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Chapter 15

Chapter 15. Nervous System Diseases and Disorders. Anatomy and Physiology. Nervous system Brain, spinal cord, and nerves Central nervous system (CNS) Brain Spinal cord Peripheral nervous system (PNS) Autonomic nervous system Cranial and spinal nerves. Common Signs and Symptoms.

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Chapter 15

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  1. Chapter 15 Nervous System Diseases and Disorders

  2. Anatomy and Physiology Nervous system Brain, spinal cord, and nerves Central nervous system (CNS) Brain Spinal cord Peripheral nervous system (PNS) Autonomic nervous system Cranial and spinal nerves

  3. Common Signs and Symptoms Headache Nausea and vomiting Weakness Mood swings Fever

  4. Common Signs and Symptoms Symptoms specific to CNS: Stiffness in neck, back, or extremities Inability to move any part of body Seizures or convulsions Paralysis Visual difficulties

  5. Common Signs and Symptoms Symptoms specific to CNS: (continued) Inability to speak Paralysis Extreme or prolonged drowsiness Stupor, unconsciousnes Amnesia or extreme forgetfulness

  6. Diagnostic Tests Cerebrospinal fluid Measurement of intracranial pressure X-rays of skull and vertebral column Myelogram Angiogram Electroencephalography (EEG) CT and MRI

  7. Infectious Diseases Encephalitis Inflammation of brain tissue caused by bacteria and viruses Symptoms: Headache Elevated temperature Stiff neck and back Lethargy Mental confusion Coma Treatment: Treatment is supportive Antiviral medication may be effective

  8. Infectious Diseases Meningitis Inflammation of meninges or coverings of brain and spinal cord Causes: Bacteria Virus Fungi Toxins E.g., lead, arsenic

  9. Infectious Diseases Meningitis Symptoms: High fever Severe headaches Photophobia Stiffness and resistance in neck (nuchal rigidity) Drowsiness, stupor, seizures Coma

  10. Infectious Diseases Meningitis Diagnosis Lumbar puncture to find causative agent Treatment Antibiotics for bacterial infection Antipyretics Anticonvulsants Quiet, dark environment

  11. Infectious Diseases Poliomyelitis Viral infection affecting brain and spinal cord Cause: Virus spread by oropharyngeal secretions and infected feces Almost eliminated by vaccine in United States

  12. Infectious Diseases Poliomyelitis Symptoms: Muscle weakness Neck stiffness Nausea and vomiting Muscles atrophy and become paralyzed Diagnosis Virus culture from throat, feces, and/or spinal fluid

  13. Infectious Diseases Poliomyelitis Supportive treatment: Analgesics Bedrest during acute phase Long-term physical therapy and braces may be needed If respiratory system involved, mechanical ventilation may be needed

  14. Infectious Diseases Tetanus Highly fatal infection of nerve tissue Cause Bacteria Clostridium tetani First symptom: Jaw stiffness Commonly called lockjaw

  15. Infectious Diseases Rabies An often fatal encephalomyelitis Caused by virus Primarily affects animals E.g., dogs, cats, raccoons, squirrels Transmitted to humans through bite of infected animal

  16. Infectious Diseases Rabies Symptoms: Fever Pain Paralysis Convulsions Rage Spasms and paralysis of muscles for swallowing Throat spasms leading to hydrophobia

  17. Infectious Diseases Rabies Symptoms: Inability to swallow Drooling of frothy saliva Treatment: Immediate washing of area with soap and water Anti-rabies injections No cure

  18. Infectious Diseases Shingles Viral disease caused by herpes zoster (chicken pox virus) Symptoms Itchy, painful, red rash and small vesicles on sensory nerve paths Symptoms last 10 days to several weeks Diagnosis Made based on the appearance of lesions Viral culture test

  19. Shingles Photo courtesy Robert A. Silverman, MD, Pediatric Dermatology, Georgetown University

  20. Infectious Diseases Shingles Treatment: There is no cure Treatment is symptomatic Antivirals Analgesics Antipyretics Antipruritics Vaccine recommended by CDC for adults over age 60

  21. Vascular Disorders Cerebrovascular accident (CVA) Also known as stroke Is due to a poor blood supply to the brain Causes Cerebral thrombus Cerebral embolism Cerebral hemorrhage

  22. Vascular Disorders CVA Symptoms: numerous symptoms depending on the area of the brain affected and the severity of the CVA Sudden loss of consciousness Confusion Poor coordination Dysphasia Dysphagia Hemiparesis

  23. Vascular Disorders CVA Diagnosis Physical exam, EEG, CT scan, and MRI Treatment: Anticoagulant Hypertensive medications Rehabilitation program

  24. Vascular Disorders CVA Risk factors: Smoking High-fat diet Obesity Lack of exercise Surgical prevention treatment: Carotid endarterectomy

  25. Vascular Disorders Transient ischemic attacks (TIAs) Also known as mini-strokes Due to insufficient blood supply to brain Symptoms: Weakness of arm and/or leg Dizziness Slurred speech Mild loss of consciousness

  26. Vascular Disorders TIAs Symptoms last few minutes to 1 hour Diagnosis by angiogram Treatment: Surgery to improve blood flow

