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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 – – – – – 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 – – – – – 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