BRAIN DISORDERS

 Head Injury

AGLG

• More common under the age of 35
• More common in males
• Drinking and driving, fighting, and many sports are risk factors
• Genetics not significant

What Are the Causes?

Road accidents are the most common cause. Sports injuries, falls, and fighting or assault account for almost all of the remainder. The severity of head injury cannot be judged by appearance because serious brain damage can occur with hardly any sign of damage to the scalp or skull.

Scalp injuries are usually not dangerous, even though they may bleed a lot because many blood vessels are close to the skin surface.

Fractures of the skull may result from a blow to the head. There may be no bleeding on the outside. The brain can be damaged directly or indirectly, and indirect damage can occur even if the skull is not damaged.

The brain may also be damaged by pressure inside the skull caused by bleeding or a build-up of fluid in the brain after an injury or overhydration.

Symptoms

Usually include a mild headache and a lump, bruise or cut on the scalp, but there may be no initial symptoms. Serious symptoms include: blurred or double vision, loss of consciousness, bad headache, nausea/vomiting, confusion or drowsiness, slurred speech, clear fluid or blood seeping from the nose and/or ears.

If you have a severe headache or a cut that requires stitches or if additional symptoms develop, seek medical help at once.

What Might Be Done?

If you have sustained a blow to the head but have not lost consciousness and have only a mild headache, it is safe to take paracetamol [see drugs section]. But aspirin or NSAIDs should not be taken because they can increase bleeding.

EMERGENCY HELP

If you are with someone who has a head injury, or sustain one yourself, you should know how to perform first aid as follows:

1. Wash your hands! Put on medical gloves if possible.
2. If there is a scalp wound, replace any skin flaps. Press a clean pad firmly and evenly over the wound to control the blood flow.
3. When the bleeding has been controlled, secure a bandage around the head in order to keep a pad in position over the wound. The tie or pin for the bandage should be away from the eyes and the wound.
4. If you / the victim remain alert, lay down in a comfortable position with the head and shoulders supported and call medical help.
5. If the victim is unconscious, place them in the recovery position after bandaging and call for medical help. Monitor pulse and breathing while you wait and be prepared to resuscitate if necessary.

You may have an X ray, MRI or CAT scan to ascertain the extent or nature of injury. You may be advised to stay in hospital overnight for observation. If it’s a minor injury, you should rest at home [however you must seek medical attention if further symptoms develop].

A person with a more severe injury is usually admitted to an intensive care unit. If there is swelling of the brain or a danger of infection, drugs may be given [see drugs section]. Surgery may be needed to relieve pressure or to remove intrusive items.

What Is the Prognosis?

Most people with a minor brain injury recover completely within a few days. The outcome of serious injury is very difficult to predict. About 50% of people survive such an injury, although recovery may take up to 2 years.

Complications:

Long-term problems following head injury can include frequent headaches, dizziness, poor concentration, and loss of balance. Persistent ringing in the ears [tinnitus] may also develop.

Some impairment, such as speech problems, may remain. People such as boxers or fighters who sustain repeated head injuries may develop Parkinson’s disease.

If a head injury results in an open wound, bacteria can cause infection. Rarely, brain damage may cause problems with movement or mental ability, and some injuries may result in recurrent seizures.

Epilepsy

AGLG

• Usually develops in children and young adults and may gradually disappear.
• Gender not a significant factor
• Excess drug abuse may contribute
• Some types run in families

Recurrent seizures, or brief episodes of altered consciousness, caused by abnormal electrical activity in the brain.

A single seizure is not labelled as epilepsy. For example, high fever in a child can cause a single seizure, as can alcoholism or withdrawal from alcohol. Very low blood glucose levels can also trigger seizures.

What Are the Causes?

Genetic factors may be involved. Epilepsy can be the result of disease or damage to the brain caused by an infection such as meningitis, a stroke, a brain tumor, or scarring following severe head injury.

In people with epilepsy, seizures may be triggered by lack of sleep or by missing a meal, by drinking excessive alcohol or by visual effects such as flashing lights or flickering screens.

Symptoms

They vary, depending on the type. Some types begin with an aura, similar to migraines, or including a sensation of fear or unease or unusual sensations of taste or smell. This may be all that happens, in what is called a ‘petit mal’ seizure. The person loses touch with his or her surroundings and seems to be staring, with eyes wide open. This experience may last from 5 to 30 seconds and the person may be unaware that anything is wrong.

