Alzheimer's Disease



Alzheimer's Disease [pic]

What is Alzheimer's disease?

Alzheimer's disease is a progressive, neurodegenerative disease that occurs in the brain and often results in the following:

• impaired memory, thinking, and behavior

• confusion

• restlessness

• personality and behavior changes

• impaired judgment

• impaired communication

• inability to follow directions

• language deterioration

• impaired visuospatial skills

• emotional apathy

With Alzheimer's disease, motor function is often preserved.

When Alzheimer's was first identified by German physician, Alois Alzheimer, in 1906, it was considered a rare disorder. Today, with one in 10 persons over age 65, and nearly half of persons over age 85, affected, Alzheimer's disease is recognized as the most common cause of dementia (a disorder in which mental functions deteriorate and breakdown).

How is Alzheimer's different from other forms of dementia?

Alzheimer's disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy. Brains affected by Alzheimer's disease often show presence of the following:

• fiber tangles within nerve cells (neurofibrillary tangles)

• clusters of degenerating nerve endings (neuritic plaques)

Another characteristic of Alzheimer's disease is the reduced production of certain brain chemicals necessary for communication between nerve cells, especially acetylcholine, as well as norepinephrine, serotonin, and soma-tostatin.

What causes Alzheimer's disease?

Although intense investigation has been underway for many years, the causes of Alzheimer's disease are not entirely known. Suspected causes often include the following:

• age and family history

• certain genes

• abnormal protein deposits in the brain

• other risk and environmental factors

What are the warning signs or symptoms of Alzheimer's disease?

According to the Alzheimer's Association, the following are the most common symptoms of Alzheimer's disease. However, each individual may experience symptoms differently. Symptoms may include:

• memory loss that affects job skills

• difficulty performing familiar tasks

• problems with language

• disorientation to time and place

• poor or decreased judgment

• problems with abstract thinking

• misplacing things

• changes in mood or behavior

• changes in personality

• loss of initiative

The symptoms of Alzheimer's disease may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is Alzheimer's diagnosed?

There is not a single, comprehensive test for diagnosing Alzheimer's disease. By ruling out other conditions through a process of elimination, physicians, or other specialists, can obtain a diagnosis of probable Alzheimer's disease with approximately 90 percent accuracy. However, the only way to confirm a diagnosis of Alzheimer's disease is through autopsy.

Examination and evaluation are essential in determining whether the dementia is the result of a treatable illness. In addition to a complete medical history and physical examination, diagnostic procedures for Alzheimer's disease may include the following:

• mental status test - testing evaluates memory, ability to solve simple problems and other thinking skills.

• neuropsychological testing

• blood work

• urinalysis - laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.

• chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

• electroencephalogram (EEG) - a procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp.

• compute d tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

• electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle stress.

Prevention of Alzheimer's:

Because the cause of the disease is unknown, there are no prevention protocols to follow at this time. And, because the controllable risk factors for Alzheimer's disease are unknown, it is not yet possible to reduce the chances of developing the disease.

Treatment for Alzheimer's:

Specific treatment for Alzheimer's disease will be determined by your physician based on:

• your age, overall health, and medical history

• extent of the disease 

• your tolerance for specific medications, procedures, or therapies

• expectations for the course of the disease

• your opinion or preference

At this time, there is no cure for Alzheimer's, no way of slowing down the progression of this disease, and no treatment available to reverse the deterioration of Alzheimer's disease. New research findings give reason for hope, and several drugs are being studied in clinical trials to determine if they can slow the progress of the disease or improve memory for a period of time.

There are some medications available to assist in managing some of the most troubling symptoms of Alzheimer's disease, including the following:

• depression

• behavioral disturbance

• sleeplessness

In managing the disease, physical exercise and social activity are important, as are proper nutrition, health maintenance, and a calm and well-structured environment.

Alzheimer's rehabilitation:

The rehabilitation program for persons with Alzheimer's differs depending upon the symptoms, expression, and progression of the disease, and the fact that making a diagnosis of Alzheimer's is so difficult. These variables determine the amount and type of assistance needed for the Alzheimer's individual and family.

With Alzheimer's rehabilitation, it is important to remember that, although any skills lost will not be regained, the care giving team must keep in mind the following considerations:

• In managing the disease, physical exercise and social activity are important, as are proper nutrition and health maintenance.

