Central Nervous System Topic Homepage
Central Nervous System Overview
The central nervous system (CNS) is composed of the brain, brain stem, cerebellum and spinal cord. At a cellular level the CNS is made up of highly specialised cells called neurones, whose electrical excitability can transmit signals in the form of action potentials. In addition to neurones the CNS also contain astrocytes, oligodendrocytes, microglia and ependymal cells.1
There are many diseases that affect the CNS,...
... including epilepsy, schizophrenia, Alzheimer’s disease and mood disorders (depression, anxiety, bipolar disorder).
Epilepsy is a neurological disease that is indiscriminate of age; affecting approximately 50 million people worldwide.2 The seizures, caused by abnormal neuronal excitation, can take four main forms; simple partial seizures, complex partial seizures, absence seizure (petit mal) or tonic-clonic seizures (grand mal).
Alzheimer’s Disease is primarily a disease of the elderly, with the risk of developing this debilitating disease increasing exponentially with age (doubling every 4.5 years).3 It is caused by the formation of plaques in the cerebral cortex, this results in the symptoms of memory loss and confusion. Currently there is no cure, although the development of the disease can be slowed through pharmacological intervention.4
Mental health disease is a global issue with schizophrenia and depression affecting 26 million and 151 million people worldwide respectively.5 There is still a stigma that surrounds these disorders. Treatment is typically through counselling and treatment with a selective serotonin reuptake inhibitor (SSRI). SSRIs act to inhibit the reuptake of serotonin by pre-synaptic neurones causing an increased concentration of this neurotransmitter at the synaptic cleft.4
1. Tortora GJ. et al. Principles of Anatomy and Physiology. Wiley. 2006 : 404-411
2. WHO. Epilepsy Atlas 2005. WHO. 2005 : 1-15
2. Mathers C. et al. Global burden of dementia in the year 2000: summary of methods and data sources. WHO. Geneva. 2000.
4. Martini FH. et al. Fundamentals of Anatomy and Physiology. Pearson International. 2009 ; 8 :554-555
5. Funk M. et al. Mental Health and Development: Targeting People With Mental Health Conditions as a Vulnerable Group. WHO Geneva. 2010 : 34
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Alzheimer's Disease
Alzheimer's disease (AD) is a progressive, neurodegenerative disease which will affect most of us at one point in time, and it’s prevalence increases with age.
In the early stages in particular, dementia is often difficult to diagnose, since many symptoms are not recognized as such or are trivialized by the patient. 20% of actual dementia cases are reported to be incorrectly diagnosed as a different disease.
In early dementia the symptoms of Alzheimer’s disease include memory loss, disorientation and confusion. These symptoms are caused by the loss of neurons and worsen with continuous neurodegeneration. The pathology of dementia is not solely the result of a cholinergic deficit. It is known that, chronically and pathologically elevated glutamate concentrations play an important role.
In general two main groups of dementia can be distinguished, requiring different types of treatment:
Depending on the stage of the disease, clinical symptoms of varying intensity dominate. With the progression of AD, treatment is aimed particularly at improving and stabilizing personal everyday functions, so as to keep patients independent for as long as possible.
Soft Tissue Sarcoma
Soft Tissue Sarcomas (STS) are malignant (cancerous) tumors that develop in tissues which connect, support, or surround other structures and organs of the body. Muscles, tendons (bands of fiber that connect muscles to bones), fibrous tissues, fat, blood vessels, nerves, and synovial tissues are types of soft tissue.
Soft tissue sarcomas are grouped together because they share certain microscopic characteristics, have similar symptoms, and are generally treated in similar ways.1 They are usually named for the type of tissue in which they begin.
Every year approximately 13,000 new cases of soft tissue sarcomas are diagnosed in adults and children in Europe. The 5-year survival rate for patients with soft tissue sarcoma is around 90% if the cancer is detected in early phases and before it has spread. However, the 5-year survival rate is 10% to 15% for sarcomas with metastasis.
Management of STS depends on the stage of disease and histological subtype.2 Surgery is the mainstay of treatment for patients with localised disease and is often curative. However, as recurrence is likely to occur when tumour cells remain after surgery, adjuvant radiotherapy is often also considered, especially for patients with intermediate or high-grade tumours. Radiotherapy is also often administered for patients in whom surgery is inappropriate or who decline surgery.2
There are a number of Associations and Organisations across Europe who strive to inform others of this disease as well as offer help and support to those affected or to those who know and want to help those suffering.
Enter the Soft Tissue Sarcoma Knowledge Centre
References
1. Cormier JN, Pollock RE. Soft tissue sarcomas. CA: A Cancer Journal for Clinicians 2004; 54(2):94–109.
2. Clark MA, Fisher C et al. (2005) “Soft-tissue sarcomas in adults.” N Engl JMed 353(7): 701–11.
Drug News
FDA approves Nymalize (Arbor Pharmaceuticals) for Sub Arachnoid Haemorrhage
15-05-2013The FDA has approved the New Drug Application (NDA) for Nymalize (nimodipine) oral solution, from Arbor Pharmaceuticals, for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in adult patients with Sub Arachnoid Haemorrhage. It is the only nimodipine oral solution indicated for the improvement of neurological outcome in adult patients with SAH....
