NEUROLOGY EPILEPSY MULTIPLE SCLEROSIS PARALYSIS SPINA BIFIDA By

NEUROLOGY: EPILEPSY, MULTIPLE SCLEROSIS, PARALYSIS, SPINA BIFIDA By: Na. Tayvia and Na’Deyah Timmons

EPILEPSY (SEIZURE DISORDER) Epilepsy is a chronic disorder for unprovoked seizures. A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.

Epilepsy (Seizure Disorder) The seizures in epilepsy may be related to a brain injury or a family tendency, but often the cause is completely unknown. Many people with epilepsy have more than one type of seizure and may have other symptoms of neurological problems as well. The word "epilepsy" does not indicate anything about the cause of the person's seizures or their severity. Sometimes EEG (electroencephalogram) testing, clinical history, family history, and outlook are similar among a group of people with epilepsy. In these situations, their condition can be defined as a specific epilepsy syndrome.

What causes epilepsy? For 6 out of 10 people with epilepsy, the cause can’t be determined. A variety of things can lead to seizures. Possible causes include: • traumatic brain injury • scarring on the brain after a brain injury (post-traumatic epilepsy) • serious illness or very high fever • stroke, which is a leading cause of epilepsy in people over age 35 • other vascular diseases • lack of oxygen to the brain • brain tumor or cyst • dementia or Alzheimer’s disease • maternal drug use, prenatal injury, brain malformation, or lack of oxygen at birth • infectious diseases such as AIDS and meningitis • genetic or developmental disorders or neurological diseases

How is epilepsy treated? Most people can manage epilepsy. Your treatment plan will be based on severity of symptoms, your health, and how well you respond to therapy. Some treatment options include. • Anti-epileptic (anticonvulsant, antiseizure) drugs: These medications can reduce the number of seizures you have. In some people, they eliminate seizures. To be effective, the medication must be taken exactly as prescribed. • Vagus nerve stimulator: This device is surgically placed under the skin on the chest and electrically stimulates the nerve that runs through your neck. This can help prevent seizures. • Ketogenic diet: More than half of people who don’t respond to medication benefit from this high fat, low carbohydrate diet. • Brain surgery: The area of the brain that causes seizure activity can be removed or altered

MULTIPLE SCLEROSIS Multiple sclerosis (MS) is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.

What causes MS? ◦ The cause of multiple sclerosis is unknown. ◦ It's considered an autoimmune disease in which the body's immune system attacks its own tissues. ◦ In the case of MS, this immune system malfunction destroys myelin (the fatty substance that coats and protects nerve fibers in the brain and spinal cord). ◦ Scientists believe the disease is triggered by an as yet unidentified environmental factor in a person who is genetically predisposed to respond.

Who gets MS? ◦ Multiple sclerosis is thought to affect more than 2. 3 million people worldwide. ◦ While the disease is not contagious or directly inherited, epidemiologists (scientists who study patterns of disease) have identified factors in the distribution of MS around the world that may eventually help determine what causes the disease. These factors include gender, genetics, age, geography and ethnic background. ◦ Most people are diagnosed between the ages of 20 and 50, although MS can occur in young children and significantly older adults. ◦ In general, MS is more common in areas farthest from the equator. ◦ MS is at least two to three times more common in women than in men, suggesting that hormones may also play a significant role in determining susceptibility to MS. And some recent studies have suggested that the female to male ratio may be as high as three or four to one.

PARALYSIS Paralysis is the loss of muscle function in any part of your body such as the face, hands, one arm or leg, one side of the body, and both arms and legs.

Paralysis ◦ It happens when something goes wrong with the way messages pass between your brain and muscles. ◦ Paralysis can be complete or partial. It can occur on one or both sides of your body. ◦ It can also occur in just one area, or it can be widespread. ◦ Paralysis of the lower half of your body, including both legs, is called paraplegia. ◦ Paralysis of the arms and legs is quadriplegia. ◦ Polio used to be a cause of paralysis, but polio no longer occurs in the U. S.

What causes paralysis? Neurological diseases, such as Cerebral Palsy, Bell’s Palsy, Multiple Sclerosis, and Peripheral Neuropathy Infectious or autoimmune diseases such as HIV, Lyme disease, Spondylitis, and Guillain-Barre syndrome Serious or life-threatening conditions such as brain tumor, trauma, hemorrhage, or stroke Trauma such as a herniated vertebral disk, broken or severed spinal cord, or direct trauma to a nerve Environmental factors such as toxins, radiation or poisons

Paralysis can affect: Joint and muscle pain. When you can't move one portion of your body, the muscles that are attached to it can become stiff and painful. Phantom pain. You may feel electrical or tingling sensations in the affected area, even if you can't move it. Difficulties with using the bathroom. You may need to use a catheter or ostomy bag. Changes in sexual functioning or fertility. Difficulty breathing without assistance. Changes in weight and body composition, particularly if you are unable to exercise; this can lead to other complications, such as diabetes or high blood pressure. Bedsores, particularly if you do not regularly stretch or exercise. Increased vulnerability to infections, particularly respiratory infections. You may suffer from pneumonia, bronchitis, frequent colds, and other medical ailments.

SPINA BIFIDA Spina bifida is what is known as a neural tube defect. It occurs during development prior to birth. It’s when the spinal cord, brain, or meninges (their protective covering) does not completely develop. It can be anywhere along the spine and usually can be seen in an opening in the baby’s back at birth. It may also appear as a sack of fluid that has grown outside the body on the spine. This sack may or may not include the spinal cord inside.

3 Types of Spina Bifida Myelomeningocele This is the most common and serious type of spina bifida. It involves a sack outside the opening in the baby’s back somewhere on the spine. This sack contains parts of the spinal cord and nerves. The spinal cord and nerves in the sack will be damaged. People with myelomeningocele have physical disabilities that range from moderate to severe. These disabilities may include: ◦ incontinence ◦ difficulty going to the bathroom ◦ inability to move or feel their legs or feet

3 Types of Spina Bifida con’t. Meningocele ◦ This type of spina bifida also involves a sack of fluid outside an opening in the baby’s back. However, the sack does not contain any part of the spinal cord. Because there isn’t a lot of nerve damage, meningocele causes only minor disabilities.

3 Types of Spina Bifida con’t. Spina bifida occulta ◦ This is a mild type of spina bifida. It may also go by the term “hidden” spina bifida. It does not cause any disabilities and may go unnoticed until later in life. There is usually no opening in the baby’s back, but only a gap in the spine. In this type, there is no damage to the spinal cord or the nerves.

Causes of spina bifida Involves a combination of genetics and environmental factors. A child born with spina bifida may not have any relatives with the condition, even though genetics play a factor. It’s also believed that a lack of folic acid, also known as vitamin B-9, plays a role in spina bifida. Other factors that are believed to play a role include: • obesity • diabetes in the mother that is not well controlled • some medications

Treatment for spina bifida The treatment for spina bifida will be different for each person because symptoms and severity can vary. In some cases, especially in spina bifida occulta, there may not be any treatment needed. However, myelomeningocele and meningocele require surgery to put the exposed sack and nerves back in place. Some of it may also require removal. The surgeon will then close the opening over the vertebrae. There may be a shunt put in place to avoid complications later in life. This surgery may be performed shortly after the child’s birth. In some cases, prenatal surgery may be done while the baby is still in the womb. Treatment for remaining symptoms can include: • • • additional surgeries medications physical therapy rehabilitation services walking aids