1. Neurological complications of diabetes mellitus, anemia, alcoholism, collagenous disorders
DM,

2. Pernicious, megaloblastic anaemia
B12 vitamin deficits, chronic gastritis, lack of intrinsic factor- malabsoption
Neuropaties, polyneuropathies
Ataxia- spinal type, dorsal columns demyelinitang lesions, myelopathy - Subacute combined degeneration
Th: supplementation B12 or folic acid

3. Alcohol and nervous system
Acute intoxication
Changes in behavior, agressivity, incoordination of movement and gait, slurred speach
Drowsiness, stupor, coma, problems with breathing

4. Alcohol and nervous system
Abstinence and withdrawal syndrome
Tremulousness, hallucinations
seizures, confusion
psychomotor and autonomic overactivity, which develops several hours or days after an addictive drinker abstains from alcohol

5. Alcohol and nervous system
Delirium tremens
In 10% starts with seizures
Profound confusion, gross tremor, hallucinations, autonomic overactivity – fever, tachycardia, dilated pupils
48-96 hours after cessation of drinking

6. Alcohol and nervous system
3. Alcohol and dementia
Chronic abuse of alcohol – cognitive deficit (loss of neurons, brain atrophy)
Wernicke´s encefalopathy (hemorhagic)
Korsakov´s syndrom

7. Alcohol and nervous system
Wernicke´s encefalopathy
Confusion, eye movement problems, ataxia – dysarthria, ataxia of body and extremities, residual signs
Loss of neurons, axons, myelin, small hemorrhagies – corpora mamillaria, around aqueductus, III. And IV. ventricles
Th.: Thiamin 100 mg/day im.,iv.
B-vitamins

8. Alcohol and nervous system
Korsak´s syndrom
Amnestic syndrom with amnesia, confabulations
Marchiafava-Bignami syndrom
Demyelinisation of corpus callosum
Confusion, seizures, dementia

9. Alcohol and nervous system
Alcoholic degeneration of cerebellum-- cerebellar atrophy
Alcoholic polyneuropathy
Alcoholic myopathy
Acute necrotisans myopathy
Chronic myopathy

10. Diabetes mellitus Hypoglycemia General signs, headache
Neurological signs – seizures, coma, acute hemiparesis

11. DM Repeating hypoglycaemia:
loss of intelect, cognitive disturbances, dementia
Hyperglycemia
Metabolic encefalopathy
DM – higher risk of stroke

12. Diabetic polyneuropathy
After 5-10 years of dibatis diseases course
10% - earlier than DM
Pathogenesis – metabolic changes and ischemic changes of vasa nervorum (hyalinisation of the wall of vesels)
Metabolic – earlier problems with sensitivity, myelin fibers are resistant agains ischemia

13. Diabetic polyneuropathy
Symmetric, mainly distal
Lower extremities – more often
Loss of proprioception, ataxia
Neuropatic pain

14. Systemic lupus erythematodes
General, skin , heart, pulmonary, renal symptoms, myalgie
Neurological– 25-75%, 3% - the first
Headache, depression, confussion, halucinations, hemiparesis, transversal spinal cord lesions, mononeuritis, polyneuritis, polymyositis, brain infarctions
Stroke- brain infarctions
Lab tests: Lupoid-like anticoagulans antiphospholipid antibodies CSF – pleocytosis
EEG – diffuse abnormalities, MRI – multiple subcortical white matter lesions