This presentation provides an overview of demyelinating diseases, focusing on multiple sclerosis (MS). It defines demyelinating diseases as those that cause myelin destruction while sparing other nervous system elements. MS is described as an autoimmune, inflammatory demyelinating disease of the central nervous system (CNS) that is more common in women. The presentation covers the pathology, clinical features, investigations, and treatment approaches for MS.
Dystonia is a movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body.
MYOPATHIES A SPECIAL AND SEPERATE ENTITY WITH SPECIFIC FEATURES IN EACH DISORDER MAKING US EASY FOR DIAGNOSIS,CONFIRMATION BY MUSCLE BIOPSY.THE SEMINAR WAS PRSENTED ON 06/07/2011...AT 09.00AM
HAVE A LOOK ..AND COMMENT..WITHOUT BIAS..
Dystonia is a movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body.
MYOPATHIES A SPECIAL AND SEPERATE ENTITY WITH SPECIFIC FEATURES IN EACH DISORDER MAKING US EASY FOR DIAGNOSIS,CONFIRMATION BY MUSCLE BIOPSY.THE SEMINAR WAS PRSENTED ON 06/07/2011...AT 09.00AM
HAVE A LOOK ..AND COMMENT..WITHOUT BIAS..
This presentation is about different diseases which presents or are associated with myotonia. Referrences were taken from Bashir Katirji Neuromuscular textbook, continuum, and seminar of neurology journal.
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
This ppt describes various movement disorders found commonly in elderly persons. It also describes hyper and hypokinetic disorder categorization with cause and pathophysiology of movement disorders.
FA is a very rare, genetic, recessive disease, affecting 1/50,000 people.
Originates from mutations in the “coding” of the mitochondria.
Discovered by Nicholaus Friedreich in the early 1860’s.
Both parents must have the dominant trait for a 25% chance of an offspring possessing the disease.
Not necessarily a disease that kills you, but eventually a wheelchair and regular assistance will be required.
Onset before age 20-25 year.
Ataxia is a medical condition which results in the lack of muscle coordination that usually affects voluntary movements such as walking, eye movements, speech, and the patient’s ability to swallow.
This presentation is about different diseases which presents or are associated with myotonia. Referrences were taken from Bashir Katirji Neuromuscular textbook, continuum, and seminar of neurology journal.
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
This ppt describes various movement disorders found commonly in elderly persons. It also describes hyper and hypokinetic disorder categorization with cause and pathophysiology of movement disorders.
FA is a very rare, genetic, recessive disease, affecting 1/50,000 people.
Originates from mutations in the “coding” of the mitochondria.
Discovered by Nicholaus Friedreich in the early 1860’s.
Both parents must have the dominant trait for a 25% chance of an offspring possessing the disease.
Not necessarily a disease that kills you, but eventually a wheelchair and regular assistance will be required.
Onset before age 20-25 year.
Ataxia is a medical condition which results in the lack of muscle coordination that usually affects voluntary movements such as walking, eye movements, speech, and the patient’s ability to swallow.
neurological disorders of demyelination, for generalized idea as a seminar work for university, department of pathophysiolog.
for more information feel free to contact me
MRI in evaluation of white matter diseases like multiple sclerosis, leukodystrophies, demyelination, dysmyelination, ADEM, leukoencephalopathies, van der knaap disease, ALD, MLD, Krabbes disease, Leighs disease, Vanishing white matter disease, Canavan disease, Alexander disease
Paraneoplastic syndrome (PNS) is the term used to refer to the disorders that accompany the benign or the malignant tumors and are not caused by mass effect or invasion / metastasis.
These disorders are triggered by an immune system response to neuronal proteins expressed by the tumor(onconeural proteins).
These PNS also occur due to substances secreted by the neoplasm itself.
Atrioventricular blocks are related to delay in conduction of the AV node..
Their recognition is primarily by ECG, anatomical correlation is by EP study.
ST elevation is not always due to STEMI. Other causes to be kept in mind to prevent the undue complications of thrombolysis. wrong patient and wrong management
The electrocardiogram, a basic tool in cardiology has been developed two centuries ago. It was recorded by a giant machine at that time, which is now being recorded on a mobile. Such is the advancement in ECG, which is still the gold standard in diagnosis of VT .
SGLT2I The paradigm change in diabetes managementPraveen Nagula
Just like ARNI, SGLT2I have changed the face of diabetes management and they have a good profile in multimodality management because of pleiotropic effects
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
3. Are those diseases which cause destruction of myelin with relative sparing of other elements of nervous system. infiltration of inflammatory cells in perivascular distribution (perivascular lymphocytic infiltration/cuffing. Demyelination occurs in CNS as well as PNS. Leucodystrophy (Dysmyelination) –intrinsic abnormality of myelin.
4. Myelin is necessary for normal conduction of nerve impulses down the axons. Without myelin, the underlying neuronal membrane does not contain enough concentrations of Na+, K+ and other ionic channels to permit sufficient flow of ions to cause depolarization to conduct an action potential.
14. Multiple Sclerosis Is an inflammatory demyelinating disease of the CNS. Second only to trauma as the most common cause of chronic neurological disability in young adults in the USA and Europe. Affects mostly between ages of 20 and 40 yrs. Is twice as common in women as men.
