Chronic And Infectious Neurological Emergencies Blended

Chronic And Infectious Causes of Neurological Emergencies

• Neurological emergencies can stem from various chronic and infectious causes, necessitating prompt assessment and treatment.

Neoplasms (Cancer)

• Definition: Abnormal growth of new tissue (tumor).

• CNS Neoplasms: High mortality rates associated with central nervous system tumors.

  • Types:

    • Benign:

      • Remains localized and does not infiltrate surrounding tissues.

      • Can cause pressure effects within the confined cranial vault.

    • Malignant:

      • Infiltrates and damages healthy tissues.

      • High likelihood of metastasis (spreading to other parts of the body).

Cancer is Uncontrolled Growth

• Involves complex processes of transcription and translation of genetic material:

  • DNA transcribes to RNA which is translated into Protein.

• organs in the body are only allowed to grow so large until they are told to stop, in the case of other cells or cancer, they will either be given signals to stop growth but will not listen to them, or not receive signals at all to stop growth.

Tumor Types

• Benign Tumor: Non-cancerous growth that remains localized.

• Malignant Tumor: Cancerous growth that invades surrounding tissue.

Symptoms of Tumors

• Potential signs include:

  • Severe headache

  • Blurred vision

  • Seizures

Brain Abscess

• Definition: A localized collection of pus in the brain.

• Signs and Symptoms:

  • Lethargy

  • Hemiparesis (weakness on one side)

  • Nuchal rigidity (stiff neck)

  • Headaches

  • Nausea/Vomiting

  • Seizures

• Management: Treatment approaches are similar to those for neoplasms.

Degenerative Neuromuscular Diseases

• Muscular Dystrophy:

  • Group of diseases causing muscle weakness and locomotion issues.

  • patient’s may present or be diagnosed with more than one degenerative muscular disease, this is called comorbodity

• progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue

• symptoms:

  • progressive muscular wasting

  • poor balance

  • drooping eyelids (ptosis)

  • atrophy

  • scoliosis

  • inability to walk

  • frequent falls

• Duchenne and Becker Muscular Dystrophies

  • predominantly affects males and is characterized by progressive muscle weakness, which can lead to significant mobility challenges, increased risk of falls and shortened life expectancy due to heart and breath complications.

• Parkinson’s Disease:

  • Symptoms due to decreased dopamine production:

    • Tremors

    • Rigidity

    • Slowness of movement

    • Postural instability

  • may cause thinking and behavioural problems later on, dementia occurs at advanced stages. depression being a major psychiatric symptom.

• Multiple Sclerosis (MS):

  • Affects central nervous system via damaging nerve cell insulation.

  • symptom either occuring in isolated attacks or building up over time

  • symptoms:

  • ataxia (loss of muscle control

  • hypoesthesias (decreased sensitivity to stimulation)

• Amyotrophic Lateral Sclerosis (ALS):

  • Also known as Lou Gehrig's Disease; leads to neuron death affecting voluntary muscle control.

  • short life expectancy of 3-5 years

Spina Bifida

• A developmental defect where one or more vertebrae fail to close, leaving part of the spinal cord unprotected.

• May cause leg weakness or paralysis, orthopedic abnormalities, and issues with bowel and bladder control.

Other Neurological Disorders

• Bell’s Palsy:

  • Causes one-sided facial paralysis with unknown origins, typically resolving in two weeks.

Guillain-Barré Syndrome

• Symptoms include:

  • Progressive weakness starting from the legs and moving upward.

  • Some patients may require ventilatory support due to respiratory muscle involvement.

  • Recovery occurs in many within three months, though some may experience lingering effects.

Myasthenia Gravis

• Characterized by weakness and fatigue, starting at the eyes.

• weakness starts at the head and moves down

  • Weakness often improves with rest, but worsening with activity.

  • can lead to respiratory weakness/collapse

Meningitis

• inflammation of the meninges, the protective layer surrounding the brain and spinal cord.

• Viral vs Bacterial:

  • Viral meningitis is typically milder and more common, affecting younger populations.

• Symptoms:

  • Fever and chills

  • Changes in mental status

  • Nausea and vomiting

  • Sensitivity to light

  • Severe headaches and stiff neck.

Alzheimer’s Disease

• disease that physically changes the organic brain matter, leading to dementia.

  • Delirium: Typically acute and reversible.

  • Dementia: Generally involves chronic cognitive impairment, a syndrome that can be caused by multiple diseases.

Spinal Disorders

• Includes issues like

  • scoliosis (severe curvature of the spine laterally)

  • kyphosis (severe curvature of the spine posteriorly)

  • lordosis (severe curvature of the spine anteriorly)

• Assessment and Management: Involves evaluating history, managing physical limitations, and addressing psychological or communication needs.

Back Pain

• Most common complaint, often related to degenerative changes, disc ruptures, or spinal tumors.

Sciatica

• Characterized by pain due to nerve compression, with initial treatments focusing on pain relief.

• consider c-spine/immobilization and Analgesics for treatment and management.

Vocabulary

• Key terms include:

  • Comorbidity

  • Metastatic

  • Benign

  • Malignant

  • Tremors

  • Autoimmune

  • Atrophy

  • Paralysis

  • Nuchal rigidity

  • decerebrate

  • dystonia

  • trismus

  • coma

  • ptosis

• Useful anatomical and medical prefixes: pre-, post-, supra-, inter-.