PC2Neuro

Bell’s Palsy

• Temporary condition causing weakness or paralysis on one side of the face
• Occurs when the facial nerve (cranial nerve VII) becomes inflamed or damaged
• Exact cause is unknown, but believed to involve inflammation of the facial nerve
• Triggers may include viral infections like herpes simplex or Epstein-Barr, and bacterial infections like Lyme disease, trauma, diabetes and sarcoidosis
• Symptoms include one-sided weakness or paralysis, drooping eyelid/eyebrow/mouth, difficulty closing the eye, loss of expression, pain, chewing/speaking issues, and drooling
• Diagnosis involves physical and medical history review, along with nerve and muscle function assessments
• Most cases resolve in weeks to months
• Treatments include steroids for inflammation, antivirals for viral infections, and eye drops for dryness
• Facial exercises assist in regaining muscle function
• Most patients fully recover within six months, though permanent weakness or complications can occur

Encephalitis

• Inflammation of the brain tissue
• Most commonly caused by viral infections like Herpes Simplex (HSV-1 and HSV-2), Varicella-zoster (VZV), West Nile (WNV), Japanese encephalitis (JEV), and Rabies
• Bacterial/fungal infections, autoimmune disorders (ex: Anti-NMDA receptor encephalitis), parasitic infections, toxins, and post-infectious syndromes are other causes
• Early symptoms include fever, headache, fatigue, and muscle aches
• Neurological symptoms include confusion, seizures, language difficulty, hallucinations and loss of consciousness
• Other symptoms include light sensitivity, stiff neck, and nausea
• Requires emergency care and hospitalization for monitoring
• Treatments involve IV fluids, anti-inflammatories, antivirals/antibiotics/antifungals, corticosteroids and immunoglobulin, or plasmapheresis for autoimmune
• Anti-seizure medications like acetaminophen or NSAIDs can offer symptomatic relief
• Rehabilitation includes physical, occupational, and speech therapy

Vertigo

• Sensation of spinning where surroundings feel like they are moving
• Can be caused by inner ear problems like BPPV or Meniere's disease, brain disorders like stroke/MS/migraines, head injuries, medications like antibiotics or anticonvulsants, or alcohol/caffeine
• Symptoms include spinning sensation, dizziness, nausea/vomiting, balance problems and nystagmus (rapid, involuntary eye movements)
• Diagnosis involves a physical exam, hearing/eye tests, and potentially MRI/CT scans
• Treatment depends on the cause and may include anti-nausea drugs, antihistamines, anticholinergics, physical therapy, or surgery
• Prevention strategies include avoiding sudden movements, limiting alcohol/caffeine, exercising regularly, and managing stress

Concussion

• A mild traumatic brain injury caused by a bump/blow to the head or body
• Can result in temporary brain dysfunction
• Symptoms include headaches, dizziness, nausea, balance issues, and concentration/memory difficulties
• Most people recover fully, allowing the brain time to heal is essential
• Seek immediate medical attention if symptoms worsen or include loss of consciousness, persistent headaches, or seizures

Guillain-Barré Syndrome (GBS)

• Rare autoimmune disorder affecting the peripheral nervous system
• Often triggered by bacterial or viral infections, such as Campylobacter jejuni or Epstein-Barr; can occur post-vaccination
• The immune system attacks the myelin sheath, leading to nerve inflammation, muscle weakness, numbness, and paralysis
• GBS develops 2-4 weeks post-infection, symptoms include muscle weakness starting in legs, numbness/tingling, walking difficulty, reflex loss, muscle pain, and breathing issues
• Diagnosis through clinical symptoms, physical exams, nerve studies, spinal tap, and blood tests Treatments include intravenous immunoglobulin (IVIg), plasmapheresis, physical therapy, and respiratory support
• Recovery can take months to years, with 5-10% experiencing permanent nerve damage

Stroke (Cerebrovascular Accident - CVA)

