
Occur when abnormal and often intense bursts of electrical activity are produced within the brain
Affect about one-half of a percent of the population

17. Signs, Symptoms, and Treatment for Seizures
Signs and symptoms of seizures include:
Temporary interference with muscle control, movement, speech, vision, or awareness
Some only have one seizure, others have repeated episodes
Treatment for seizures include:
Medication taken for life
Surgery may be required

18. Types of Headaches Migraine headaches Tension headaches
Cluster headaches
Post-traumatic headaches

19. Critical Thinking Question
When is it important to seek professional help for a headache?

20. Huntington’s Chorea
Hereditary degenerative disorder of the cerebral and basal ganglia
Also referred to as Huntington’s Disease (HD)
Generally the onset begins during the mid to late thirties, sometimes in juveniles

21. Signs, Symptoms, and Treatment for Huntington’s Chorea
Signs and symptoms:
Changes in physical and emotional patterns
Involuntary movement
Rigidity
Problems with balance and coordination
Difficulty swallowing
Slurred speech
Treatment:
Analgesics and benzodiazepines used to regulate pain, spasms, and seizures
No known cure
Death occurs within 15 years of being diagnosed

22. Hydrocephalus Commonly occurs in infants
Characterized by excessive amount of CSF within ventricles of the brain causing the brain to compress against the skull
Without proper treatment, this condition can result in brain damage

23. Signs, Symptoms, and Treatment of Hydrocephalus
Signs and symptoms:
Most common symptom is an enlarged head
Large scalp veins
Irritability
Vomiting
Treatment:
Shunt surgically inserted into a ventricle to drain CSF

24. Meningitis
An infection of the meninges which surround and protect the brain and spinal cord
Cause may be a virus or bacteria
If left untreated there is a high death rate

25. Signs, Symptoms, and Treatment of Meningitis
Signs and symptoms:
Neck stiffness
Headache
Vomiting
High fever
Chills
Treatment:
Immediate medical treatment
Antibiotics
Anti-inflammatory medications
Analgesics
Anticonvulsants
Isolation may be required to prevent its spread

26. Multiple Sclerosis (MS)
Chronic, debilitating autoimmune disease affecting the brain and spinal cord
There is no known cure
Body directs the antibodies and white cells to attack the myelin sheath surrounding the nerves in the brain and spinal cord
Inflammation and injury to sheath and nerves results; scarring is possible
Transmission of nerve impulses is impeded, making movement, vision, or sensation difficult

27. Signs and Symptoms of Multiple Sclerosis
Double vision
Dizziness
Paralysis
Loss of balance
Problems with speech and vision
Pins-and-needles sensations
Bladder incontinence
Numbness
Muscle stiffness
Uncontrollable tremors

28. Treatment Depends on type and severity of disease
Drug therapy utilized to minimize effects of symptoms, improve quality of life

29. Neuralgia
Causes vary and include chemical irritation, trauma (including surgery), inflammation, and infections
Signs and symptoms include
Pain, usually brief but may be severe
Often feels as if it is shooting along the nerve

30. Treatment of Neuralgia
Treatment varies depending on the cause, location, severity of pain and other factors
Treatment may include:
Rest, stretching, and heat
Aspirin, acetaminophen, or ibuprofen
Narcotic pain killers, nerve blocks, anesthetic agents administered via local injection
Surgical procedures to decrease sensitivity

31. Parkinson’s Disease Progressive disorder No known cure
Caused by degeneration of nerve cells in parts of the brain that control movement
Because of the degeneration, there is a shortage of the neurotransmitter dopamine, causing the movement impairments that characterize the disease

32. Parkinson’s Disease
Causes depression, personality change, dementia, sleep disturbances, speech impairment, and sexual difficulties
Worsens over time

33. Signs and Symptoms of Parkinson’s Disease
Tremor of a limb (especially at rest)
Localized to one side and one limb, and usually seen in the hand
Slow movement
Bradykinesia (inability to move)
Akinesia (rigid limbs, shuffling gait, stooped posture)
Reduced facial expression (the “mask”)
Soft voice

34. Treatment of Parkinson’s Disease
The medication levodopa
Levodopa must eventually be discontinued due to side effects
Surgical intervention helps minimize involuntary motions

35. Sciatica Refers to a pain that runs along the sciatic nerve
Often caused by inflammation due to a pinched root of the sciatic nerve
Typically occurs on one side

