Neurological Pathology

Question 1

Define ‘neurological pathologies’ and explain some causes of neurological disorders.

Answer 1

Neurological pathologies are diseases of the central nervous system (encompassing the brain, spinal cord and meninges) and peripheral nervous system, including the ANS and SNS.

Causes:

• Genetic disorders
• Congenital abnormalities e.g., spina bfida
• Environment and lifestyle e.g., exposure to toxins, malnutrition, injury

Question 2

List 4 neurological pathologies and explain their causes

Answer 2

1. Spina Bfida - neural tube defect
   Cause: Spinal canal and backbone don’t fuse correctly before birth. Associated with folate deficiency.
2. Hydrocephalus - build up of CSF on the brain
   Cause: body produces too much CSF, or there is an issue with the arachnoid villi which stops the CSF being absorbed into blood.
3. Paralysis - complete or partial loss of muscle function
   Cause: multiple - cerebral palsy, exposure to toxin, injury, stroke.
4. Poliomyelitis - a polyneuropathy caused by infection of the poliovirus which causes paralysis if the spinal cord is affected.

Question 3

Describe paralysis.

Answer 3

Paralysis is the partial or complete loss of muscle function. Partial loss of muscle function is known as ‘paresis’, complete loss of muscle function is ‘plegia’ (true paralysis).

Can be widespread, or limited to one area of the body.

Can affect one, or both sides of the body.

Question 4

Describe the two kinds of paralysis.

How does each occur?

Answer 4

Flaccid:

• Lower neurone damage -impulses don’t reach the muscles
• Reflex arc disrupted so muscle deprived of innervation = low muscle tone
• characterised by weak, flabby muscles

Flaccid paralysis is most commonly caused by injury.

Spastic

• Upper neurone damage
• Reflex arc not disturbed so muscle not deprived of innervation = muscle tone retained
• injury to cortical neurones = no control over muscle contraction (spasms)
• characterised by tight, painful muscles

Spastic paralysis is most commonly caused by conditions that damage brain and spinal cord e.g., cerebral palsy.

Question 5

Explain the difference between upper and lower neurones.

How does each become damaged?

Answer 5

Collaboration between upper and lower motor neurones facilitates voluntary movement:

• Upper motor neurones relay information from the brain to the brain stem and spinal cord.
• Lower motor neurones are activated my UMN, and directly stimulate muscles to contract.

Upper motor neurone is caused by conditions that affect the brain/spinal cord.

Lower motor neurone damage is caused when injury to a limb involved the nerves supplying the muscle.

Question 6

Describe the symptoms of paralysis.

Answer 6

• Tingling sensation
• Pain
• Numbness
• Difficulty talking e.g., slurring
• Vision changes
• Difficulty balancing
• Difficulty breathing

Question 7

1) Damage to one side of the brain causes?
2) Damage to the spine causes?
3) Damage to the lower spine causes?
4. Damage to the upper spine causes?

Answer 7

1) Paralysis on the opposite side of the body. E.g., damage to left brain causes right sided paralysis.
2) Equal sided paralysis
3) Lower limb paralysis (paraplegia)
4) Paralysis of all four limbs (quadriplegia)

Question 8

Describe the two variations of paralysis.

Answer 8

Paresis

• partial paralysis
• muscle weakness

Plegia

• true paralysis
• complete loss of muscle function

Question 9

Describe polyneuropathies, including their causes.

Give an example of a polyneuropathy.

Answer 9

Polyneuropathy’s are a group of rare neurological conditions that cause widespread paralysis due to the simultaneous malfunction of multiple peripheral nerves.

Causes include:

• Genetics
• Infection by pathogen
• Symptom of diabetes
• Exposure to a toxin
• Exposure to drugs

An example of a polyneuropathy is poliomyelitis. Caused by infection by the polio virus which causes paralysis if the spinal cord is infected.

Question 10

What are the various treatment approaches for paralysis?

Answer 10

There is no cure for paralysis, so treatment is aimed towards the management of life with paralysis.

Physiotherapy - aims to preserve muscle tone, muscle strength and range of motion

Speech therapy - aims to improve speech and reduce risk of choking

Respiratory therapy - aims to preserve intercostal and abdominal muscles to retain ability to force a strong cough. Reduces risk of choking and risk of respiratory infection.

Occupational therapy - aims to help improve quality of life for those with paralysis, including making adaptations to home/living environment, promoting independence, planning meaningful activities, and self care.

Psychological therapy - helps the patient deal with the mental impact and stress of becoming paralysed.