Olanike Soremekun Odeniyi

Down Syndrome

What is Neurology? - American Academy of Neurology

BRAIN CONCUSSION.
It is a term which is used to describe the alteration in cognitive functions (e.g., attention, language, memory, thinking and perception, learning) following a traumatic injury to the brain with or without loss of consciousness.

Brain concussion is best refers to as mild traumatic brain injury otherwise called Mild TBI.

CAUSES OF BRAIN CONCUSSION
1. Sport related head trauma
2. Vehicular accidents
3. Assaults
4. Some medical conditions such as Untreated or poorly epilepsy
5. Fall from a height.

HOW DOES CONCUSSION OCCURS.

The brain itself is protected by a rigid skull bone. The brain consistency is similar to a gel and can easily get bruised within the closed skull (cranium) if a sudden and rapid force it applied onto the skull.

There are places within the brain which meditate wakefulness and it called the ascending reticular activating systems (ARAS).

This ARAS is located at a junction between thalamus and the mid-brain which is susceptible to forces produced by rapid acceleration- deceleration motion following an impact with a fixed object. This causes disruptions in chemicals (neurotransmitters) produced in the brain and their interactions with various receptors without necessarily causing structural damage to the brain.

CONSEQUENCE OF BRAIN CONCUSSION.
1. Transient memory loss (anterograde or retrograde)
2. Visual disturbances
3. Confusion
4. Language dysfunction – naming difficulty
5. Muscular incoordination
6. Headache
7. Nausea and vomiting

HOW TO HELP SOMEONE WITH BRAIN CONCUSSION.
1. Always suspect a concomitant neck injury (cervical spine injury) along with concussion, so secure the neck with a cervical collar to avoid further injury.
2. Call for an ambulance immediately, in Lagos dial 112 for emergency ambulance service.
3. Leave the person in the care of the paramedics for evacuation!
4. In the hospital, an emergency physician will determine the extent of brain injury, the need for a brain imaging and management modality.

POST-CONCUSSION SYNDROME

Following a concussion, up to a larger percentage of sufferers continue to experience headache and dizziness for at least a month or more. However, post-concussion syndrome is a combination of irritability, depression, insomnia and subjective intellectual dysfunction within 4-weeks of their head injury.

❤️❤️❤️ sending love and prayers to all the victims of Earthquake in Syria and Turkey.

Different presentation of an epileptic fit

FACIAL PARALYSIS

Facial paralysis is a clinical condition in which the muscles of facial expression loose their function as a result of failure of the action of the FACIAL NERVE.

Nerve can be likened to electrical cable which either transmit sensory or motor function.

In the case of facial nerve also known as the 7th cranial nerve, it supplies motor function to muscles on the face, the pinna, ear canal, special taste sensation to the anterior 2/3rd of the tongue and secretomotor function to the submandibular gland (salivary gland), lacrimal gland(tear gland), and the nasal mucosa (covering of the nostril).

Facial paralysis may affect either one side of the face or both sides of the face.

Also, when it affects one side of the face, it may be total i.e. affecting both upper and lower part of the face or affect only the lower part of the face.

When it affects the lower face only and the upper face is spared it is called “facial paralysis of central origin”. This implies that the upper part of the face is spared while the weakness is limited to level below the lower eyelid.

When it affects both upper and lower face, it is regarded as “facial paralysis of peripheral origin”.

WHAT ARE THE CAUSES OF FACIAL NERVE PARALYSIS.

a. Facial nerve paralysis of Central origin:

• This is usually caused by stroke.

• Upper part of the face is not affected, the forehead muscles can fold.

• Patient may likely have risk factors to develop a stroke.

• A neuro-imaging (brain CT-scan) is done in this case to confirm the diagnosis and appropriate treatment is instituted by experts.

b. Facial nerve paralysis of peripheral origin:

• There are multiple causes of this type of facial nerve weakness.

• It usually affects the whole face either on one side or both sides.

• It is often called lower motor neuron facial nerve weakness.

• It may be due to the following;

i. Idiopathic – i.e., the cause is unknown.

ii. Infections – usually viral especially in immunocompromised patients (reactivation of herpes simplex virus, varicella zoster virus)

iii. Tumours of the brainstems such as cerebellopontine angle tumours, facial neuromas, cholesteatoma, or other skull base tumours etc.

HOW TO DO DIAGNOSE THIS CONDITION

Facial nerve paralysis as a clinical condition can present to the ENT doctors, neurologists, or General Practitioners.

Every patient presenting with a facial nerve weakness requires detailed evaluation as cause usually vary from individual to individual. So, somebody’s treatment may not work for you.

TREATMENT:

This is based on the aetiology (cause) of the facial nerve weakness.

TAKE-HOME POINTS

 If you experience a facial nerve present to the hospital same day as early diagnosis may resort facial function.

 Do not delay, as the presentation may be more sinister than it appears!

 Always request to see an expert inform of an Ear, Nose, and Throat surgeon or a Neurologist for proper evaluation.

 The commonest form to Unilateral total facial muscle paralysis is Bell’s Palsy in which early presentation restores facial functions and cosmetic appeal.

NB: Next presentation, I will cone down on Bell’s Palsy which is the commonest cause of facial paralysis.

Health is wealth!

Do all your comprehensive medical tests

See your family physician for Advise.

TOPIC: STROKE (CEREBROVASCULAR DISEASE).

WHAT IS A STROKE: In layman’s term, stroke can be defined as rapidly occurring signs and symptoms due to cessation of blood flow to areas within the brain, spinal cord, or the eyes.
This cessation of blood flow can be due to formation of blood clots which obstruct the blood vessels or rupture (busted vessel) of blood vessels.

