Tag Archives: neurology

Regrowing Spinal Tissue

Proper handling and cleaning of surgical instruments during surgery helps to prevent infections.

Spinal cord injuries are generally regarded as impossible to recover from. The spinal cord is responsible for connecting the brain to most of the body, providing the pathways through which the brain sends signals to the muscles in the arms, legs, and other areas, and receives information from these areas—touch sensations, when a person feels something on the skin. When the spinal cord is injured, these communications are disrupted, and the brain can not communicate as effectively—or at all—with these areas. There are 12,000 new cases of spinal cord injury every year in the United States, generally from automobile accidents, falls, violence, and sports injuries, and most result in permanent paralysis and sensory problems.

Now researchers have found a way to help recovery, and have successfully saved at least one patient’s spine. The researchers used olfactory stem cells to regenerate damaged tissue. The cells were taken from the scent receptors in the nose, an area in which cells are regularly damaged and regularly repaired by the body. Because of this, the tissue could be removed from the olfactory bulb and would be regenerated as part of the ordinary repair process; it also meant that thee cells, which are designed to regenerate and which, being stem cells, are not locked into any specific function, could grow new spinal cord tissue when used there. Though none of the patients in which this was tried made a complete recovery, all three experimental subjects showed a significant degree of recovery and gained back at least some of the lost function.

The most successful procedure was done in a Bulgarian man named Darek Fidyka, who’d had his spinal cord entirely severed in a knife attack, and became completely paralyzed from the chest down. As a result of his injuries, he’d been unable to move or feel anything below his rib cage. Fidyka was the most severely injured of the three patients in the study, and according to doctors, he is believed to be the first person ever to recover from such an injury. From total paralysis, he has recovered to the point that he can walk, with the help of a walker, and drive a car.

Advances In Fighting Migraines

migraine

Migraine affects more than 10 percent of people throughout the world, and about 12 percent of people in the United States. It strikes three times as many women as men. Migraine is wildly under-diagnosed, however, because exactly what it is and how it works is not clear. That means that public health experts estimate that more than half of all people with migraine have never received a diagnosis. It also means there is no reliable treatment for migraine headaches. It is also difficult to research treatments because people who experience migraines show no symptoms between times.

That’s why prevention is best. As best as can be understood, migraines appear to be linked to a neurotransmitter—a chemical used by the brain for various functions—called dopamine. The exact nature of the link is not clear, but dopamine in migraines may be activated by triggers which vary from person to person. Among the most common migraine triggers are onions, alcohol, secondhand smoke, and MSG. Some chemical compounds are also common triggers, such as the nitrates used in curing meat or tyramine, which naturally forms in aged foods such as wine or certain cheeses. Stress is another frequent cause of migraines, not necessarily directly, but in the period after the stress has passed hen the body is recovering from its heightened state. That means a migraine sufferer’s best option may be to learn and avoid their specific triggers, though this can require painful trial and error

However, it may not always be possible to avoid triggers. In these cases, there are some treatments that may help alleviate symptoms. While caffeine is a trigger for some patients, in others it can improve matters. Some prescription medications also have benefits. Beta blockers, the antidepressant amitriptylene, and anti-seizure medications seem to prevent migraines from occurring. More unusual approaches have also been tried. One of these is transcranial magnetic stimulation, in which powerful magnets are moved over the skull. Although it’s not clear what effect this has, it has been shown to work for many patients. Another treatment option that helps with migraines is medical marijuana, though again, that can be a trigger for some patients.

Epilepsy Causes And Treatments

epilepsy

Each year, around 200,000 Americans are diagnosed with epilepsy, making it the most common neurological disorder among people in the United States. Epilepsy is estimated to affect one percent of the population. Sufferers of this seizure disorder have episodes of abnormally high brain activity. The condition may be experienced from annoying, or something to be watched but that is manageable, or as a truly debilitating illness requiring constant care, depending on the patient and on the severity, frequency, and duration of their seizures. In three out of four cases, epilepsy can be treated with medication.

The causes of epilepsy are rather varied. Heredity seems to play a role in some instances; this is frequently the case when someone is born with epilepsy. Epilepsy can also come from brain damage, perhaps due to a stroke or to a concussion, a blow to the head, or some other form of brain damage. Meningitis and other brain infections can also result in epilepsy. Often, people over 60 are diagnosed with epilepsy in the complete absence of head trauma, and experts believe this indicates a link with dementia.

