Disease Of The Nervous System

Disease of the nervous system

By

Dr. Muhammad Shahzad

Aslam

Ph.D., M.Phil., Pharm-D, R.Ph

CASE PRESENTATION

•Summary: An 86-year-old male nursing home resident is

found wandering the

•streets. His cognitive function has worsened progressively

over several years.

•He does not have a history of head trauma or

cardiovascular disease but has

•significant language impairment.

•◆ Most likely etiology: Alzheimer disease

•◆ Distinctive pathologic findings: Cortical atrophy,

neuritic or senile plaques, neurofibrillary tangles, and

amyloid angiopathy

Alzheimer disease

1. Alzheimer disease (AD) is the most common

cause of dementia in the elderly population

2. Impaired higher intellectual function and altered

mood and behavior

3. Later, this progresses to disorientation, memory

loss, and aphasia, findings indicative of severe

cortical dysfunction, and over another 5 to 10

years, the patient becomes profoundly disabled,

mute, and immobile

4. Death usually occurs from intercurrent

pneumonia or other infections

Alzheimer disease

Epdemiology:

1. Risk factor: Age

2. 3% in persons 65 to 74 years old

3. 19% in those 75 to 84 years old

4. 47% in those older than 84 years

Pathogenesis:

•beta amyloid

•Aβ, accumulates in the brain over time

Morphology

Macroscopic examination of the brain

•Cortical atrophy

•Widening of the cerebral sulci

•Ventricular enlargement

Microscopic examination

Presence of plaques

Neurofibrillary tangles

Neuritic plaques

hyperphosphorylated tau

The Stages of Alzheimer’s Disease

Mild Moderate Severe

Memory

Loss

Language

Problems

Mood and

Personality

Changes

Diminished

Judgment

Behavioral, Personality

Changes

Unable to Learn or

Recall New

Information

Long-Term Memory

Affected

Wandering, Agitation,

Aggression, Confusion

Require Assistance

with ADLs

Unstable Gait

Incontinence

Motor Disturbances

Bedridden

Dysphagia

Mute

Poor/No ADLs

Vacant

LTC Placement

Common

Stage

Symptoms

ADL = activities of daily living

LTC = long-term care

Learning Outcomes

•Discuss the epidemiology, morphology,

pathogenesis and clinical features of

Alzheimer disease

PARKINSION DISEASE

CASE PRESENTATION

A 70-year-old male farmer was referred to a

movement disorders outpatient clinic due to a 1-

year nondisabling intermittent resting tremor of the

Parkinson disease

1. Characterized by tremor, rigidity,

bradykinesia and instability

2. Motor disturbances