Thursday, November 05, 2009

Brain Damage, Neurodegeneration and Dementia, Oh My!

Week 8?/Chapter 8 (plus Dementia Max PowerPoint slides)

Non-cortical (sub-cortical?) conditions:
A lot of these are predominantly movement/motor disorders with or without cognitive impairment. ALS (Lou Gherig's Disease) is exclusively motor and is not discussed here.

Multiple sclerosis (MS) - demyelinating disease (auto-immune disorder?)
  • wide ranges of symptoms depending on central (including cortex) or peripheral
  • relapsing-remitting or chronic progressive form; even CP form can begin as RR
  • variable signs & symptoms as well as clinical course
  • limb weakness, ataxia, sensory loss, etc.
Parkinson's Disease:
Parkinson (1817) described the syndome, also known as "paralysis agitans". Destruction of substantia nigra of the basal ganglia and presence of Lewy bodies; subcortical/nonvoluntary motor control, smoothing. Parkisonism is similar signs & symptoms but from another cause.
  • Parkinson's shuffle - stooped, small steps, straight-lines, etc.
  • slow, including speech (and hyphonic)
  • rigid, cogwheeling, TREMO at rest
  • cognition? depends, at the very least, it is also slowed
  • responds to dopamine therapy (l-dopa)
Huntington's Disease/Chorea:
writhing, genetic. More rare. Basal ganglia also, but striatum. Personality and cognitive changes.

Profound brain injury, coma, locked in syndrome.

DEMENTIA?

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