• Loss of blood flow to the brain that causes brain cell death, leading to brain damage, disability, or death
• Call 911 if a stroke is suspected for immediate treatment
• Ischemic stroke is caused by a blood clot blocking a brain vessel, accounting for 80% of strokes
• Hemorrhagic stroke is caused by a brain vessel that ruptures and bleeds
• Transient ischemic attacks (TIAs) are "mini-strokes" due to temporary blockage with no permanent damage, but indicate a higher risk of future stroke
• Stroke risk factors include high blood pressure, diabetes, heart disease, smoking, family history, age, race, alcohol/drug use, inactivity, high cholesterol, unhealthy diet, and obesity
• Stroke symptoms appear quickly and include numbness/weakness (especially on one side), confusion, speech/vision trouble, dizziness, and severe headache
• Diagnosis involves symptom review, medical history and physical exam, and diagnostic/heart imaging tests
• Acute treatment aims to stop the stroke using medicines like tPA to dissolve clots, blood thinners, or surgery to open blocked carotid arteries
• Hemorrhagic stroke treatments focus on stopping bleeding using blood pressure medicines or aneurysm repair surgeries
• Stroke rehabilitation helps regain lost skills, and prevention via lifestyle changes and medicines reduces future stroke risk

Botulism

• Clostridium botulinum produces botulinum toxins in low-oxygen conditions
• Botulinum toxins are lethal substances that block nerve function and lead to muscular and respiratory paralysis
• Types of human botulism include foodborne, infant, wound, and inhalation
• Foodborne botulism,rare but fatal if untreated, from improperly processed food
• Homemade canned or fermented foods carry extra caution
• Clostridium botulinum spores are heat-resistant and germinate, grow, and excrete toxins without oxygen
• Seven toxin types (A-G) exist; A, B, E, and rarely F cause human botulism; and C, D, and E cause illness in other mammals, birds, and fish
• Botulinum toxins are ingested through improperly processed foods in which the bacteria survive
• Symptoms include descending paralysis, fatigue, vertigo, blurred vision, dry mouth, difficulty swallowing/speaking, diarrhea, constipation, and no fever/loss of consciousness
• Symptoms appear within 12-36 hours post-exposure, and it has a 5-10% fatality rate if untreated
• C. botulinum , grows and produces toxins in the absence of oxygen Spores exist widely in soil, river and sea water
• Toxin formation occurs with low oxygen, specific temperatures and preservatives, common in inadequately processed foods
• The bacterium will not grow in conditions with a pH of less than 4.6
• The toxin is destroyed by boiling at >85°C for >5 minutes
• Food samples should be obtained immediately and sent to labs for testing
• Infant botulism affects infants where spores germinate in their gut and produce toxins due to lack of intestinal defenses
• Symptoms in infants include constipation, loss of appetite/head control, weakness, and altered cry
• Infant botulism has been linked to spore-contaminated honey, and honey is not recommended until 1 year old
• Wound botulism occurs when spores enter a wound and reproduce in an anaerobic environment, often from black tar heroin
• Inhalation botulism is rare and caused by intentional/accidental release of aerosolized toxins
• Median lethal dose is 2 nanograms/kg of body weight for humans
• Waterborne botulism is possible thru ingestion of pre-formed toxin only
• C. botulinum can be found in Botox
• Diagnosis involves clinical history, examination, and laboratory confirmation by detecting botulinum toxin in serum/stool/food
• Treatment involves immediate antitoxin and supportive care and rarely requires antibiotics
• Prevention is based on good food preparation, heating/sterilization, and hygiene
• WHO’s Five Keys to Safer Food are a basis for educational programs for food handlers

Transient Ischemic Attack (TIA)

• Often referred to as a "mini-stroke," is a temporary interruption of blood flow to the brain
• Causes neurological symptoms that resolve in 24 hours
• TIAs are usually caused by blood clots(thrombosis), artherosclerosis, or emboli
• Symptoms may include sudden numbness or weakness, confusion or difficulty speaking, trouble seeing or dizziness, and headache
• Diagnosis involves physical exam, history, and imaging like CT scans/MRIs
• An ECG and ultrasound of the main arteries supplying blood to the brain can be carried out
• Treatment prevent future strokes via medication, lifestyle changes (like quitting smoking), or surgery to remove blockages

Radiculopathy

• Nerve roots that branch out from the spinal cord become compressed or irritated
• Causes pain, numbness, tingling, weakness, and other symptoms along the affected nerve pathway
• Common causes include herniated discs, spinal stenosis, bone spurs, tumors, and injuries
• Symptoms can vary
• A doctor conducts a physical exam and reviews medical history to diagnose radiculopathy
• Types include Cervical Affects the nerves in the neck, Lumbar Affects the nerves in the lower back and Thoracic Affects the nerves in the middle back
• Treatment for radiculopathy depends on underlying cause and symptom severity
• Injections, physical therapy and medications can be provided
• Surgery is an option in severe cases