A recent technological advance offers hope of a treatment technique that could make the disease easier to live with. The notion of predicting seizures has tantalized epilepsy researchers for years, if not longer. In patients whose epilepsy doesn’t respond to medication, which it frequently does not, prediction, and the planning it allows, is an important component of living a normal life. Assistance dogs have a limited ability to tell when one is about to happen, but not a lot of epileptic people require the services of a dog and the timeframe isn’t very long. Now crowdsourced research has found a predictive approach that can tell with 82 percent accuracy whether a person is soon to have a seizure.

Another option for people who cannot control their epilepsy with medication is surgery. One surgery implants a device in the brain to detect and try to counteract seizures as they happen. This is rarely performed, in part, a study has shown, that people believe the procedure is higher risk than it actually is.

Charcot-Marie-Tooth Disease

charcot

Charcot-Marie-Tooth disease, named for the two French scientists and the English doctor who separately discovered it in 1886, is a genetic disease that affects about one in 2,500 people, making it the most common genetically based nervous system disorder. It is caused by genetic mutations that affect the myelin sheath that protects the nerves, disrupting the signals from the brain. It leads to muscle weakness, foot problems, pain or loss of sensation in the extremities, poor muscle development and muscle loss, frequent falls, and an odd gait. Symptoms usually start in early childhood, though in some cases initial onset may not strike until after age 30. Charcot-Marie-Tooth is a hereditary condition, afflicting anyone born with the genetic mutations that cause the symptoms.

As the disease progresses, the patient may slowly lose manual dexterity and suffer increasing weakness in the hands and arms. In some people, hearing and eyesight get progressively worse over time. Many patients develop the spinal deformation known as scoliosis, in which the spine starts to curve into an S shape. In some cases, the vocal cords atrophy and the person has difficulty swallowing and speaking. Charcot-Marie-Tooth patients are often shorter than average due to the muscular problems. People with the disease are particularly prone to gastrointestinal problems.

Treatment for Charcot-Marie-Tooth disease is focused on alleviating the symptoms, because there is no cure, though researchers have begun to investigate the possibility of using an analog to a growth factor ordinarily produced by the cells but that Charcot-Marie-Tooth disease interferes with. People with the condition often require orthopedic devices for mobility, but doctors use physical therapy and occupational therapy to avoid or forestall this. Other assistive devices can be helpful in allowing patients to do everyday tasks.

Now, however, a new study may put doctors on the road to a cure. Zebrafish are commonly used in medical research because they are similar to humans in surprisingly many respects, and the zebrafish complete genome is known, making mutations easy to both introduce and recognize. One research team has begun using zebrafish to explore Charcot-Marie-Tooth disorder, and have learned that motor neurones are involved in the condition. This suggests possible treatment approaches along the line of other motor neuron diseases.

Mal de Debarquement

cruise ship

A disease called mal de debarquement is caused by ocean cruises. It can also be caused be any other long trip, such as a long car ride, but it is most commonly cruises. The name is French for "disease of disembarkation," as in getting off the ship or plane, or out of the car. The primary symptom of mal de debarquement is the feeling that the person is still at sea. The condition can also cause the cognitive impairment known as "brain fog," or fatigue and trouble concentrating, along with dizziness, headaches, confusion, and often tinnitus and hearing problems.

Although there is commonly a period after getting off a ship or airplane during which a person may experience unsteadiness or confusion, mal de debarquement sufferers have these symptoms for weeks, months, or even years, though with some relief while traveling. In addition, while it can be brought on by cruises or flights, it can also be caused in some cases by high speed elevators or even noting at all. The disease is the result of a neurological disturbance but the exact cause—the reasons travel can cause these symptoms—is unknown, though research points to the inner ear, responsible for balance. It most commonly effects women in their mid-40s, but anyone can acquire the condition.

There is no known cure for the condition, but treatment are mostly about addressing the symptoms; that is the same sort of treatments for any similar movement problem. The common treatments are exercises and physical therapy. Medications that help with balance are effective in patients with this condition. However, motion sickness drugs do not seem to be helpful for mal de debarquement. Even untreated, however, symptoms generally go away on their own. More than half of all cases cleared up within three years.

Researchers have recently found a new type of treatment they say promises to help people with mal de debarquement get their legs back. The treatment procedure aims to stabilize the balance mechanism in the patient’s inner ear by means of rocking movements to help reset the balance reflex. Treatments helped most subjects who were studied in clinical trials with minimal side effects, and the technique is expected to help other patients.

