What is Neurology?

Neurology is a branch of medicine dealing with disorders of the complete nervous system including brain and mind. Medical professionals specializing in the field of neurology are called neurologists and are trained to diagnose, treat, and manage patients with neurological disorders

Neurological Disorders Include:

A neurological disorder is a dysfunction of the body’s nervous system, structural, biochemical or electrical abnormalities in the brain or spinal cord, or in the nerves leading to or from CNS, can result in symptoms such as paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion/speech disorders , pain and altered level of consciousness. There are many recognized neurological disorders, some relatively common but many rare. They may be revealed by neurological examination and studied and treated within the specialties of neurology , neurophysiology and clinical neuropsychology. Interventions include clinical and bedside treatment , lifestyle changes, physiotherapy or other therapy like neurorehabilitation, pain management, medication, or certain operations performed by neurosurgeons. The World Health Organization estimated in 2006 that neurological disorders and their sequalae affect as many as one billion people worldwide, and identified health inequalities and social stigma/discrimination as major factors contributing to the associated disability and suffering Causes i.e WHO made an association with world federation of neurology to conduct a joint research work world wide .

Classification:

Neurological disorders can be categorized according to the primary location affected, the primary type of dysfunction involved, or the primary type of cause. The broadest division is between central nervous system (CNS) disorder and peripheral nervous system (PNS) disorder. List of brain, spinal cord and nerve disorders in the following overlapping categories:

• Brain:

o Brain damage according to cerebral lobe (see also lower brain areas such as basal ganglia, cerebellum, brainstem):
 Frontal lobe damage
 Parietal lobe damage
 Temporal lobe damage
 Occipital lobe damage

o Brain dysfunction according to type:
 Aphasia (language)
 Dysarthria (speech)
 Apraxia (patterns or sequences of movements)
 Agnosia (identifying things/people)
 Amnesia (memory)

• Spinal cord disorders (see spinal pathology, injury, inflammation)
• Peripheral Nervous System disorders
• Cranial nerve disorders
• Autonomic Nervous System disorders
• Seizure Disorders such as epilepsy
• Movement Disorders such as Parkinson disease
• Sleep Disorders
• Headaches (including Migraine)
• Low Back and Neck Pain (see Back pain)
• Other Pain (see Neuropathic pain)
• Delirium and Dementia such as Alzheimer disease
• Dizziness and Vertigo
• Stupor and Coma
• Head Injury
• Stroke (CVA, Cerebrovascular attack)
• Tumors of the Nervous System (e.g. Cancer)
• Multiple Sclerosis (MS) and other Demyelinating diseases
• Infections of the Brain or Spinal Cord (including Meningitis)
• Prion Diseases (a type of infectious agent)

Disorders involving muscles.

Structural disorders of the brain and spinal cord.
Structural disorders of the nerves in the face, trunk and limbs.
Conditions which are not caused by structural disease such as many varieties of headache.
Conditions such as epilepsy, fainting and dizziness which are often caused by disordered physiology, rather than abnormal anatomy.
Neurological conditions are the most common cause of serious disabilities and have a major, but often unrecognized, impact on health and social services.

Public Speaking and Panic Attacks – It is often observed that many people’s top ranking fear is not death but having to speak in public. The joke is that these people would rather be lying in the casket at the funeral than giving the eulogy.

Public speaking for people who suffer from panic attacks or general anxiety often becomes a major source of worry weeks or even months before the speaking event is to occur.These speaking engagements do not necessarily have to be the traditional “on a podium” events but can be as simple as an office meeting where the individual is expected to express an opinion or give verbal feedback. The fear of public speaking and panic attacks in this case centers on having an attack while speaking. The individual fears being incapacitated by the anxiety and hence unable to complete what he or she is saying. The person imagines fleeing the spotlight and having to make all kinds of excuses later for their undignified departure out the office window? Causes – The short and obvious answer: panic attacks are caused by high anxiety. But, what exactly is anxiety? Understanding how anxiety crops up will help you defeat panic attacks.

Post Polio Syndrome – Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. PPS is mainly characterized by new weakening in muscles that were previously affected by the polio infection and in muscles that seemingly were unaffected. Symptoms include slowly progressive muscle weakness, unaccustomed fatigue (both generalized and muscular), and, at times, muscle atrophy. Pain from joint degeneration and increasing skeletal deformities such as scoliosis are common. Some patients experience only minor symptoms. While less common, others may develop visible muscle atrophy, or wasting.

PPS is rarely life-threatening. However, untreated respiratory muscle weakness can result in underventilation, and weakness in swallowing muscles can result in aspiration pneumonia.
The severity of residual weakness and disability after acute poliomyelitis tends to predict the development of PPS. Patients who had minimal symptoms from the original illness will most likely experience only mild PPS symptoms. People originally hit hard by the poliovirus and who attained a greater recovery may develop a more severe case of PPS with a greater loss of muscle function and more severe fatigue. It should be noted that many polio survivors were too young to remember the severity of their original illness and that accurate memory fades over time.

Headache-Migraine Headaches – The commonest form of headache is what we normally refer to as ordinary or tension-type headaches and once more these are only partly understood.
In this case the list of possible causes is extremely long and includes everything from what we eat to how stressed we are. Trying to pinpoint a precise cause has however so far proved too difficult and just what produces the ordinary everyday headache remains a mystery.

Perhaps the only saving grace is that there is a large number of medications available to cope with the different types of headache and most of these are both safe and effective for the majority of sufferers.
Migraines have long proved difficult to treat and the original ergot drugs used to treat them had varying degrees of success. These were then largely replaced by triptans which proved to be more effective but unfortunately carried some drawbacks. Nowadays however the second generation of triptan drugs are proving safe, have fewer side effects and work well for most sufferers.