Tonic-clonic seizures may be preceded by this kind of experience or they may not.  There is then loss of consciousness, with convulsions as the body stiffens, and breathing becomes irregular or stops briefly. Uncontrolled body movements occur for several minutes and then the muscles relax, sometimes causing incontinence. The person may be confused after the attack and need to sleep directly afterwards or may develop a headache. There is usually no memory of what has happened.

What Might Be Done?

If only one seizure has occurred, no treatment may be necessary.

An EEG may be used to examine your brainwave patterns.

An underlying cause, such as diabetes, may need to be addressed. If seizures are recurrent, drugs may be prescribed [see drugs section]. If so, you should have regular blood tests to monitor drug levels.

If drugs do not control the seizures, and a small area of brain tissue is found to be the cause, surgery may be recommended.

If more than one seizure happens consecutively or if the seizure continues for more than 5 minutes, the person should be admitted to hospital as an emergency.

What Is the Prognosis?

About 1 in 3 people who have a single seizure will have another one within 2 years. The risk of recurrent seizures is highest in the first few weeks after an attack.

However, the long-term outlook is good for most people, who go into remission within 10 years.

Narcolepsy 

AGLG

• Usually develops before the age of 20
• Gender not a significant factor
• Lifestyle not significant factor
• Sometimes runs in families

Narcolepsy causes you to fall asleep at any time of day, suddenly and for no apparent reason, often when carrying out a monotonous task, such as while eating. Affected people can be awoken easily but may fall asleep again shortly afterwards. Some people have vivid hallucinations before falling asleep, others find they are unable to move [sleep paralysis]. About 75% of people with narcolepsy also have cataplexy [a temporary loss of strength in the limbs causing the person to fall to the ground]. Cataplexy can sometimes be triggered by an emotional response, such as fear, or laughter.

What Are the Causes?

Narcolepsy is an inheritable disease but this does not account for all cases. Not enough research has been done to ascertain other causes so far [2006]

What Might Be Done?

Narcolepsy is usually easily diagnosed because these symptoms are pretty unique unless you’re on a lot of weird drugs. EEG may be useful to record the electrical activity of your brain [see technology section] asleep or awake or both. You may wish to use modafinil [provigil] to keep yourself awake. Some people prefer other kinds of medication [see drugs section]. There are also medications to address cataplexy.

If you want to try to cope without drugs you should take regular naps during the day and keep busy when you are awake.

What Is the Prognosis?

Although narcolepsy is usually a lifelong condition, current medication is safer than it has ever been. There is also sometimes a spontaneous improvement over time.

Dementia/Senility

AGLG

• More common over the age of 65, except for ‘early onset’ dementia
• Gender is not a significant factor
• Lifestyle risk factors; lack of use leading to atrophying or wrong use leading to damaging chemical release and mass oxidation are very significant [see neurohacking tutorials].
• Sometimes runs in families

Dementia is sometimes called senility although a person can be referred to as ‘a bit senile’ without being thought of as having dementia. It presents a combination of memory loss, confusion, and general intellectual and creative decline. The affected person may not notice that there is anything wrong, which can make things difficult.

Dementia is usually progressive because by the time it is noticed it is too late to do much about it, although symptoms can still to a certain extent be reversed.

Persons with severe depression may appear to have dementia, because the conditions have similar symptoms, such as forgetfulness.

What Are the Causes?

The underlying abnormality in dementia is a decline in the number of brain cells, resulting in shrinkage of the brain tissue. Alzheimer’s disease is the most common cause of dementia. Less common causes include small blood clots in the brain, Huntington’s disease, Parkinson’s disease, CJD and AIDS, long-term alcohol abuse, severe vitamin B1 or B12 deficiency, or head injury.

 Young people can also suffer with dementia, although it is most commonly seen in the elderly.

Symptoms

May develop gradually over months or years, and may include: Anxiety, impairment of short term memory, gradual loss of intellect and creativity, increased difficulty in reasoning and understanding, depression, difficulty engaging in conversations, reduced vocabulary, emotional outbursts, wandering and restlessness, neglect of personal hygiene, and possibly urinary incontinence.

What Might Be Done?

You might want to have tests for any underlying cause of memory loss. If memory loss is due to vitamin deficiency, supplemental injections may be used. Certain medications or intoxicants can cause memory loss and can be relieved by a change of medication.

