This document provides an overview of nervous system physiology, diseases treated by pregabalin, and key topics in neurobiology. It discusses the central and peripheral nervous systems, neurons, neurotransmitters, voltage-gated calcium channels, and conditions such as diabetic peripheral neuropathy, post-herpetic neuralgia, fibromyalgia, and partial onset seizures. The goal is to explain the nervous system, diseases treated by pregabalin, and provide neurobiological context.

1. Nervagab Medical Knowledge
Readiness
Scientific Affairs
Cycle Meeting December 2016
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2. By the End of this Training You should be able to :
• Explain the Nervous system and neurons physiology.
• Explain diseases of indications of Pregablin like : Diabetic Peripheral
Neuropathy , Post herpetic neuralgia , Fibromyalgia , partial onset seizures.
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Neurobiology

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5. Nervous System
1-Central nervous system 2-peripheral nervous system

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7. Nerves (neurons)

8. Action potential

9. Electrical signals travelling along the peripheral nerves caused by a certain
stimulus in the form of:
Neuron membrane depolarization/repolarization

10. Synapse
The junction between axon terminals of a neuron and the dendrites of the
following neuron

11. Neurotransmitters
Endogenous chemicals that transmit signals across a synapse or junction
from one neuron (nerve cell) to another "target" neuron.
1- Excitatory neurotransmitters:
• Dopamine
• Epinephrine
• L-glutamate
2- Inhibitory neurotransmitters:
• Serotonin
• Endorphins
• GABA https://www.youtube.com/watch?v=3Jy0VsLnv8w

12. Voltage gated calcium channels
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Voltage-gated calcium channels are the primary mediators of
depolarization-induced calcium entry into neurons. There is great
diversity of calcium channel subtypes due to multiple genes that encode
calcium channel α1 subunits, co assembly with a variety of ancillary calcium
channel subunits, and alternative splicing. This allows these channels to fulfill
highly specialized roles in specific neuronal subtypes and at particular sub
cellular loci. While calcium channels are of critical
importance to brain function, their inappropriate
expression or dysfunction gives rise to a variety of
neurological disorders, including, pain, epilepsy,
migraine, and ataxia.

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Diabetic Peripheral
Neuropathy

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Diabetic neuropathy is the most common complication of diabetes mellitus (DM), affecting as many as 50%
of patients with type 1 and type 2 DM. Diabetic peripheral neuropathy involves the presence of symptoms or
signs of peripheral nerve dysfunction in people with diabetes after other possible causes have been excluded
Peripheral neuropathy
Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often
affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often
worse at night, and may include:
•Numbness or reduced ability to feel pain or temperature changes
•A tingling or burning sensation
•Sharp pains or cramps
•Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing
•Muscle weakness
•Loss of reflexes, especially in the ankle
•Loss of balance and coordination
•Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain

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Post herpetic
Neuralgia

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Post herpetic Neuralgia is a complication of shingles, which is caused by the chickenpox
(herpes zoster) virus. Post herpetic neuralgia affects nerve fibers and skin, causing burning pain
that lasts long after the rash and blisters of shingles disappear.
The signs and symptoms of post herpetic neuralgia are generally limited to the area of your skin where
the shingles outbreak first occurred — most commonly in a band around your trunk, usually on one
side of your body. However post herpetic neuralgia is also common in people whose shingles occurred
on the face.
Signs and symptoms may include:
Pain that lasts 3 months or longer after the shingles rash has healed. The associated pain has been
described as burning, sharp and jabbing, or deep and aching.
Sensitivity to light touch. People with the condition often can't bear even the touch of clothing on the
affected skin (allodynia).
Itching and numbness. Less commonly, post herpetic neuralgia can produce an itchy feeling or
numbness.

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Fibromyalgia

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Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue,
sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by
affecting the way your brain processes pain signals.
Symptoms of fibromyalgia include:
Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that
has lasted for at least three months. To be considered widespread, the pain must occur on both sides of
your body and above and below your waist.
Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of
time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders,
such as restless legs syndrome and sleep apnea.
Cognitive difficulties. A symptom commonly referred to as "fibro fog" impairs the ability to focus, pay
attention and concentrate on mental tasks.
Other problems. Many people who have fibromyalgia also may experience depression, headaches, and
pain or cramping in the lower abdomen.

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Partial Onset
Seizures

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Simple partial seizures can be even more subtle. While the person cannot control the seizure itself, he or
she remains aware that something is going on. For example, simple partial seizures might cause an
involuntary movement of the leg, an occasional sense of déjà vu, or the perception of an odor that isn’t really
there.
A seizure occurs when there is a surge in this electrical activity. This causes a host of physical symptoms
such as muscle contractions, visual disturbances, and blackouts. Seizures can affect the entire brain, but
when it occurs in just one area, it is called a partial seizure.
Epilepsy is a neurological disorder where the normal electrical activity in the brain is disturbed. Epilepsy
causes seizures. A seizure can cause a variety of symptoms and signs, including loss of consciousness,
abnormal behavior, temporary confusion, and uncontrollable jerking movements.

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