Conditions and Diseases of the Nervous System

 

There are perhaps more discrete conditions and diseases of the nervous system than of all other systems combined (Cecil's, 2007).

The following is a description of the most common conditions and diseases of the central and peripheral nervous systems. For further, more comprehensive listings of neurological pathologies, please consult more definitive resources.

 

 

  • CNS conditions
    and diseases
  • peripheral conditions
    and diseases
  • degenerative
    diseases
  • infectious
    diseases
  • movement
    disorders
  • tumours

  • trauma

Cerebrovascular Diseases

 

Inflammatory Diseases

 

Other

 

Peripheral Nervous System

Peripheral Neuropathies

 

Inflammatory Neuropathies

Infectious Neuropathies

  • varicella-zoster virus
  • leprosy
  • diptheria

Hereditary Neuropathies

 

Neuromuscular Junction Disease

Metabolic and Toxic Neuropathies

  • peripheral neuropathy in diabetes mellitus
  • metabolic and nutritional peripheral neuropathies
  • neuropathies associated with pregnancy
  • toxic neuropathies

Traumatic Neuropathies

Tumours of Peripheral Nerves

 

 

neuropraxia - stretch or compression: some loss of melin, with impulse slowing that returns

 

axontemesis -

 

neurotemesis

Degenerative Diseases

Infections

Movement Disorders

Basal ganglia and cerebellum, which control automatic and voluntary

 

 

Hyperkinetic Disorders

The four questions to ask are:

Is it rhythmic? yes - tremor

Is it supressible? yes - tic, stereotypy

Is it sustained? - yes, dystonia

Is it stereotyped? yes - myoclonus, hemiballism

Non-rhythmic, non, suppressible, non sustained, non-sterotyped - chorea, athetosis, akethesia, tardive dyskinesia

 

 

 

tremor

postural tremor

  • present throughout range of motion
  • autosomal dominant, with variable penetrance
  • bilateral, responds to alcohol and propanolol
  • can be present at rest and in given posture if it is severe enough

 

rest tremor

  • 5-7 Hz
  • best tested with arm resting in lap
  • can reemerge once limb is kept in one spot for a while (mimicking a postural tremor)

Intention tremor

appears when approaching a target, fine motor activities are at their finest.

suggests potential problems in pontocerebellum

 

task-specific tremor

 

 

isometric tremor

  • 14-16 Hz
  • tremor when muscles are contracted
  • hard to see, but can hear with a stethoscope on back

 

 

distonia

Dystonia is a movement disorder caused by contractions of opposing muscle groups, resulting in sustained, twisting postures.

Types of dystonia include:

  • focal
  • segmental
  • multifocal
  • generalized

Blepharospasm is a focal dystonia with sustained eye closure.

 

Hemifacial spasms are unilateral, synchronous contraction of the facial (VII) nerve, with paradoxical raising of the eyebrow

 

Oromandibular dystonia is bilateral and nonsyncronous

 

tic

A suppressible, dysrhythmic movement disorder.

There is some urgency to move prior to movement, which relieves them.

Tics can be seen with Tourette's syndrome, which appears before the age of 18.

 

 

stereotypy

Stereotypy is a suppressible, dysrhythmic movement disorder. Unlike tics, there is no urgency to move.

Stereortypy is associated with mental retardation or mental health conditions.

 

 

tardive (delayed) dyskinesia

  • can appear up to a year
  • commonly caused by neuroleptics

 

 

 

 

athetosis

  • slow, writhing movements of the extremities

 

 

 

 

chorea

  • jerky, random movements of the limbs and orofacial structures
  • dance-like, as m ovements flow form one part to another
  • seen in Huntington's Disease

 

 

 

 

akethesia

  • sense of restlessness and need to move
  • common manifestation is 'restless legs syndrome'

myoclonus

A nonsustained movement disorder with sudden, shocklike movements, often induced by action

  • may be generated by problems in cortex, brain stem, or spinal cord

 

clonus

Clonus is a series of involuntary muscle contractions due to sudden stretching.

 

It is associated with upper motor neuron damage, including ALS, stroke, multiple sclerosis, or spinal cord damage.

 

Hypokinetic Disorders

often seen in Parkinson's Disease

 

bradykinesia: Bradykinesia is the delay in movement initiation and a decline in rage and speed

freezing

rigidity

 

  • dopamine blockers, ie tetrabenazine, reserpine; antipsychotics
  • GABAergic drugs, ie benzodiazepines
  • anticholinergics for dystonia

Tumours

trauma

  • head injury
  • spinal injury
  • radiculopathy
  • thoracic outlet syndrome

 

Additional Resources

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