Migraine Headache

• Severe, throbbing, or pulsating headache typically occurring on one side of the head
• Believed to be related to abnormal brain activity and changes in blood flow
• Stress, hormonal changes, sleep deprivation, lights/noises/smells and certain foods can trigger these headaches
• Symptoms include throbbing pain on one side of the head, nausea/vomiting, light/sound/ smell sensitivity, auras, fatigue, and dizziness
• Types include migraine w/ or w/o aura, and chronic migraines that occur on >15 days a month
• Physical and neurological exams may be conducted

Acute Confusion or Delirium

• A sudden change in mental function characterized by confusion, altered awareness, and difficulty focusing
• Delirium is a syndrome resulting from an underlying cause and can develop rapidly and fluctuate throughout the day
• It is characterized with disturbed consciousness, impaired cognition, fluctuating course, and behavioral changes
• Can be triggered by medical conditions, medications, substance use, underlying illnesses, older adults, and dementia
• Symptoms include confusion, disorientation, changes in alertness/behavior, hallucinations, distractibility, and rambling speech
• Diagnosis done via clinical assessment and screening tools

Cluster Headache

• Headache due to the headache condition itself
• One of the most painful conditions
• Usually occurs between the ages of 30-40
• The patient will experience excruciating head pain on one side of the head
• Cluster headache will often feature a headache described as ‘boring’, burning or piercing
• The patient may also experience red eyes, or a runny nose
• Attacks may last from 15 minutes to 3 hours
• Patterns of attacks will last for weeks and months at a time
• Cluster headache has no cure
• Acute treatment is provided to stop an attack as it’s happening
• A 6mg shot of sumatriptan can help after 15 minutes
• Verapamil is a treatment for choice for cluster headache
• Other drugs include lithium, melatonin and sphenopalatine Stimulation
• Often associated with smokers

Subarachnoid Hemorrhage

• A bleeding into the space between the brain and the arachnoid membrane (one of the protective layers)
• Causes include Ruptured brain aneurysm (most common), traumatic brain injuries, arteriovenous malformation, and high blood pressure
• Symptoms include: Severe headache, nausea, stiff neck, sensitivity to light, confusion, loss of consciousness, and possible seizures
• A CT or MRI scan can be carried out for diagnosis
• Treatment includes: Surgical intervention, medications and rehabilitation
• Can follow with long term neurological deficits
• Described as “Worst head ache of my life”

Tension Headache

• Headache due to contractions in the head and neck in response to stress, anxiety, poor posture, and caffeine withdrawal.
• The patient with experience tightening of pain in the neck that includes muscle knots
• Over the counter medication can be taken
• Other treatments include; Massage/hot or cold medication
• Avoid caffeine and stay active
• See a doctors to check for any eye strain

Intracranial Hemorrhage

• Bleeding occurring inside the skull, placing pressure on the brain
• Types: Subarachnoid (in the Subarachnoid space), and within the brain tissue: Intracerebral, Subdural or Epidural and Intraventricular
• Caused by trauma or aneurysms
• Can result in Seizures, severe headaches or nausea
• Treatment includes: Medication or fluids, lowering pressure on the brain or surgery to remove clot

Seizures

• Disturbance in the electrical system of the brain
• Results in loss of consciousness
• Caused by Brain Injury, Stroke or tumor and infections
• Types:Generalized, tonic-clonic and Absence
• Symptoms: Sudden loss of consciousness, confusion, chomping, foam around mouth
• If a person has a seizure gently law them down in a side position
• Contact emergency health services

Meningitis

• Inflammation of the protective membranes covering the brain or the spinal cord
• Can be bacterial or viral
• Types: Bacterial, viral, fungal and Parastic
• Classic Triad:
  • Fever
  • Headache -Neck stiffness
• Other Symptons: Sensitive to sunlight
• ManACWy vaccine protectant against serogroups A, C, W, and Y
• Recommend for: Adolescents, high risk groups and areas
• MENB: Protects against Neisseria meningitis serogroup B. For Adolescents and young adults (16-23 years, especially 16-18)High-risk populations

Trigeminal Neuralgia

• Sudden, sever,, electric- shock
• Triggers: Chewing, speaking tooth brushing and light touch
• Attacks can last seconds to 2 minutes
• Treatment: Anti convulsants and muscle relaxes
• The anticonvulsant Carbamazepine as a first-line of treatment