Neurologiy - Overview

Blackouts/Syncope

• Temporary loss of consciousness or near-fainting spells.
• Vasovagal episodes (fear, heat, low blood sugar), carotid sinus hypersensitivity, and cough or "wee" syncope can cause blackouts.
• Treatment involves lying the patient flat, raising legs, ensuring an open airway, and identifying triggers like fear or dehydration.
• Prevention involves avoiding known triggers and maintaining adequate hydration and food intake.

Epilepsy

• Characterized by recurrent seizures, such as tonic-clonic, absence, or focal seizures.
• Abnormal brain electrical activity can be idiopathic or secondary to head injury.
• Antiepileptic drugs like carbamazepine and valproate can treat epilepsy.
• IV benzodiazepines can be used in emergencies like status epilepticus.
• Prevention focuses on medication adherence and avoiding known triggers.

Stroke/TIA

• Stroke involves disruption of blood supply to the brain, potentially causing permanent deficits, while TIA resolves quickly.
• Thrombosis, embolism, or hemorrhage can cause Stroke/TIA.
• Treatment includes antiplatelets like aspirin, thrombolysis for ischemic stroke, and managing BP/cholesterol.
• Prevention includes lifestyle changes (no smoking and managing BP) and aspirin or anticoagulants if indicated.

Multiple Sclerosis (MS)

• MS involves demyelination in the central nervous system, leading to vision problems and motor/sensory deficits.
• Autoimmune factors triggered by environmental or genetic factors likely causes MS.
• Disease-modifying drugs (interferons), steroids for relapses, and supportive therapy can treat MS.
• Early treatment reduces progression, but MS is not clearly preventable.

Parkinson’s Disease

• A degenerative disease characterized by tremor, rigidity, and bradykinesia resulting from dopamine deficiency.
• Loss of dopaminergic neurons in the substantia nigra, possibly due to genetic or environmental triggers causes Parkinson's.
• Levodopa, dopamine agonists, MAO-B inhibitors, and deep brain stimulation can treat Parkinson's.
• A healthy lifestyle may lower the risk, but there is no confirmed prevention.

Motor Neurone Disease (MND)

• Progressive degeneration of motor neurons (UMN/LMN) causes muscle weakness and eventually respiratory failure.
• The causes are mostly unknown, but some are genetic.
• Supportive care (PEG feeding, respiratory support) and riluzole can prolong life slightly.
• No known prevention methods.

Cranial Nerve Problems

• Deficits in nerves control facial sensation/movement, swallowing, and eye movements.
• Trauma, tumors, infections, demyelination (e.g., trigeminal neuralgia in MS), and stroke can cause cranial nerve problems.
• Treatment manages the underlying cause with surgery, medication, and supportive therapy.
• Prevention depends on the cause, such as avoiding trauma and managing risk factors for stroke.

Stokes-Adams Attacks

• Sudden syncope results from transient cardiac arrhythmias.
• Complete heart block or significant bradycardia causes Stokes-Adams attacks.
• Treatment involves a pacemaker if severe.
• Prevention requires cardiac monitoring and treating the underlying arrhythmia.

Febrile Convulsions

• Seizures in young children triggered by fever.
• A rapid rise in temperature causes Febrile convulsions.
• Cooling measures (tepid sponging, paracetamol) is usually self-limiting.
• Prompt fever management in susceptible children help prevent Febrile convulsions.

Myasthenia Gravis (MG)

• An autoimmune disease that reduces the functioning of acetylcholine receptors and causes muscle weakness.
• Antibody-mediated destruction of ACh receptors.
• Acetylcholinesterase inhibitors (e.g., pyridostigmine), immunosuppressants, and thymectomy in some cases can treat MG.
• Early diagnosis helps manage symptoms.

Eaton-Lambert Syndrome

• A paraneoplastic disorder (often small cell lung cancer) causes muscle weakness that improves with repeated use.
• Antibodies affect presynaptic calcium channels.
• Treatment involves treating the underlying malignancy and immunomodulatory therapy.
• Reducing cancer risk by stopping smoking prevents Eaton-Lambert Syndrome.

