1. 1 Anatomy Review Central Nervous System Peripheral Nervous System Meninges Blood Brain Barrier

2. 2 Bacterial Meningitis 1. Neisseria meningitidis –15% mortality due to Rx delays –Infants, young adults –Fatigue, overcrowding –Death due to ___________ shock –Treatment: –Vaccine does not cover all strains 2. Hemophilus influenzae –Commonest cause of meningitis prior to vaccine development –H. influenzae type B (Hib) –30-50% carrier rate in children –Fatal without treatment Seizures, mental retardation common in survivors Largest cause of mental retardation in U.S.A. and world-wide

3. 3 Meningitis (cont.) 3. Streptococcus pneumoniae –Commonest adult cause of bacterial meningitis –Spreads from other sites –40% mortality rate Viral Meningitis –Self limiting, non-fatal –Enterovirus and mumps virus most common

4. 4 Rabies _______________ inclusions seen in brain Re-emerging in U.S.A. with ______ as carriers Fatal encephalitis 20-60 day incubation Virus travels to CNS slowly and replicates slowly Agitation, confusion, hallucinations Death within days of ______ symptoms _______________ seen as throat muscles are infected and spasm Vaccination can be used to “cure”

5. 5 Bacterial Nerve Diseases Tetanus ____________________ Anaerobic, endospore former Found in soil, manure Vaccine is available (10 yr) ___________ wounds _____________ paralysis, respiratory failure Antitoxin and antibiotics for treatment Botulism _______________ ___________ paralysis, respiratory failure Botulotoxin in contaminated canned goods (honey fed to infants) Wounds may rarely be infected Antitoxin (Ab) will neutralize preformed toxin

6. 6 Viral Nerve Diseases — Poliomyelitis Poliovirus (____________) –Affinity for CNS motor neurons –Fever, back pain, muscle spasms –Young/old may suffer permanent paralysis –Virus is excreted in human feces, problem in developing nations –Vaccines are available –Eradication target year – soon!