Smoking and diet are important risk factors for blood clots inside the brain, another cause of dementia.

What Is the Prognosis?

There are many promising drugs currently [2006] in clinical trials for dementia, but none so far affect a total cure.

Dementia is best avoided rather than cured, because it is unlikely to be reversible after many symptoms appear [see neurohacking tutorials].

Alzheimer’s Disease 

AGLG

• More common over age 65
• Gender not significant
• Lifestyle a relevant factor [bad diet and lack of use leading to atrophying, or wrong use leading to damaging chemical release and mass oxidation are significant [see neurohacking tutorials].
• Sometimes runs in families

Brain cells gradually degenerate and deposits of an abnormal protein build up in the brain. As a result, brain tissue shrinks, and there is a progressive loss of mental abilities, known as dementia.

What Are the Causes?

15% of people with Alzheimer’s have a parent with the disorder. Lifestyle is an extremely relevant factor.

Symptoms: Severe impairment of short term memory maybe the first symptom of Alzheimers disease, unless you are sensitive to your own mental state [one neurologist began to suspect Alzheimers in his nineties only when he could no longer think nine moves ahead in chess]. Further symptoms will appear which may include poor concentration, difficulty in understanding written and/or spoken language, and getting lost [in familiar surroundings]. As symptoms progress, others may include slower movement when walking, rapid mood swings from happiness to tearfulness, personality changes, aggression, paranoia and feelings of persecution, insomnia or restlessness at night.

After several years, the person can no longer take care of themselves and needs permanent full-time assistance. They are likely to become incontinent and completely dependant, requiring feeding, dressing and washing.

What Might Be Done?

There is likely to be a single test for Alzheimer’s available pretty soon. Blood tests may be required to exclude other causes of the early symptoms, for example vitamin deficiencies. CAT scanning or MRI may also be used to exclude other brain disorders. An assessment of mental ability [functional analysis] may be done to determine the severity of the dementia. Drugs may be used to slow the progress of dementia [see drugs section] and to deal with symptoms such as depression.

Alzheimer’s is best avoided rather than cured, because it is unlikely to be reversible after many symptoms appear [see neurohacking tutorials]. People often survive physically in a vegetative state for ten years or more from the time of diagnosis.

Ingestion or absorption of metals should be avoided [for example aluminium from cooking pots/utensils, copper from jewellery,] because people with Alzheimers have difficulty excreting metallic toxins.

Parkinson’s Disease 

AGLG

• More common over age 60
• More common in males
• Lifestyle factors are physical violence, sports, drug abuse
• Sometimes runs in families

A progressive brain disorder causing shaking and problems with physical movement. Parkinson’s results from the degeneration or destruction of neurons in the basal ganglia [see anatomy section]. This results in a deficiency of dopamine [see drugs & chemicals section] and troubles with sensorymotor control.

What Are the Causes?

About 3 in 10 sufferers have a relative with the disorder. Repeated head injuries [even minor ones] may cause Parkinson’s, as may some antipsychotic medications [see drugs section]. Extreme abuse of cannabis or other dopamine agonists can cause some of the symptoms [see drugs section].

Symptoms

They can appear suddenly or slowly, depending on the cause. They include: tremor of one hand, arm, or leg, usually when resting, that later occurs on both sides; muscle stiffness, making it difficult to start moving; slowness of movement, shuffling walk with loss of arm swing, expressionless or mask-like face, stooped posture. As the disease progresses, stiffness, immobility, and constant trembling of the hands makes daily tasks more difficult to perform. Speech may become slower and more hesitant and swallowing may be difficult. Many people with Parkinson’s develop depression, and about 3 in 10 develop dementia.

What Might Be Done?

It is not always possible to diagnose immediately. You may want tests such as CAT scanning or MRI [see technology section] to exclude other possible causes.

Drugs, physical treatments, surgery and implants [see relevant sections] can all be used to treat Parkinson’s. Deep brain stimulation in particular holds promise.

If you suspect you may have Parkinson’s disease, as well as consulting for a diagnosis you should pay attention to your general health. Selegiline [see drugs section] appears to be protective. Making sure you get some exercise each day will help you to maintain strength and mobility. You should also rest whenever tired.

What Is the Prognosis?

Variable, because effective techniques and drugs are only just becoming available [2006], but people are continuing to lead active lives for longer as treatment progresses. Literally at the moment the prospect of complete cure may depend on your age.