• Plan daily activities that help to provide structure, meaning, and accomplishment for the individual.

• As functions are lost, adapt activities and routines to allow the individual to participate as much as possible.

• Keep activities familiar and satisfying.

• Allow the individual to complete as many things by himself/herself as possible. The caregiver may need to initiate an activity, but allow the individual to complete it as much as he/she can.

• Provide "cues" for desired behavior (i.e., label drawers/cabinets/closets according to their contents).

• Keep the individual out of harm's way by removing all safety risks (i.e., car keys, matches).

• As a caregiver (full-time or part-time), it is important to understand and act accordingly to your own physical and emotional limitations.

Multiple Sclerosis

What is multiple sclerosis (MS)?

Multiple sclerosis (MS) is a chronic disease of the central nervous system. It is an unpredictable condition that can be relatively benign, disabling, or devastating. Some individuals with MS may be mildly affected while others may lose their ability to write, speak, or walk -- when communication between the brain and other parts of the body becomes disrupted.

What happens during an attack?

• Inflammation occurs in areas of the white matter of the central nervous system in random patches called plaques.

• This is followed by destruction of myelin, the fatty covering that insulates nerve cell fibers in the brain and spinal cord to assist the high-speed transmission of electrochemical messages between the brain, the spinal cord, and the rest of the body. When myelin is damaged, transmission of messages may be slowed or blocked completely.

• This leads to diminished or lost function.

What causes multiple sclerosis?

There are many possible causes of MS, including:

• viruses

• environmental factors

• genetic factors

• immune system factors

• other

Stroke [pic]

What is a stroke?

A stroke, also called a "brain attack," happens when brain cells die because of inadequate blood flow. A stroke is considered to be a cardiovascular disease and a neurological disorder.

What causes a stroke/brain attack?

Most strokes are caused by the blockage of an artery in the neck or brain, and the rest by bleeding into or around the brain. When brain cells die, function of the body parts they control becomes damaged or destroyed. This may include paralysis, speech problems, memory and reasoning deficits, coma, and possibly death.

What happens during a stroke?

According to the American Heart Association:

A brain attack occurs when a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged by a blood clot or some other particle.

When the brain doesn't get the needed blood flow, because of a rupture or blockage, it is deprived of oxygen. Thus, nerve cells cannot properly function and die within minutes.

And when nerve cells cannot function, the part of the body controlled by these cells cannot function either. The devastating effects of stroke are often permanent because dead brain cells are not replaced.

What are the types of strokes?

There are four main types of stroke:

1. Cerebral thrombosis - caused by blood clots

2. Cerebral embolism - caused by blood clots

3. Cerebral hemorrhages - caused by hemorrhages

4. Subarachnoid hemorrhages - caused by hemorrhages

Cerebral thrombosis and cerebral embolism:

• the most common types of brain attacks

• account for about 70-80 percent of all strokes

• are caused by clots that plug an artery

cerebral thrombosis

• the most common type of brain attack

• occurs when a blood clot (thrombus) forms and blocks blood flow in an artery bringing blood to part of the brain. Blood clots usually form in arteries damaged by atherosclerosis

• most often, cerebral thrombotic strokes occur at night or first thing in the morning when blood pressure is low

• this type of stroke is often preceded by a transient ischemic attack (TIA) or "mini-stroke"

cerebral embolism:

• occurs when a wandering clot (embolus) or some other particle forms in a blood vessel away from the brain -- usually in the heart

• the clot is carried by the bloodstream until it lodges in an artery leading to the brain or in it, blocking the flow of blood

• the most common cause is blood clots that form during atrial fibrillation, a disorder in which the two small upper chambers of the heart (the atria) quiver instead of beating effectively. Blood is not pumped completely out of them when the heart beats, allowing it to pool and clot. About 15 percent of strokes occur in people with atrial fibrillation

Cerebral hemorrhages and subarachnoid hemorrhages:

• caused by ruptured blood vessels

• have a much higher fatality rate than strokes caused by clots

cerebral hemorrhages:

• occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood

subarachnoid hemorrhages:

• occurs when a blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and the skull (but not into the brain itself)

Causes Of Cerebral Palsy

Most people assume cerebral palsy (CP) is caused by just one reason: a lack of oxygen to a baby's brain at birth.