WHAT ARE BLOOD VESSELS: There are tube-like structures that carries blood either from the heart to other areas of the body including the brain or carry blood away from other bodily structures into the heart.

ARTERIES: carries blood away from the heart to other areas of the body

VEINS: carries blood into the heart from other areas of the body.

WHO CAN HAVE STROKE: Anybody, including neonate, children, young adults, pregnant women, and elderly.
The reasons and risk factors for developing stroke in different age groups differs.

NEONATES (NEWBORN) – may develop stroke as a result of prematurity, infections, or metabolic insults.

CHILDREN – may also develop stroke as a result of infections affecting the brain or the heart and even may be complication arising from sickle cell disease.

YOUNG ADULTS: risk factors responsible for stroke in this age group may be due to substance abuse (use of illicit drugs, alcoholism). Sometimes it may be due to genetic abnormalities.

PREGNANT WOMEN: pregnant hormones make blood to be more viscous (thicker) and this may result in clot formation in pregnancy. Also, some women developed rapid elevation in blood pressure during pregnancy which may result in pre-eclampsia or eclampsia.

OLDER ADULTS: age is an independent risk factors for developing stroke however does not work alone but with other risk factors which I will mention below.

WHAT ARE THE RISK FACTORS FOR STROKE: divided into modifiable (treatable) and non-modifiable (untreatable).

MODIFIABLE RISK FACTORS: Hypertension, Diabetes, Obesity, Elevated cholesterol, Obesity, Sedentary Lifestyles, heart disease, Smoking, Alcoholism, infections, blood disorders etc.

NON-MODIFIABLE RISK FACTORS: Aging, Male gender, positive family history of stroke, previous history of stroke etc.

WHAT ARE THE SYMPTOMS OF STROKE: the symptoms varied and are always different in different individuals. Stroke symptoms usually occur suddenly just like an attack.

This attack is NEVER spiritual attack but a sudden “brain attack”.
It might be mild to severe debilitating symptoms but always sudden in onset.

Symptoms may include sudden onset violent headache, sudden visual loss (usually unilateral), sudden inability to speak or difficulty in speaking, sudden weakness in the arm, leg, and face. In addition, there may be loss of consciousness, seizures etc.

WHAT TO DO IN SUCH SITUATION: Get to the hospital immediately no matter how mild it looks so that early intervention can save live and prevent long hospital stay.

TAKE HOME MESSAGE:
 Stroke is a medical emergency, so always seek help immediately
 Stroke can be prevented from happening if your risk factors are diagnosed and managed adequately
 Stroke is not an attack from principalities and power
 If you develop a stroke, please go to the nearest hospital not the nearest church.
 Stroke is managed in the hospital by many specialists which include; Neurologist, Cardiologist, Neurosurgeon, Haematologist, Physiotherapist, Specialist Nurses, and Interventional Radiologist etc.

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MYTHS AND MISCONCEPTION ABOUT EPILEPSY

WHAT IS EPILEPTIC SEIZURE?
It is a transient occurrence (temporary) of signs and symptoms that is due to abnormal and excessive discharge from the brain cells called Neurons.

WHAT IS A NEURON?

A neuron is a single cell which either receives information from the outside of our body and send into the brain or the one cell that send information from the brain to the outside of the body.
>The one which sends information out is called Motor Neuron
>The one which receive information is called Sensory Neuron.
>The third one is the interneuron which is in between the motor and sensory neurons to connect information between them.

So therefore, Epilepsy is a disorder (condition) that affects the brain transiently.

Epilepsy is NOT caused by witches or witchcraft, spells, arrows from the enemies or contact with lizard saliva. It is NOT due to jealous step-mum's spell, demons, destiny or village people.

Epilepsy may run in some families, but not necessarily must be inherited.

Epilepsy may be hereditary in some patients, but majority of people developed epilepsy due to acquired insults to the brain.

Epilepsy have treatment and can readily be managed by doctors in the hospitals.

Epilepsy treatment DOES NOT involve casting of spells from the body, does not involve fasting and praying (fasting will trigger epileptic fits the more).

Epilepsy is simply the brain neurons producing too much of its usual discharge which now cause the clinical symptoms seen.

Clinical symptoms of epilepsy varies depending on the area of the brain where the discharge starts from.

Symptoms may include;
> Loud shout
>Sudden fall without Jerks
>Blank Stares
>Body stiffness
>Muscle jerking
>Aggression/Confusion
>Transient laugh or smiles incongruous to the situation at hand
>Repetitive purposeless moves e.t.c.

If you have a sufferer, take such person to any General Hospital or University Teaching Hospital within your locality.

> AVOID STIGMATIZATION OF PEOPLE LIVING WITH EPILEPSY, IT IS NOT CONTAGIOUS

>PASTORS/PROPHETS SHOULD AVOID INDOCTRINATION AS EPILEPSY HAS NOT SPIRITUAL AETIOLOGY

>TEACHERS SHOULD DESIST FROM STIGMATIZING CHILDREN WITH EPILEPSY. ADVISE THEM TO SEEK MEDICAL HELP AND STOP CHASING THEM AWAY FROM SCHOOL

>TO OUR LEGISLATORS - BILLS TO SUBSIDIZE CARE AND TREATMENT OF EPILEPSY

This is Dr Olanike Odeniyi's page.

This page will discuss Neurology topics in layman's term that anybody will understand.

It may also include other medical knowledge not limited to Neuroscience.

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