Migraine Predicts Parkinson’s

migraine

Researchers believe they have found a connection between a tendency to get migraines and risk of Parkinson’s disease. In particular, people who get migraine with aura—an alteration in vision that often presages a migraine—are twice as likely to develop Parkinson’s later in life as people without migraines. Migraine affects an estimated 30 million people and is the most common brain disorder in adults, so potentially millions of people are at risk for Parkinson’s disease, as well as for the cardiovascular illnesses with which migraine is also associated.

In addition, people in the study with a family history of Parkinson’s were more likely to get migraines, providing more evidence of a connection. The reason for the link, if it exists, is not entirely clear, but one possibility is that dopamine, a messenger chemical in the brain that has been implicated as a major cause of Parkinson’s, is also involved in migraines. Past research has indicated that dopamine receptors may be involved in migraines.

The dopamine issues that cause migraines, however, are imperfectly understood themselves. Their causes—called triggers—vary from person to person. Among the most common migraine triggers are onions, alcohol, secondhand smoke, and MSG. Some chemical compounds are also common triggers, such as the nitrates used in curing meat or tyramine, which naturally forms in aged foods such as wine or certain cheeses. Stress is another frequent cause of migraines. A recent study found that referring to a stressful situation as a "headache" isn’t just a metaphor; people with more stress in their lives are more prone to headaches of the literal sort. With migraines, it seems the let-down after is a bigger problem, and keeping stress levels even is important for prevention.

In fact, avoiding triggers in general is the most effective way of preventing migraines. There is a learning curve to this, since avoiding triggers requires first determining what they are. However, once a patient’s triggers have mostly been determined, avoiding them can significantly reduce migraine instances. In addition, medications and medical devices are available to prevent migraines or lessen their severity or duration. Two new electromagnetic stimulation devices, for example, seem to be useful for stopping migraines as soon as they start, if not sooner.

Tracking MS Causes

doctor-and-patient

Nearly half a million Americans experience symptoms including numbness or weakness on one side of the body, vision loss on one side of the body, dizziness and slurred speech, tingling and electric shock-like sensations, and bowel and bladder difficulties. These are symptoms of multiple sclerosis which occurs when the protective covering over the spinal chord is damaged or destroyed. The symptoms usually start to appear in the person’s late teens to late 50s, but scientists recently found that there are antibodies in blood that can be found some time before any symptoms start to appear.

The antibodies appear to be what is attacking the protective layer, called the myelin sheath, but it is unclear what cases them to form. Risk of developing multiple sclerosis goes up further from the equator, though with prominent exceptions including high-risk Sardinians in the tropics, low-risk American Indians and Māori closer to the poles. This geographical factor is unusual except in parasitic illnesses, but there is no evidence multiple sclerosis is caused by a parasite. It has been suggested the the condition is triggered by bacteria; a recent study found that food poisoning, in particular a toxin produces by a species of the foodborne bacteria Clostridium, can damage myelin, but this may not be the sole cause.

While multiple sclerosis does not appear to be hereditary, it does often appear with autoimmune diseases, most of which are, and there is a genetic component to risk. Another thing that increases the risk is use of hormonal birth control. Women who in a study, took pills the combined estrogen and progestin were more than one third more likely to develop multiple sclerosis than women who weren’t on the pill. It was not clear whether different combinations of hormones, or hormonal birth control not taken orally, had the same effect.

A link has also been found between sleep disorder and multiple sclerosis. This, researchers say, may be the fatigue that is often part of the disease. An earlier study found that many people with multiple sclerosis also suffer sleep apnea, but one reason for that may be that obesity is a risk factor for both. The more recent study found that around a third of multiple sclerosis patients experience moderate to severe insomnia, though most are undiagnosed.

Rabies

rabies

The 19th-century French chemist and microbiologist Louis Pasteur was prolific in his discoveries, but today, 119 years after he died at age 72, he is remembered primarily for a handful. Pasteur invented the food preservation process that bears his name. He is responsible for discoveries, such as the nature of bacteria, that established the field of microbiology; he was among the first scientists to apply that understanding to the question of how diseases are transmitted. And it was Louis Pasteur who developed the first vaccine for rabies, a usually fatal viral disease that causes inflammation in the brain.

Rabies is transmitted from animals to humans—and from animals to other animals—through saliva, which is mostly passed through bites. When an animal with rabies bites another animal, the virus is transmitted. One of the effects of rabies is a tendency to violence, including biting. Although dogs are both the prototypical vector and the most common worldwide, in the Americas, bat bites are actually more often the culprit. However, any small mammal could be carrying rabies. There are about 7,000 cases a year in the United States.