We have also seen an increase in the use of preventive medications for migraines such as beta blockers, calcium channel blockers, anti-depressants, anti-seizure medications and a variety of other drugs which are commonly used to treat other well known conditions. For some people these will indeed stop headaches from occurring at all, while in other people they act to reduce the frequency of headaches. What you do in the opening minutes about the migraine may very well determine how long it lasts and how severe it will be.

Anyone who has ever experienced migraine headaches knows how painful and tortuous life can be after a migraine begins. One never knows if the headache, once it begins, will turn into one of those migraine headaches that can leave someone incapacitated for hours or for days.
What makes decisions by people who suffer with migraine headaches particularly difficult is the fact that migraines can be confused with other headaches early on. And, people with migraine headaches are just as likely to develop other common types of headaches like sinus and tension headaches like everyone else.

Sleep Apnea – is a common sleep disorder characterized by brief interruptions of breathing during sleep. These episodes usually last 10 seconds or more and occur repeatedly throughout the night. People with sleep apnea will partially awaken as they struggle to breathe, but in the morning they will not be aware of the disturbances in their sleep. The most common type of sleep apnea is obstructive sleep apnea (OSA), caused by relaxation of soft tissue in the back of the throat that blocks the passage of air. Central sleep apnea (CSA) is caused by irregularities in the brains normal signals to breathe. Most people with sleep apnea will have a combination of both types. The hallmark symptom of the disorder is excessive daytime sleepiness. Additional symptoms of sleep apnea include restless sleep, loud snoring (with periods of silence followed by gasps), falling asleep during the day, morning headaches, trouble concentrating, irritability, forgetfulness, mood or behavior changes, anxiety, and depression.

Sleeping Sickness – or African trypanosomiasis is a parasitic disease in people and animals, caused by protozoa of genus Trypanosoma and transmitted by the tsetse fly. The disease is endemic in certain regions of Sub-Saharan Africa, covering about 36 countries and 60 million people. It is estimated that 50,000 to 70,000 people are currently infected, the number having declined somewhat in recent years.
Sotos Syndrome – is a rare genetic disorder characterized by excessive physical growth during the first 2 to 3 years of life. The disorder may be accompanied by mild mental retardation, delayed motor, cognitive, and social development, hypotonia (low muscle tone), and speech impairments. Children with Sotos syndrome tend to be large at birth and are often taller, heavier, and have larger heads (macrocrania) than is normal for their age. Symptoms of the disorder, which vary among individuals, include a disportionately large and long head with a slightly protrusive forehead, large hands and feet, hypertelorism (an abnormally increased distance between the eyes), and downslanting eyes. Clumsiness, an awkward gait, and unusual aggressiveness or irritability may also occur. Although most cases of Sotos syndrome occur sporadically, familial cases have also been reported.

Spasticity – is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and may interfere with movement, speech, and manner of walking. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. It may occur in association with spinal cord injury, multiple sclerosis, cerebral palsy, damage to the brain because of lack of oxygen, brain trauma, severe head injury, and metabolic diseases such as adrenoleukodystrophy, amyotrophic lateral sclerosis (Lou Gehrig’s disease), and phenylketonuria. Symptoms may include hypertonicity (increased muscle tone), clonus (a series of rapid muscle contractions), exaggerated deep tendon reflexes, muscle spasms, scissoring (involuntary crossing of the legs), and fixed joints. The degree of spasticity varies from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms.

Spinal Cord Infarction – is a stroke either within the spinal cord or the arteries that supply it. It is caused by arteriosclerosis or a thickening or closing of the major arteries to the spinal cord. Frequently spinal cord infarction is caused by a specific form of arteriosclerosis called atheromatosis, in which a deposit or accumulation of lipid-containing matter forms within the arteries. Symptoms, which generally appear within minutes or a few hours of the infarction, may include intermittent sharp or burning back pain, aching pain down through the legs, weakness in the legs, paralysis, loss of deep tendon reflexes, loss of pain and temperature sensation, and incontinence.

Spinal Cord Injury – usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don’t completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.

Spinal Cord Tumors – Brain and spinal cord tumors are abnormal growths of tissue found inside the skull or the bony spinal column, which are the primary components of the central nervous system (CNS). Benign tumors are noncancerous, and malignant tumors are cancerous. The CNS is housed within rigid, bony quarters (i.e., the skull and spinal column), so any abnormal growth, whether benign or malignant, can place pressure on sensitive tissues and impair function. Tumors that originate in the brain or spinal cord are called primary tumors. Most primary tumors are caused by out-of-control growth among cells that surround and support neurons. In a small number of individuals, primary tumors may result from specific genetic disease (e.g., neurofibromatosis, tuberous sclerosis) or from exposure to radiation or cancer-causing chemicals. The cause of most primary tumors remains a mystery. They are not contagious and, at this time, not preventable. Symptoms of brain tumors include headaches, seizures, nausea and vomiting, vision or hearing problems, behavioral and cognitive problems, motor problems, and balance problems
Stroke – (CVA) is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain.

Symptoms:- One may have Abrupt loss of Vision, Energy, Coordination, Sensation, Speech. Weaknesses or Paralysis down one side of the body, Loss of Balance. Sudden and Severe Headache followed rapidly by Loss of Consciousness. For complete cure cut off time to start latest treatment TPA is only 3-4 hrs of starting treatment.Patients of stroke should be hospitalised and given the appropriate medication. Patients with stroke needs careful handling cases may take long time to recover , first 48 – 72 hrs are very crucial which decides the fate of the patient. Awareness regarding the factors predesposing Stroke can minimize the occurrences and if at all it occurs timely treatment can safe gaurd the fatal casualty.