Degenerative Brain Disease

Question 1

What are some main degenerative brain diseases?

Answer 1

• multiple sclerosis
• motor neurone disease
• parkinson’s disease

Question 2

what is multiple sclerosis?

Answer 2

Lesions on the CNS, the axons are demyelinated causing progressive functional loss

Question 3

what are symptoms and signs of multiple sclerosis?

Answer 3

symptoms:
- muscle weakness
- visual disturbance
- autonomic dysfunction
- pain
- balance/hearing loss

signs:
- spasticity
- altered reflexes
- tremor
- optic atrophy
- proprioceptive loss

Question 4

what are some investigations for MS?

Answer 4

• history/exam
• MRI
• CSF analysis

Question 5

what are the dental aspects of a patient with MS?

Answer 5

• limited mobility & psychological disorders
• treat under LA
• orofacial motor & sensory disturbance
• Enhanced trigeminal neuralgia risk

Question 6

what is motor neurone disease?

Answer 6

degeneration in the spinal cord
patients between 30-60. Death with 3 years of diagnosis

Progressive loss of motor function
death due to: ventilation failure, aspiration pneumonia

Question 7

What may the patient notice during motor neurone disease?

Answer 7

• weakness in ankle or leg
• slurred speech
• weak grip
• weight loss

Question 8

what is treatment for motor neurone disease?

Answer 8

None is effective

• physio & occupational therapy
• Riluzole (medication), some get 6-9months life extension
• aspiration prevention (reduce salivation, peg tube feed)

Question 9

what are dental aspects of motor neurone disease?

Answer 9

• difficulty in acceptable of dental care
• realistic treatment planning (especially if short life expectancy)
• drooling & swallowing difficulties

Question 10

what is parkinson’s disease?

Answer 10

degeneration of dopaminergic neurons in the brain (shortage of dopamine results in affected movement)

Question 11

what are clinical signs of parkinsons?

Answer 11

bradykinesia (slow movement, and slow initiation of movement

rigidity (increased muscle tone)

tremor (slow amplitude)

Question 12

what are some medical treatments for parkinson’s disease?

Answer 12

• Dopamine medication [tablets, infection, infusion]
• surgical (deep brain stimulation)

Question 13

what are the dental aspects of someone with parkinson’s disease?

Answer 13

difficulty accepting treatment (body tremor making mouth opening hard)

dry mouth (from medication)

possible drug interactions