15. MULTIPLE SCLEROSIS IN INDIA Low prevalence 1.33 / 100,000 Constitutes 2.5% of neurology admissions India being tropical country, prevalence is very low More common in north India than south India
16. Opticospinal type of multiple sclerosis seen in India There is no family history of MS in affected Indian patients suggesting and environmental cause for MS Other types of demyelination seen in India are ADEM Neuromyelitisoptica
17. Cerebellar involvement in Indian patients is seen in 30-58% Oligoclonal bands in the CSF is seen in only 33-45% There seems to be no association of HLA DR2 MS society of India registered 4,000 MS patients so far It is estimated that there are approximately 40,000 MS patients in the community
18. Aetiology MS is caused by an interplay of multiple genetic and environmental factors. Incidence is higher in temperate zones and low in equatorial zones. Risk of familial recurrence is 15% Monozygotic concordance is 35%
19. Heritability is polygenic with associations with various class-II MHC alleles and the gene for TNF alpha as well as HLA haplotypes (HLA DR2 & a lesser extent DR3, B7 & A3) Immune mechanism is suggested due to presence of increased levels of activated lymphocytes in the CSF and increased immunoglobulin synthesis within the CNS
20. PATHOPHYSIOLOGY MS is a result of both humoral and cellular immune response to a pathogen which remains unknown There is breakdown of blood brain barrier, causing the humoraland the cellular factor to interact and ultimately destroy the myelin (and in some cases even the axons of CNS) The severity of myelin (and axonal) destruction and the degree of subsequent remyelination determines the extent of neurological deterioration and recovery after each exacerbation .
21. PATHOLOGY MS is characterised by multi focal areas of demyelination (with relative preservation of axons) loss of oligodendrocytes and astroglial cells.
22. Clinico-Pathological Correlation Persistent neurological deficits are caused due to large plaques which produced conduction block. If there is partially demyelinated axon, transient worsening of function occurs. Uhthoff’s phenomenon – worsening with increased body temparature
23. Mechanical stimulation of demyelinated axons can generate action potentials denovo in the axon and may explain Lhermitte’s phenomenon ( Electric shock like sensation on flexing the neck) Spontaneous action potentials are thought to cause paroxysmal positive symptoms such as trigeminal neuralgia, myokymia and visual phenomenon
24. Clinical features suggestive of Multiple sclerosis Sudden loss of vision (optic neuritis) Diplopia / internuclearophthalmoplegia Recurrent facial palsy Scanning speech, nystagmus, intention tumors (charcot’s triad) Trigeminal neuralgia in young Paraplegia (transverse myelitis) Tingling in spine with limbs on neck flexion (L hermitte’s phenomenon) Neurogenic bladder
25. Clinical Features of MS Pyramidal weakness – 45% Optic neuritis - 40% Sensory loss - 35% Brain stem dysfunction – 30% Facial Palsy Trigeminal neuralgia Inter nuclear ophthalmoplegia Cerebellar ataxia / Tremur – 25% Spincter disturbances - 20% (neurogenic Bladder)
26. Clinical course of MS Relapsing Remitting (RR) Most common type - 55% Characterised by exacerbations and remissions Secondary progressive Relapsing remitting course at onset followed by a progression – 30% Primary Progressive Nearly continuous worsening of disease not interrupted by relapses Progressive Relapsing Progressive disease from onset, with clear acute relapses that may or maynot resolve with full recovery
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28. Investigations No diagnostic test for MS (due to lack of sensitivity and specificity) CSF study MRI Evoked potentials
29. CSF Slight increase in protein in 40% - <60mg/dl Increase in lymphocytes 20-30% Globulins increased significantly CSF IgG is increased in 40-60% of patients Oligoclonal IgG bands demonstrable in 90% of patients However, other inflammatory conditions have CSF oligoclonal bands as in syphilis, meningoencephalitis,SSPE and GB syndrome.
30. Evoked potentials; measure conduction through CNS and reveal areas of demyelination by showing slowed conduction through pathways where myelin has been damaged.
31. Types of Evoked potentials Visual evoked potentials (VEP) abnormal in 70% of MS patients Brainstem auditory evoked potentials (BAEP) abnormal in 47% of patients Somatosensory evoked potentials (SSEP) abnormal in 69% of patients
32. MRI Shows abnormality in 80% of patients with MS. Sensitive, non invasive but lacks specificity Seen best on T2 weighted MRI images , are circumscribed, confluent mainly periventricular plaques, fewer plaques in other locations and involvement of corpus callosum
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35. Treatment 1 Prophylactic treatment with disease modifying lesions Treatment of acute relapse and progressive MS Symptomatic treatment
36. Treatment with Disease modifying lesions Three(3) drugs approved to reduce the rate of attacks by 30% β- interferon 1α β- interferon 1 β Glatiramer acetate All these reduce the frequency and severity of relapse and can thus reduce the future disability and improve the quality of life Treatment should be started after diagnosis and continued indefinitely
37. Treatment for acute relapse and progressive MS IV methylprednisolone – 1gm IV OD x 3 – 7days followed by oral prednisolone in tapering doses over 1-3weeks
38. Immunosuppressant therapy with cyclophosphamide, azathioprine, mitoxantrone, methotrexate has been tried with variable success.
39. Other Disease modifying treatments in MS IV immunoglubulins for immune modulation. Plasmapheresis for immune modulation. Monoclonal antibodies to beta integrins (Natalizumab) Monoclonal antibodies to lymphocyte epitopes(campath1-H)
40. Symptomatic treatment Treatment of Fatigue Amantadine Pemoline Rest Treatment of spasticity Baclofen Tizanidine Dantrolene Diazepam Physiotherapy
41. Treatment of cerebellar tremor/ataxia Difficult to treat Drugs that increase GABA levels (Primary neurotransimittor of cerebellum) Clonazepam Valproate INH Surgical ablation of thalamus for tremor Treatment neurogenic bladder Oxybutinin Probanthine Hyoscyamine Prazosinfor sphincter detrusordyssynergia
42. PROGNOSIS 1/3rd do well through out their life 1/3rd have neuro deficits but can lead a fairly normal life 1/3rd becomes disabled requiring a walker, wheelchair or even total care There is no cure for M S