Tumours (Brain Tumours)

• Benign or malignant growth in the cranial vault can raise intracranial pressure and cause neurological deficits.
• Primary brain tumors or metastases (from lung, breast, GI, kidney) can cause brain tumors.
• Treatment involves surgery, radiotherapy, chemotherapy, and managing raised intracranial pressure.
• Not typically preventable, but early detection is important if symptomatic.

Meningitis

• Inflammation of meninges (bacterial or viral).
• Bacterial (e.g., meningococci) or viral infiltration of CNS can cause meningitis.
• Treatment involves urgent antibiotics for bacterial infections and supportive care for viral infections.
• Vaccination (meningococcal, pneumococcal) and prompt treatment of infections can prevent Meningitis.

Brain Abscess

• A localized collection of pus in brain tissue.
• Spread from oral sepsis, otitis media, sinusitis, or haematogenous route.
• Treatment involves surgical drainage, high-dose antibiotics, and treating the source of infection.
• Adequate dental care and early treatment of ENT infections can prevent Brain Abscesses.

Cerebral Palsy

• A non-progressive motor function disorder that results from cerebral damage around birth.
• Birth injury and perinatal hypoxia cause Cerebral Palsy.
• Treatment includes physiotherapy, supportive measures, and orthopedic interventions.
• Quality antenatal/perinatal care to reduce hypoxic events can prevent Cerebral Palsy.

Spina Bifida

• A congenital defect where vertebral arches don’t fuse, potentially causing neurological deficits.
• Possible low folic acid in pregnancy.
• Treatment involves surgical correction and supportive therapies for mobility/hydrocephalus.
• Folic acid supplementation pre-conception & early pregnancy.

Huntington’s Disease

• An autosomal dominant neurodegeneration characterized by choreiform movements, psychiatric changes, and dementia.
• Inherited trinucleotide (CAG) repeat in the HTT gene.
• Symptomatic treatment (e.g., tetrabenazine for chorea) and supportive therapy.
• Genetic counseling for at-risk families is recommended.

Drugs/Treatments/Tests

• Levodopa (L-dopa): Replenishes dopamine levels in Parkinson’s by crossing the blood-brain barrier and converting to dopamine.
• Dopamine Agonists (e.g., Bromocriptine): Stimulate dopamine receptors in Parkinson’s.
• Selegiline (MAO-B inhibitor): Slows dopamine breakdown in Parkinson’s.
• Riluzole: Modestly prolongs survival in MND.
• Antiepileptics (e.g., Carbamazepine, Valproate): Stabilize neuronal membranes to reduce seizure frequency.
• Benzodiazepines (e.g., Diazepam IV): Emergency seizure control in status epilepticus.
• Antiplatelet (Aspirin): Prevents platelet aggregation; used post-TIA/stroke prophylaxis.
• Anticoagulants (e.g., Warfarin): Prevent stroke in atrial fibrillation.
• Thrombolysis (tPA): Dissolves clots in ischemic stroke (time-critical).
• Steroids (High-dose): Reduce inflammation in MS relapses and also for certain CNS infections/tumors swelling.
• Acetylcholinesterase Inhibitors (e.g., Pyridostigmine): Improves neuromuscular transmission in MG.
• Antibiotics: Used for Meningitis, brain abscess, and impetigo.
• Immunosuppressants: Used for MS and Myasthenia Gravis.
• Deep Brain Stimulation (DBS): A surgical implant for Parkinson’s refractory to medication.
• MRI/SPECT/DaT Scan: Imaging techniques for Parkinson’s diagnosis or tumor detection.
• Carotid Surgery: Removes plaque to prevent stroke/TIA.
• PEG Feeding/Tracheostomy: Supportive measures in advanced MND or severe neuromuscular conditions.

Overview of neurological issues, including epilepsy, stroke and syncope. Includes symptoms, treatments, and preventative measures.