Neurological Pathologies of human body

ALZHEIMER’S DISEASE
The commonest form of dementia is characterized by slow, progressive mental deterioration. Neuritic plaques (primarily in the hippocampus and parietal lobes) and neurofibrillary tangles (mainly affecting the pyramidal cells of the cortex) are present.

Clinical Features
Memory loss both in short and long-term apraxia, aphasia, visuospatial impairment, and aggressive behavior.

ARACHNOIDITIS
Chronic inflammation of the nerve root sheath in the spinal canal with or without nerve root symptoms. Chronic arachnoiditis occurs as a result of meningitis, myelography, or spinal surgery.


Clinical Features
Severe low back pain, radicular pain, leg weakness, gait disorder, incontinence.

ANTERIOR CORD SYNDROME
Occurs due to the flexion injury at the cervical region resulting into damage of anterior portion of spinal cord or its vascular supply.


Clinical Features
Loss of motor function, loss of sense of pain and temperature.

Neurological Diseases

BELL’S PALSY
Lower motor neuron paralysis of the face, related to inflammation and swelling of the facial nerve (VII) within the facial canal or at the stylomastoid foramen. Usually unilateral. Good recovery is common.

Clinical Features
Asymmetry of face, weakness or paralysis of facial muscle, unable to close eye of affected side, difficulty in chewing, drooling of saliva from affected side, verbal communication is affected.

BROCA’S DYSPHASIA
Caused due to lesion or damage of Broca’s area on the inferior frontal cortex. Broca’s area is near the motor cortex for the face and arm and so may be associated with weakness in these areas.


Clinical Features
Difficulty in speaking, non-fluent speech, difficulty in writing, reducing word output.

BROWN-SEQUARD SYNDROME
It occurs due to damage to one side of the spinal cord commonly caused by stab injuries.


Clinical Features
Loss of sensory sensation on same side, loss of sense of pain and temperature on the opposite side.

BULBAR PALSY
Occurs due to lower motor neuron lesion, may be unilateral or bilateral. The nerve supplying the bulbar muscles of head and neck are mainly affected.

Clinical Features
Paralysis or weakness of muscles of face, jaw, pharynx, larynx and palate, impairment in swallowing, coughing, speaking and gag reflex.

CEREBRAL PALSY
Group of condition characterized by motor dysfunction due to non-progressive brain damage early in life classified into various types.

Clinical Features
Retarded development, the performance of various movements in pattern, there will be persistence of infantile behavior in all function including primitive reflexes.

CENTRAL CORD SYNDROME
Occurs from hyperextension injury to the cervical region, associated with congenital or degenerative narrowing of spinal canal, resulting due to compressive force causing hemorrhage and edema.

Clinical Features
Sensory impairment, neurological deficit of upper and lower extremity.

CHARCOT-MARIE-TOOTH DISEASE
Progressive disorder of peripheral nerve which is hereditary, characterized by gradual progressive distal weakness and wasting, mainly affecting the peroneal muscle in the leg. In the later stages arm muscles can also be involved. This is also known as hereditary motor sensory neuropathy (HMSN).

Clinical Features
Difficulty in running, foot deformity, muscle
wasting, lower extremity weakness.

DISSEMINATED ENCEPHALOMYELITIS
Occurs due to pre-vascular CNS demyelination resulting due to viral infection. Myelin loss is followed by axonal degeneration and then by cell body degeneration (irreversible).

Clinical Features
Neurological and motor dysfunction, limb weakness.

GUILLAIN-BARRÉ SYNDROME (GBS)
An acute or subacute symmetrical predominantly motor neuropathy involving more than one peripheral nerve, frequently it may involve the facial and other cranial nerve, does not have any known etiology, and reaches a peak of disability by one to four weeks. There is destruction of myelin sheath and inflammatory cell. Infiltration of nerve mostly affects the proximal part of nerve root. In most of the cases, onset of symptoms is preceded by a mild gastrointestinal or respiratory infection. GBS usually ends up with recovery.

Clinical Features
Neurological dysfunction, lower limb weakness, difficulty in walking, muscle weakness, facial paralysis, diminished reflexes, pain and autonomic disturbances. In severe cases, respiratory problems are seen.

HEMIPLEGIA
Paralysis of half side of the body, i.e. it affects both upper and lower limbs of same side. It may be due to thrombosis, embolism, hemorrhage, hypertension, intracranial infections, trauma or hysteria.

Clinical Features
Upper and lower limb weakness, facial paralysis, in some cases there may be sensory loss.


HORNER’S SYNDROME
A group of symptoms occurring due to lesion of the sympathetic pathways in the brainstem, spinal cord, hypothalamus, superior cervical ganglion, internal carotid sheath or C8-T2 ventral spinal roots.

Clinical Features
Pupil constrictions of same side, loss of facial sweating on affected side of face, drooping of the upper eyelid.

HUNTINGTON’S DISEASE
Disease caused by a defect in chromosome IV, which can be transmitted by either of the parent. It can be hereditary in nature. Onset is insidious and occurs between 35 and 50 years of age.

Clinical Features
Chorea, progressive dementia, changes in behavior.

HYDROCEPHALUS
An increase in cerebrospinal fluid (CSF) volume, usually resulting from impaired absorption, rarely from excessive secretion. Classified into two types: communicating and non-communicating. Causes includes congenital, intrauterine infection, intracranial bleeding, hemorrhage, congenital malformation, etc.

Clinical Features
Vomiting, nausea, irritability, behavioral changes, bradycardia, delayed milestone development, drowsiness, papilledema.

LOCKED-IN SYNDROME
This is a neurological disorder in which there occurs total paralysis of all the voluntary muscles except those of face. Caused due to trauma of demyelinating diseases and vascular diseases.

Clinical Features
Inability in speaking, difficulty in hearing.

MENINGITIS
It is the inflammation of the leptomeninges and underlying subarachnoid C and F, caused by bacteria or viral infections, commonly occurs in children under 5 years of age and adults over 15 years of age. Classified into acute and chronic meningitis. Acute due to meningococcal, Pneumococcal Haemophilus influenzae, gram-negative meningitis, chronic neoplasm infection, AIDS, syphilis.

Clinical Features
Headache, high fever, cold hands and feet,
lethargy, change in level of alertness, respiratory
distress, apnea, cyanosis.


MOTOR NEURON DISEASE
This is a pathological progressive degenerative disease. Changes are more marked in anterior horn cell of spinal cord, motor nuclei of medulla and the corticospinal tracts.

Clinical Features
Wasting of muscles especially upper limbs and those innervated from the medulla, combined with symptoms of corticospinal tract degeneration various types are: Amyotrophic lateral sclerosis: Occur due to lower motor neuron lesion. There is weakness of limbs
and face muscular atrophy may also be seen. Progressive bulbar palsy: Caused due to damage of motor nuclei is area of brainstem. There is pain and spasm, dyspnea, dysphagia, sore eyes and dysarthria, paralysis of muscles of face, larynx, pharynx and muscle wasting.


MULTIPLE SCLEROSIS
This is a slow progressive CNS disease characterized by disseminated patches of demyelination in the brain and spinal cord resulting in multiple and varied neurologic symptoms and signs with remission and exacerbation. Women are affected more; age of onset is 20 to 40 years.

Clinical Features
Ataxia, motor and sensory disturbance, visual disturbances, fatigue, bowel and bladder dysfunction, pain and spasm, behavioral changes, bulbar dysfunction.

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