  27. Functional Disorders Degenerative disk disease Headaches Epilepsy Bell’s palsy Parkinson’s disease

  28. Functional Disorders Degenerative disk disease Degeneration or wearing away of intervertebral disk Allows vertebrae to bump or rub against each other Symptoms: Difficulty walking Radiating pain in back and in one or both legs Diagnosis by X-ray, myelogram, CT scan, and MRI

  29. Functional Disorders Degenerative disk disease Treatment: Rest back and legs Back brace Analgesics Anti-inflammatories Exercise to ease pain Surgery

  30. Functional Disorders Headaches One of the most common disorders in humans Usually a symptom of another disease rather than a disorder in and of itself Disorders that typically have headaches as a symptom include: Sinusitis Meningitis Encephalitis Hypertension Anemia Constipation Premenstrual tension Tumors

  31. Functional Disorders Headaches Caused by two mechanisms: Tension on facial, neck, and scalp muscles Vascular changes in arterial size of vessels inside head Contributing factors: Stress Toxic fumes Noise Lack of sleep Alcohol consumption

  32. Functional Disorders Headaches Headaches may be acute or chronic Pain may be mild to unbearable and incapacitating Pain may be constant, pressure, throbbing, stabbing, or intermittent Types: Tension Cluster Following lumbar puncture Migraine

  33. Functional Disorders Headaches Diagnosis: History and physical, X-ray, EEG, MRI, and CT Treatment: Lifestyle changes – improved diet, sleep, exercise Analgesics Bedrest Muscle massage Muscle relaxants Warm baths Biofeedback

  34. Functional Disorders Epilepsy Chronic disease of brain Intermittent episodes of abnormal electrical activity in brain Symptoms: Seizure Convulsions

  35. Functional Disorders Epilepsy Common types of seizures Petit mal Grand mal Status epilepticus Diagnosis by EEG, CT scan, cerebral angiogram, and blood tests Treatment: Anticonvulsive medications Close monitoring and adjusting of medication

  36. Functional Disorders Bell’s palsy Affects facial nerve (7th cranial) leading to unilateral (one-sided) paralysis Affects individuals 20 to 60 years of age Symptoms: Drooping weakness of eye and mouth Inability to close the affected eye Drooling of saliva

  37. Functional Disorders Bell’s palsy Symptoms: (continued) Unable to whistle or smile Distorted facial appearance Diagnosis by history and symptoms Treatment: Analgesics Anti-inflammatories

  38. Functional Disorders Parkinson’s disease Slow, progressive brain degeneration Cause is unknown, but may be related to a decrease of brain neurotransmitter – dopamine Symptoms: Rigidity and immobility of hand Very slow speech pattern Pill-rolling motion of fingers Expressionless facial appearance

  39. Functional Disorders Parkinson’s disease Symptoms: (continued) Abnormal bent-forward posture Short, fast-running steps with shuffling appearance Symptomatic treatment: Dopamine replacement Physical and psychological therapy

  40. Dementias Loss of mental ability due to loss of neurons or brain cells Types of dementia Senile (old age) Alzheimer’s disease – the most common type of senile dementia Senile and Alzheimer’s disease are often used synonymously, but they are not the same. Vascular Head trauma Substance induced

  41. Dementias Alzheimer’s disease A form of senile dementia Usually affects individuals age 70 and older Early symptoms: Short-term memory loss Inability to concentrate Slight changes in personality

  42. Dementias Alzheimer’s disease Symptoms of disease progression: Diminished communication skills Meaningless words Inability to form sentences Increased forgetfulness Irritability and agitation

  43. Dementias Alzheimer’s disease Diagnosis Positive only by autopsy Initially, diagnosis may be made by ruling out other brain diseases Treatment Supportive, no known cure Focused on safety, maintaining nutrition, hydration, personal hygiene Emotional support for family and caregivers

  44. Dementias Vascular dementia Atrophy and death of brain cells due to decreased blood flow Atherosclerotic plaque can cause decreased blood flow Common with aging

  45. Dementias Vascular dementia Symptoms: Changes in memory, personality, and judgment Irritability Depression Sleeplessness Lack of personal hygiene

  46. Dementias Vascular dementia Diagnosis: History and physical, blood flow testing Treatment: Increasing blood flow to brain Carotid endarterectomy

  47. Dementias Head trauma dementia Death of brain cells due to head trauma Symptoms: Decrease in mental intellect and cognitive function Loss of ability to reason, remember, or show appropriate emotions Changes in personality

  48. Dementias Head trauma dementia Diagnosis: History, cranial X-rays, CT scan, and MRI Treatment: Correct damage, if possible Therapy and rehabilitation Prevention: Is often easy to prevent with proper use of protective equipment

  49. Dementias Substance-induced dementia Brain cell death from drug toxicity and toxins Toxic substances include: Alcohol Cocaine Heroine Lead Mercury Paint fumes and thinner Insecticides Symptoms: Mental impairment Decreased cognitive ability

  50. Sleep Disorders Insomnia The most common form of sleep disorder Inability to fall or stay asleep Cause: Stress, pain, fear, depression, caffeine, alcohol, nicotine, and bronchodilators Treatment: Identifying and removing cause

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