Neurology is the branch of medicine dealing with all diseases of the nervous system, including those of the brain, spinal cord and nerves.1
The nervous system is a highly specialised and complex structure.2 It is an information-processing system that regulates all physiological functions of the body.2 When a disease affects this system, it can result in difficulty moving, speaking, breathing or ...
There are more than 600 neurological disorders; the most common are Alzheimer's disease (dementia), Parkinson's disease, migraine and epilepsy.3
Alzheimer's disease is a neurodegenerative disease that causes progressive and irreversible loss of mental functions, such as memory, language, orientation and judgment.3 Usually diagnosed from the age of 65, it is the leading cause of dementia and dependency in elderly, and affected about 24 million people worldwide in 2005 according to the World Health Organisation.3
Parkinson's disease is a neurodegenerative disease characterised by tremors when muscles are at rest, slowness of voluntary movements and increased muscle tone (rigidity).4 It is often diagnosed after 65 and affects 1% of people of this age bracket.4
Migraine is one of the most prevalent neurological disorders, affecting up to 18% of the population.5 Migraine is characterised by attacks of severe unilateral head pain, associated with nausea, vomiting, phonophobia, and photophobia.5
Epilepsy is a chronic neurological disorder affecting both sexes, regardless of age or country of origin.3 Epilepsy consists a set of neurological conditions characterised by the occurrence of at least one epileptic seizure.6 Epileptic seizure is a sudden symptom, characterized by abnormal brain hyperactivity. It may manifest as seizures or unconsciousness, or even visual or auditory hallucinations.6
Neurological diseases, especially neurodegenerative diseases like Alzheimer's or Parkinson's disease, remain incurable with a poorly understood etiology. With the population aging, neurological diseases are a major health problem, particularly for developing countries where life expectancy increases dramatically.3 Studies are ongoing to identify risk factors that would allow better prevention of neurological diseases, pending the development of effective treatments.3
1. Reinhard Rohkamm R. Color atlas of neurology. Thieme editionedition. 2004 : 440 pages.
2. Michael-Titus A. et al. The nervous system. Elsevier Editionedition. 2007 : 371 pages.
3. World Health Organization. Neurological disorders: Ppublic health challenges. WHO editionedition. 2006 : 218 pages. Available online.
4. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003, : 431-96.
5. Zaza Katsarava Z. The many facets of migraine. The Lancet Neurology. July 2011 ; 10 (7) : 607.
6. Fisher R.S. et al. Eepileptic seizures and epilepsy: Ddefinitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005 ; 46 (4) : 470–472.
Content on this page
- Neurological Disorders Knowledge Centres
- Neuropathic Pain
- Alzheimer's Disease
- Niemann-Pick type C
- Soft Tissue Sarcoma
The Neuropathic Pain Knowledge Centre is a unique resource containing a wealth of current information in this field of medicine.
The nervous system (central and peripheral) constantly receives and interprets information about the body's surroundings and the body's own functioning, responding by sending out messages to tissues and organs.
The Knowledge Centre addresses the two types of pain: nociceptive and clinical. Nocicpetive pain aims to protect individuals from harm. Clinical pain results from damage or inflammation of a part of the body and consists of both spontaneous pain that may arise with no apparent peripheral stimulus, and from hypersensitivity to peripheral stimuli1 due to peripheral and central sensitisations.
Neuropathic pain is often described as a shooting, stabbing or burning sensation. Estimates suggest that neuropathic pain may affect as much as 3% of the population.
Different types of neuropathic pain exist depending on their origin, details of which can be found in the Knowledge Centre: Painful Diabetic Neuropathy, Herpes Zoster and Post-Herpetic Neuralgia (PHN), HIV Associated-Neuropathy (HIV-AN), Cancer-related Neuropathic Pain, Post-surgical/Post-traumatic Neuropathic Pain.
As Neuropathic pain doesnâ€™t respond to conventional therapy with analgesics, the different treatment regimens are antidepressants, anticonvulsants, opioids, topical agents and combination treatment.
To help physicians in the pharmacological management of this condition, recent guidelines are available.
1. Ji R-R, et al. Central sensitization and LTP: Do pain and memory share similar mechanisms? Trends in Neuroscience 2003;26(12):696â€“705
Date of preparation: August 2012 PAIN/12/0003/EUd
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.
Niemann-Pick type C disease is a rare genetic lysosomal storage disorder that causes severe, progressive neurological symptoms. It is a very serious, life-threatening condition that can affect infants, children and adults. NP-C is characterized by cellular accumulation of lipids, in particular unesterified cholesterol and glycosphingolipids, in many parts of the body including brain, liver and spleen.
The variability of NPC presentations provides a wide range of life expectancy. In general, early-onset patients tend to die during childhood or early adolescence, while patients with later-onset disease who appear to be less drastically affected can live into late adulthood.
Accurate diagnosis of NPC requires awareness of many clinical phenotypes, narrowing of differential diagnosis by ancillary testing and final confirmation by biochemical testing – the current mainstay of primary diagnosis in NPC.
The prevalence of NPC has undoubtedly been underestimated in the past due to a mixture of factors including confusing terminology, prior lack of specific biochemical or genetic tests, varied pathology, and the many variant clinical manifestations of the disease.
Current, non-specific treatments for NPC focus mainly on supportive care, aimed toward managing the symptoms of the disease. As such, these treatments have no effect on disease progression or long-term outcomes.
Specific therapies for the intended treatment of NPC are based on targeting known pathophysiological and/or biochemical defects involved in the pathogenesis of the disease. While earlier attempts proved largely ineffective, more recent efforts indicate possible hope for the future.
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.
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.
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Treatment of narcolepsy with cataplexy in adult patients....
Keppra is indicated as monotherapy in the treatment of partial onset seizures with or without secondary generalisation in patients from 16 years of age with newly diagnosed epilepsy. Keppra is...
Treatment of patients with moderately severe to severe Alzheimers disease....
Headaches are one of the most common neurological problems presented to GPs and neurologists. They..
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Fibromyalgia 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..
Fibromyalgia 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..
Quantitative sensory testing (QST) is a psychophysical method used to quantify somatosensory function in response to controlled stimuli in healthy subjects and patients. Although QST shares similarities with the quantitative assessment of hearing or vision, which is extensively used in clinical practice and research,..
Induction of Monocyte Chemoattractant Protein-1 (MCP-1) and Its Receptor CCR2 in Primary Sensory Neurons Contributes to Paclitaxel-Induced Peripheral Neuropathy
The Journal of Pain
The use of paclitaxel (Taxol), a microtubule stabilizer, for cancer treatment is often limited by its associated peripheral neuropathy (chemotherapy-induced peripheral neuropathy [CIPN]), which predominantly results in sensory dysfunction, including chronic pain. Here we show that paclitaxel CIPN was associated with..
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