Transcript Slide 1

Chapter Fifteen
Neurological Disorders
CHAPTER 15
NEUROLOGICAL DISORDERS
Brain Damage
• Stroke
– Brain’s blood supply is interrupted by either bleeding or
sudden blockage
• Cerebral hemorrhage
• Ischemia
– Excitotoxicity
Figure 15.2 The Brain’s Blood Supply
Figure 15.3 Brain Infarct
Brain Damage
• Head Injury
– Traumatic Brain Injuries (TBI)
• Open head injuries
• Concussions
– Coup and countercoup
– Post concussion syndrome – lack of concentration, reduction in processing
speed, deficits in higher-order cognitive functions
– Chronic Traumatic Brain Injuries (CTBI)
• Dementia pugilistica (Boxer’s syndrome)
Figure 15.4 Coup and Countercoup
Figure 15.5 Boxers Risk Repeated Head Injuries
Brain Damage
• Brain Tumors
– Majority arise in glial cells and the cells of the meninges
– Symptoms of Tumors
• Pressure in the skull
• Specific disruptions related to location
– Types of Tumors
• Gliomas and meningiomas
• Grades I to IV
– Treatment for Tumors
• Surgical removal
• Chemotherapy
• Thalidomide to starve tumors
Figure 15.6 A Meningioma
Brain Damage
• Seizures and epilepsy
– Uncontrolled electrical disturbances in the brain correlated
with changes in consciousness
– Types of Seizures
• Partial seizures
– Simple
– Complex
• Generalized seizures
– Grand mal
– Petit mal seizures
• Treatment for Epilepsy
• Antiepileptic drugs, surgery, ketogenic diet in children
Figure 15.7 Pathways for the Spread of Partial
and Generalized Seizures
Figure 15.8 EEG Recordings During Generalized
Seizures
Multiple Sclerosis
• Autoimmune condition – immune system
attaches the central nervous system
– Demyelination of axons
– Affects white matter in different locations
– Modest heritability and environmental factors
Figure 15.9 Multiple Sclerosis Damages Myelin
Brain Infections
• Parasites
– Neurocysticercosis – pork tape worm
– Treatment - seizure control
• Bacterial, Viral, and Fungal Infections
– Encephalitis – inflammation of brain after viral infection
– Meningitis – inflammation of membranes that cover and
protect the brain and nervous system
– AIDS Dementia Complex
• Collection of neurological symptoms that result fro HIV virus or
opportunistic infections
Figure 15.10 Complicated Neurocysticercosis
Involves Multiple Infections in the Brain
Figure 15.11 HIV Viral Particles Bud from an
Infected Cell
Brain Infections
• Transmissible Spongiform Encephalopathies
– A group that includes bovine spongiform encephalopathy
(BSE) or mad-cow disease
• Produce psychological disturbances and progressive loss of
cognitive functions, motor disturbances, and finally death
– The TSE Mystery
• Creutzfeldt-Jakob disease (CJD) human form of TSE
• Kuru in New Guinea provided evidence of transmission
– Prions and TSEs
• Role of abnormal form of prion protein
– BSE and New Variant Creutzfeldt-Jakob Disease
• New variant emerged in humans
Figure 15.12 Bovine Spongiform Encephalopathy
Figure 15.15 Prion Proteins Have Normal and
Abnormal Forms
Figure 15.16 Time Course of the BSE Epidemic in
the United Kingdom
Figure 15.17 Classic Creutzfeldt-Jakob Disease
Shows Different Age Prevalence than New
Variant
Migraine
• Symptoms of excruciating head pain, nausea,
and vomiting for 4-72 hours
• Migraine generator located in brainstem
• Treatments
– Triptans
– Behavioral adjustments
Figure 15.18 Migraine Aura
Assessment of Neurological Disorders
• Patient’s health history
• Physical examination
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Sensory systems
Touch sensitivity
Movement
Spinal reflexes
Tests such as Halstead-Reitan battery
Recovery from Damage
• Kennard Principle
– Young brains reorganize after damage more efficiently
than adult brains
• Subsequent research suggest a more complex
relationship between developmental stage
and recovery
Therapy for Brain Damage
• Rehabilitation
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Improving cognitive, emotional, and physical processes
Constraint therapy
“Mental muscle” approach
“Specific tasks” approach
Virtual reality (VR) therapy
• Pharmacological Therapies
• Neural Tissue Transplants
– Fetal cell transplants and stem cells