Diseases of the Neurological System Introduction Acute neurological diseases initiate metabolic responses that require intensive nutrition therapy Ex head trauma spinal cord injury Progressive neurological diseases involve many possibilities for impairment of nutritional intake and status All the different routes that could be affected throughout the brain that could be involved with nutritional processes that take place Complicated nutritional problems not easily identified solved because different routes taken within the brain and nerves Nutritional therapy important to maintain optimal quality of life When there is a neurological issue there can be many nutritional consequences and implications as a result of this Appropriate AND aggressive nutrition is important The Nervous System Has 2 major divisions Central Nervous System CNS Brain spinal cord associated nerves Major function o Process sensory info after the appropriate responsive motor signal is generated CNS process information after motor signal generated Peripheral Nervous System PNS All other components of the nervous system except for brain and spinal cord Major function o Conducts the transmission of impulses between the CNS and peripheral organs Distinct areas in the brain cortex cerebellum and brain stem which are responsible for specific functions Understanding basic functions of CNS allows you to interpret and understand predict possible dysfunctions that may be seen in brain injuries or neurological diseases Neurological Disorders Can be acute traumatic event result in impairment of nutritional intake require alternative paths for nutrition support Example closed head injury o Acute traumatic event o Happens suddenly o May need alternative nutritional support Chronic neurological disorders treated with multiple medications can have serious drug and nutrient interactions require nutritional changes adjustments or supplements need to be made Progressive neurological disorders lead to physical changes directly impact nutritional status Example cant physically feed yourself direct impact Example not chewing properly swallow direct nutritional impact Epilepsy A condition characterized by recurrent seizures episode spontaneous uncontrolled electrical activity among cerebral Seizure neurons o When seizure happens impairment of physical function psychological function loss of consciousness changes of the ability to perceive information o Important to differentiate seizure activity from a diagnosis of epilepsy Single Seizure result from a fever metabolic or electrolyte abnormalities hypo hyperglycemia high low blood sugars Defined as more than 2 unprovoked seizures Epilepsy Common causes Head trauma o Hypo hyperglycemia issue CNS infections tumors drug and alcohol abuse CNS tumors Cerebral Vascular Diseases CVD 22 3 different seizure types o Tonic clonic seizures aka grand mal seizures Seizures when patients lose consciousness and limbs stiffens More common type seizures Stroke and Aneurysm Stoke Cerebral Vascular Accident CVA defined as an interruption of brain function due to blockage or interruption of blood flow to the brain o Arteries supplying blood to the brain are obstructed can t get blood to Ischemic Stroke brain Hemorrhagic Stroke o Occurs when a vessel bursts and releases blood into the brain tissue o AKA aneurysm can see an aneurysm when there is a hemorrhagic stroke Transient Ischemic Attack TIA o Episode of ischemia when blood flow is quickly restored o But if symptoms persists greater than 24 hours event will go from the transient ischemic attack stroke o Risk Factors multifaceted Non modifiable risk factors Age gender ethnicity genetics Modifiable risk factors Presence of hypertension cardiovascular disease diabetes hyperlipidemia cigarette smoking doubles the risk of ischemic stroke alcohol use illicit drug use lifestyle factors diet oral contraceptives Aneurysm o Dilation or the weakening of smooth muscle usually found at the points where cerebral arteries divide or split o Picture when ruptured hemorrhagic stroke o Risk factors Epidemiology o Cigarette smoking alcohol ingestion o 4th leading cause of death in US o African American women are most at risk in US for strokes and aneurysm Clinical manifestation symptoms o Loss of vision or speech o Paralysis or muscle weakness o Change altered in mental status o Severe as coma o Subtle as confusion or memory loss Progressive Neurological Disorders Parkinson s Disease 1870s first described in a publication written by James Parkinson s called essay on shaking palsy parkisons disease was evolved from the essay A neuromuscular neurodegenerative disease caused by the loss of dopamine producing cells in the substantia nigra portion of the brain Know that its not just a shakin palsy neuromuscular neurodegenerative disease Cause loss of dopamine producing cells in the brain Epidemiology Most common of all neuromuscular disorders Affects 1 of the population over the age of 65 in US and Canada Less common in Asian and African Americans populations Incidence increases with age Rarely diagnosed before the age of 40 More commonly diagnosed in men than women Etiology Genetics Environmental Toxins Prions or protein malformations Oxidative Stress Loss of dopamine producing cells Imbalance of Neurotransmitters leading to excitotoxicity Mitochondrial Dysfunction Loss of ability to reproduce Dopamine Producing Cells o Including loss that comes with aging Abnormal Inflammatory Response with certain cells of brain Improper Response to Dopamine within the Brain Increased Rate of Cell Death o Particularly those of dopamine cells issues with Parkinson s Pathophysiology Involves abnormalities of the cells within substantiate nigra o Portion of the basal ganglia deep within the cerebral hemispheres within cerebral cortex dopamine o Neurons within the substantiate nigra produce neurotransmitter that Imbalance of dopamine and GABA within the brain the usually would maintain slow coordinated movements muscle tone and posture o Imbalance of excitatory dopamine and inhibitory GABA neurotransmitters normally maintain slow coordinated muscle tone posture and movements o Pristine balance between excitatory and inhibitory neurotransmitters dopamine and GABA o Parkinsons disease Loss of dopamine causes imbalance between excitatory and inhibitory communications Parkinson disease type symptoms where coordinated movements are NOT coordinated Muscle tone and posture becomes more rigid