Prevention is best effective at the source, but often the animals that transmit the disease are feral if not actually wild, which presents an obstacle to finding and vaccinating all animals that could potentially spread rabies. That is why people are advised to avoid wild or feral animals when possible, and admire them from a distance. Even strays can be dangerous if they’ve been stray for a significant amount of time.

The reason there is such a focus on prevention is because there is no cure; if the disease is allowed to develop, it is almost certainly fatal. Fortunately, there is a certain amount of lag time between the bite and the disease taking hold during which measures can be taken that may save the patient’s life. Post-exposure prophylaxis can be used to try to ensure the disease never comes to pass. This involves cleaning the wound and administering rabies vaccine as soon as possible.

If symptoms do appear, there is still a slim possibility of saving the patient. A procedure called the Milwaukee Protocol, after the city where it was created, has been used with limited success, though the six patients who recovered since the procedure was created in 2004 is more than had recovered from rabies in all of human history until then. It involves anti-viral drugs administered to a patient in an induced coma.

Lead Poisoning

lead warning

Lead was once ubiquitous. In fact, the Latin name for the metal, plumbum, is the source of the word "plumbing." In ancient Rome, the pipes that were inherent to the city’s advanced for the time sewer system were made of lead, as were the famous aqueducts and the cups out of which they drank wine. When they did so, although the Romans watered down their wine, the alcohol wore away at the interior of the cups, and some lead got into the wine itself. This was exacerbated when they used lead pots to distill wine or cook with it, or deliberately added it to wine to sweeten it. Some scholars believe this ingestion of lead was a major contributing factor to the declining birthrates that hastened the fall of the Roman Empire.

That’s because lead, like mos heavy metals, is highly toxic to human organs, including the heart, digestive system, and reproductive system. Lead is also a neurotoxin, affecting intelligence and cognitive functioning, and when ingested by children can cause permanent neurological problems that result in behavioral issues and learning disabilities. Unfortunately, while the dangers of lead poisoning were recognized at least 2,500 years ago, lead has been widely used regardless for most of that time.

Although most new sources of exposure are in industrial settings, where people are enabled and encouraged to take precautions, lead paint was widely used until relatively recently, exposing many people to the danger. Children, especially, in homes with lead paint are prone to breathing it in or even ingesting it—since most lead paint is old by now, it is often peeling, or creating lead dust in the air. It has to be removed carefully however, lest removal worsen the problem it’s intended to solve. Lead was also added to gasoline, and its presence in exhaust cause people to inhale it and be exposed that way.

The effects of long-term lead exposure on the brain and central nervous system are irreversible, though some studies point to the possibility of repairing the harm. A very small number of children with lead encephalopathy—brain swelling caused by high levels of acute lead exposure—can avoid permanent brain damage with treatment. The other effects are largely treatable, however, using chelation therapy, which gets the lead to pass with urine rather than being stored by the body.

Epilepsy

epilepsy

Epilepsy is the most common neurological disorder among people in the United States. Around 200,000 Americans are diagnosed each year, and it is estimated to affect one percent of the population. It is a seizure disorder; people with epilepsy suffer periodic bouts of abnormally high brain activity. Depending on the severity, frequency, and duration of these seizures, the disease can range from annoying, through something to be watched but that is manageable, all the way up to a truly debilitating illness requiring constant care. Three fourths of cases of epilepsy can be treated with medication.

There are a variety of causes for epilepsy. For some people, heredity seems to play a role, particularly when the disease is congenital. Sometimes people who have had strokes get brain damage that leads to epilepsy. Head trauma can have a similar effect, with people who have had concussions or otherwise suffered blows to the head starting to get seizures afterward. Meningitis and other brain infections can also have this result. Most people with epilepsy who didn’t have the disease as children or get it from brain damage as adults are diagnosed after age 60; in these cases, there appears to be a link with dementia.

While epilepsy can often be controlled with medication, the medications used have noticeable side effects, which can include dizziness, fatigue, weakness, irritability, and anxiety, in as many as 90 percent of people who are taking them. However, new techniques are helping to better control the disease, without side effects that can themselves be a serious blow to quality of life.

One technique uses an implantable neurostimulation device to stabilize abnormal electrical activity in the brain. This abnormal activity is what is experienced by the patient as a seizure. The implant detects this activity and creates its own electrical impulses, which counter the seizure. Researchers are also investigating using stem cells to create new neurons for patients with certain forms of epilepsy. If successful in humans—the technique has been demonstrated to be effective in laboratory animals—the stem-cell neurons could be used to replace flawed neurons connected with epilepsy in these patients.