36. Sciatica Signs and symptoms: Treatment:
Sharp pain from the lower back, down the back of the thigh
Pain may be worse during periods of activity, as well as at night
Increased pain when weather changes
Treatment:
Rest
Restrict activities that may cause pain and discomfort
Analgesics
Cold or heat therapy
Gentle stretching exercises
Surgical intervention

37. Spina Bifida
Most frequently occurring, permanently disabling, and devastating of all birth defects
Affects approximately 1 out of every 1,000 newborns in the U.S.
More children have spina bifida than muscular dystrophy, MS, and cystic fibrosis combined
Spine fails to close properly during first month of pregnancy
No known cure
Any and all nerve damage is permanent

38. Forms of Spina Bifida Spina bifida occulta Closed neural tube defects
Meningocele
Myelomeningocele

39. Signs and Symptoms of Spina Bifida
Vary depending on the form
Spina bifida occulta
Malformation of 1 or 2 vertebrae and the affected spinal area is covered by skin and not visible
Symptoms are rare with this form
Closed neural tube
Defects are varied
Some individuals show no symptoms
Others have paralysis, causing urine and bowel dysfunction

40. Signs and Symptoms of Spina Bifida
Meningocele
Meninges protrude from spinal opening
Symptoms may or may not be present
Those present are similar to closed neural tube defects
Myelomeningocele
Most severe form
Entire spinal cord is exposed
Paralysis may be partial or complete below the area of the myelomeningocele

41. Treatment of Spina Bifida
Some children may need surgical intervention as they grow and develop
Milder forms may not require any treatment
Surgery in utero has been tried; however, complications can be great for both the mother and the fetus

42. Terms Related to Paralysis
Quadriplegia
Paralysis from the shoulders down
Paraplegia
Paralysis from the waist down
Hemiplegia
Occurs when paralysis affects one side
Paralysis is indicated by a complete lack of movement at the point of injury and below

43. Treatment and Complications of Paralysis
Aimed at reducing complications
Physical therapy may be helpful in hemiplegic patients with complications due to stroke
Complications associated with paralysis include
Pressure sores (decubitus)
Thrombosis
Muscle atrophy
Pneumonia

44. Strokes Also known as cerebrovascular accident (CVA)
Third leading cause of death in the U.S.
Death occurs to the brain tissue when the blood supply to the brain is decreased by a clot or a hemorrhage
Brain cells can die when the oxygen supply is interrupted for more than a few minutes
Speed is important in diagnosis and treatment

45. Signs and Symptoms of Stroke
Signs and symptoms are sudden and require emergency intervention including:
Numbness or weakness on one side
Confusion or trouble speaking
Vision disturbances in one or both eyes
Dizziness
Loss of balance or coordination
Severe headache with no known cause

46. Treatment for a Stroke Emergency intervention is vital
Stabilize the condition by either dissolving blood clots or stopping hemorrhage
Surgery may be necessary
Medications to control the swelling of the brain and control blood pressure
Medications and treatments are given after the incident to reduce the chance of recurrence

47. Transient Ischemic Attacks (TIAs)
Frequently precursors of strokes
“Ministrokes” that can last anywhere from a few seconds to hours
Signs and symptoms include:
Temporary sudden weakness
Numbness
Change of consciousness
Symptoms depend on the portion of the brain affected

48. Treatment of TIAs
It is important for patients to seek medical attention during a TIA
Treatment includes:
Anticoagulants
Aspirin therapy used to reduce the risk of blood clot formation

49. Methods to Reduce the Risk of Future TIAs
Cease smoking
Stop overeating
Decrease alcohol consumption
Lower blood pressure
Control diabetes

50. Types of Trauma to the Brain
Epidural and subdural hematomas develop when the head receives a blow
Subdural hematomas cause pressure in the brain that must be relieved with shunting
Trauma to the brain can also cause a:
Concussion – an injury caused by sharp jarring or a blow to the head
Contusion – a bruising of the brain
Skull fractures known as depressions can cause brain injury

51. Signs and Symptoms of Brain Trauma
Vary depending on the type of injury
Common symptoms include:
Loss of consciousness
Headache
Confusion
Dizziness
Blurred vision
Ringing in the ears
Behavioral, mood, and sleep pattern changes

52. Treatment of Brain Trauma
Treatment varies depending on the type of injury
Treatments include:
Rehabilitation exercise
Medications to suppress seizures, such as benzodiazepines and barbiturates

53. Questions? 53