Succesful Phase III studies with Fycompa (Eisai) for Epilepsy published in Epilepsia
14-05-2013Data from three pivotal Phase III clinical studies of Fycompa (perampanel), from Eisai, shows the drug reduced partial Epilepsy seizure frequency and improved responder rates compared to placebo. The pooled analysis of nearly 1,500 patients in Study 304, 306 and 307 showed that median reductions in partial seizure frequency were greater with perampanel 4 mg (-23·3%), 8 mg (-28·8%), and 12 mg...
Two analyses show Fycompa (Eisai) effective for Epilepsy
11-05-2013Two new analyses on clinical experience with Fycompa (perampanel), from Eisai, show it is effective and well tolerated in patients with difficult-to-treat partial Epilepsy. The results describe the first real life experiences of perampanel as an adjunctive therapy. In the first study, on 45 patients followed up for at least six months, 47% had a reduction in seizure frequency of at least 50%...
Central Nervous System Drug Data - A-Z
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Recent Drug Updates
Cymbalta 30mg / 60mg hard gastro-resistant capsules
08-05-2013Treatment of major depressive disorder.Treatment of diabetic peripheral neuropathic pain.Treatment of generalised anxiety disorder. Cymbalta is indicated in adults....
ZONEGRAN
08-05-2013Zonegran is indicated as adjunctive therapy in the treatment of adult patients with partial seizures, with or without secondary generalisation. ...
Neupro 2mg/24h , 4mg/24h , 6mg/24h , 8mg/24h Transdermal patch
08-05-2013Neupro is indicated for the treatment of the signs and symptoms of early-stage idiopathic Parkinson's disease as monotherapy (i.e. without levodopa) or in combination with levodopa, i.e. over the...
Clinical Guidelines
Headaches: Diagnosis and management of headaches in young people and adults
Sep 2012Headaches are one of the most common neurological problems presented to GPs and neurologists. They..
... are painful and debilitating for individuals, an important cause of absence from work or school and a substantial burden on society.
Headache disorders are classified as primary or secondary. The aetiology of primary headaches is not well understood and they are classified according to their clinical pattern. The most common primary headache disorders are tension-type headache, migraine and cluster headache. Secondary headaches are attributed to underlying disorders and include, for example, headaches associated with medication overuse, giant cell arteritis, raised intracranial pressure and infection. Medication overuse headache most commonly occurs in those taking medication for a primary headache disorder. The major health and social burden of headaches is caused by primary headache disorders and medication overuse headache.
This guideline makes recommendations on the diagnosis and management of the most common primary headache disorders in young people (aged 12 years and older) and adults.
Alteplase for treating acute ischaemic stroke
Sep 2012Alteplase (Actilyse, Boehringer Ingelheim) is a tissue plasminogen activator manufactured by..
... recombinant DNA technology. It activates the production of plasmin from its precursor plasminogen. Plasmin is an enzyme that degrades fibrin clots. The aim of treatment is to reduce the impact of ischaemia by restoring blood flow through the occluded (blocked) artery.
Clinical Trials
Risk of Falls in Fibromyalgia (FM)
29-03-2013Fibromyalgia is a chronic illness characterized by persistent widespread muscle pain with generalised hyperalgesia and allodynia. It can be accompanied by other concomitant symptoms: fatigue, sleep disturbances, musculoskeletal disorders, distress and psychological disorders. The prevalence has been reported to be..
... between 2 and 5%.
The hypothesis of this study is that women with fibromyalgia present high risk of falls and balance disorders compared with healthy women. The objective of this study was to investigate wether gait pattern changes in single and dual task conditions were associated with the risk of falling in women with fibromyalgia.
Neurodynamic Intervention in Fibromyalgia (FM)
29-03-2013Fibromyalgia is a chronic illness characterised by persistent,widespread muscle pain with generalised hyperalgesia and allodynia. It can be accompanied by other concomitant symptoms like fatigue, sleep disturbances, musculoskeletal disorders, distress and psychological disorders. This condition is very prevalent. It..
... has been reported to be about 2-5% of the general global population.
Fibromyalgia have been reported to have neurodynamic disorders. The purpose of this prospective study was to examine the combined effects of soft tissue mobilization and nerve slider neurodynamic technique on pain and pressure sensitivity in women with fibromyalgia.
Medical Videos
Medical Journal Abstracts
Newly diagnosed multiple sclerosis in state of Qatar
Clinical Neurology and Neurosurgery
Feb 2013
Background: Epidemiologic studies on multiple sclerosis (MS) are well-documented in the western population but to a lesser extent in Arab world. Objective: To study the demographics, clinical aspects, radiologic and laboratory features along with the degree of disability inflicted, and factors affecting disease..
Subacute peripheral and optic neuropathy syndrome with no evidence of a toxic or nutritional cause
Clinical Neurology and Neurosurgery
Feb 2013
Background: The syndrome of subacute simultaneous peripheral neuropathy and bilateral optic neuropathy is known to occur in tropical countries, probably due to malnutrition or toxicity, but not often seen in developed countries. We report seven patients in London who were not malnourished or alcoholic, and in whom no..
Medical Apps
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