A recent report convened by the American College of Obstetrics and Gynecologists challenges that assumption and gives credence to the fact that there is not a single cause of cerebral palsy. Researchers found that just 6 to 10 percent of CP cases result from a problem at delivery, while roughly 75 to 90 percent of CP cases are caused by something before labor, including maternal infections, strokes, prematurity, and other prenatal problems.

"Cerebral palsy is a movement disorder that affects about two to three of every 1,000 children," explains Dr. Steve Kinsman, the director of pediatric neurology at the University of Maryland Hospital for Children. "It is very difficult to pinpoint the exact cause of cerebral palsy. We know that a child has suffered from brain damage, but many times, we don't know why, though we are getting better at diagnosing causes with more advanced imaging and metabolic and genetic tests," adds Kinsman.

Most children are diagnosed with the disorder when they are two or three years old, though there are typically signs of CP in babies, including breathing problems, poor muscle tone, and difficulty walking. Cerebral palsy is most often diagnosed by analyzing how a child moves.

There are varying degrees of severity. Some children may not be able to walk or talk, while others can move more easily. Almost immediately after a child is diagnosed, he or she will begin physical therapy to help develop muscle strength and motor skills. Cerebral palsy does not get progressively worse as a child ages. The majority of children learn to thrive, despite their limitations.

Parkinson's Disease [pic]

What is Parkinson's disease?

Parkinson's disease (PD or, simply, Parkinson's) is the most common form of parkinsonism, a group of motor system disorders. It is a slowly progressing, degenerative disease that is usually associated with the following symptoms, all of which result from the loss of dopamine-producing brain cells:

• tremor or trembling of the arms, jaw, legs, and face

• stiffness or rigidity of the limbs and trunk

• bradykinesia -- slowness of movement

• postural instability, or impaired balance and coordination

Facts about Parkinson's disease:

It is incorrectly believed that Parkinson's disease disappeared after the introduction of levodopa (L-dopa) in the 1960s. In fact, about 50,000 Americans are diagnosed with Parkinson's disease each year, with more than half a million Americans affected at any one time. And more people suffer from Parkinson's disease than multiple sclerosis, muscular dystrophy, and amyotrophic lateral sclerosis combined.

What are causes of Parkinson's disease (PD)?

The specific cause of PD is unknown, however, medical experts believe the symptoms are related to a chemical imbalance in the brain caused by brain-cell death. Parkinson's disease is chronic (persists over a long period of time), and progressive (symptoms grow worse over time).

Although the disease may appear in younger patients, it usually affects people in late middle age, and men and women in almost equal numbers. There is also a form that strikes teenagers. It knows no social, economic, or geographic boundaries. It is not contagious, nor is it likely passed on from generation to generation.

Parkinson's Syndrome, Atypical Parkinson's, or Parkinsonism:

Parkinson's disease is also called primary parkinsonism or idiopathic Parkinson's disease. (Idiopathic is the term for a disorder for which no cause has yet been identified).

In the other forms of parkinsonism, either the cause is known or suspected, or the disorder occurs as a secondary effect of another, primary neurological disorder that may have both primary and secondary symptoms of Parkinson's disease. These disorders, described as Parkinson's Syndrome, Atypical Parkinson's, or simply parkinsonism, may include:

• tumors in the brain

• repeated head trauma

• drug-induced parkinsonism - prolonged use of tranquilizing drugs, such as the phenothiazines, butyrophenones, reserpine, and the commonly used drug, metaclopramide for stomach upset

• toxin-induced parkinsonism - manganese and carbon monoxide poisoning

• postencephalitic parkinsonism - a viral disease that causes "sleeping sickness"

• striatonigral degeneration - the substantia nigra of the brain is only mildly affected, while other areas of the brain show more severe damage

• parkinsonism that accompanies other neurological conditions - such as Shy-Drager syndrome (multiple system atrophy), progressive supranuclear palsy, Wilson's disease, Huntington's disease, Hallervorden-Spatz syndrome, Alzheimer's disease, Creutzfeldt-Jakob disease, olivopontocerebellar atrophy, and post-traumatic encephalopathy

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