neurologic

The brain, spinal cord, and nerves make up the nervous system. Together they control all the workings of the body. When something goes wrong with a part of your nervous system, you can have trouble moving, speaking, swallowing, breathing, or learning. You can also have problems with your memory, senses, or mood.

There are more than 600 neurologic diseases. Major types include:

• Diseases caused by faulty genes, such as Huntington's disease and muscular dystrophy
• Problems with the way the nervous system develops, such as spina bifida
• Degenerative diseases, where nerve cells are damaged or die, such as Parkinson's disease and Alzheimer's disease
• Diseases of the blood vessels that supply the brain, such as stroke
• Injuries to the spinal cord and brain
• Seizure disorders, such as epilepsy
• Cancer, such as brain tumors
• infections, such as meningitis

Acute flaccid myelitis (AFM) is a neurologic disease. It is rare, but serious. It affects an area of the spinal cord called gray matter. This can cause the muscles and reflexes in the body to become weak.

Because of these symptoms, some people call AFM a "polio-like" illness. But it is different from polio. AFM is not caused by polioviruses.

AFM can be caused by several different viruses. Researchers think that enteroviruses have been causing the recent increases in the number of children with AFM. AFM can also be caused by other viruses, including flaviviruses, herpesviruses, and adenoviruses.

Most people with AFM had a mild respiratory illness or fever (like you would get from a viral infection) before they got AFM.

Anyone can get AFM, but most cases (more than 90%) have been in young children.

Most people with AFM will suddenly have:

• Arm or leg weakness
• A loss of muscle tone and reflexes

Some people also have other symptoms, including:

• Facial drooping/weakness
• Trouble moving the eyes
• Drooping eyelids
• Trouble swallowing
• Slurred speech
• Pain in the arms, legs, back, or neck

Sometimes AFM can weaken the muscles that you need for breathing. This can lead to respiratory failure, which is very serious. If you get respiratory failure, you may need to use a ventilator (breathing machine) to help you breathe.

If you or your child develops any of these symptoms, get medical care right away.

AFM causes many of the same symptoms as other neurologic diseases, such as transverse myelitis and Guillain-Barre syndrome. This can make it difficult to diagnose. To find out if you have AFM, your doctor may use:

• A neurologic exam, including looking at where there is weakness, poor muscle tone, and decreased reflexes
• An MRI to look at the spinal cord and brain
• Lab tests on the cerebrospinal fluid (the fluid around the brain and spinal cord)
• Nerve conduction and electromyography (EMG) studies. These tests check nerve speed and the response of muscles to the messages from the nerves.

It is important that the tests are done as soon as possible after the symptoms start.

There is no specific treatment for AFM. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend treatments for specific symptoms. For example, physical and/or occupational therapy may help with arm or leg weakness. Researchers do not know the long-term outcomes of people who get AFM.

There is no specific way to prevent AFM. But you can take steps to prevent getting sick from a virus by:

• Washing your hands often with soap and water
• Avoiding touching your face with unwashed hands
• Avoiding close contact with people who are sick
• Cleaning and disinfecting surfaces that you frequently touch, including toys
• Covering coughs and sneezes with a tissue or upper shirt sleeve, not hands
• Staying home when sick

Centers for Disease Control and Prevention

If you are like most people, you walk thousands of steps each day. You walk to do your daily activities, get around, and exercise. It's something that you usually don't think about. But for those people who have a problem with walking, daily life can be more difficult.

Walking problems may cause you to:

• Walk with your head and neck bent over
• Drag, drop, or shuffle your feet
• Have irregular, jerky movements when walking
• Take smaller steps
• Waddle
• Walk more slowly or stiffly

The pattern of how you walk is called your gait. Many different diseases and conditions can affect your gait and lead to problems with walking. They include:

• Abnormal development of the muscles or bones of your legs or feet
• Arthritis of the hips, knees, ankles, or feet
• Cerebellar disorders, which are disorders of the area of the brain that controls coordination and balance
• Foot problems, including corns and calluses, sores, and warts
• Infections
• Injuries, such as fractures (broken bones), sprains, and tendinitis
• Movement disorders, such as Parkinson's disease
• Neurologic diseases, including multiple sclerosis and peripheral nerve disorders
• Vision problems

To make a diagnosis, your health care provider will ask about your medical history and do a physical exam. This will include checking your bones and muscles and doing a neurological exam. In some cases, you may have other tests, such as lab or imaging tests.

Treatment of walking problems depends on the cause. If the cause is a medical condition, treating that condition often improves your walking. Some common types of treatments for walking problems may include:

• Medicines
• Mobility aids such as walkers and canes
• Physical therapy
• Special shoes, insoles, splints, or braces
• Surgery

Aphasia is a language disorder that makes it hard for you to read, write, and say what you mean to say. Sometimes it makes it hard to understand what other people are saying, too. Aphasia is not a disease. It's a symptom of damage to the parts of the brain that control language.

The signs of aphasia depend on which part of the brain is damaged. There are four main types of aphasia:

• Expressive aphasia is when you know what you want to say, but you have trouble saying or writing your thoughts.
• Receptive aphasia affects your ability to read and understand speech. You can hear what people say or see words on a page, but you have trouble making sense of what they mean.
• Global aphasia is the loss of almost all language ability. You can't speak, understand speech, read, or write.
• Anomic or amnesia aphasia is when you have trouble using the right words for certain things, people, places or events.

In some cases, aphasia may get better on its own. But it can be a long-term condition. There's no cure, but treatment may help improve language skills.

Aphasia happens from damage to one or more parts of the brain involved with language. The damage may be from:

• Stroke, which is the most common cause of aphasia
• Brain tumor
• Brain infection or inflammation
• Brain injury
• Other brain disorders or neurologic diseases that affect the brain and get worse over time, such as dementia

Anyone can have aphasia at any age, but most people with aphasia are middle-aged or older. Most aphasia happens suddenly from a stroke or brain injury. Aphasia from a brain tumor or other brain disorder may develop slowly over time.

If a health care provider sees signs of aphasia, the provider will usually:

• Test the person's ability to understand language and speech. This includes asking questions and checking to see if the person can follow simple commands.
• Order an imaging scan to see if there's a brain injury and what part of the brain is damaged. Possible tests include:
  • MRI
  • CT scan

If imaging shows signs of aphasia, more tests may be needed. These tests measure how much the brain damage has affected the ability to talk, read, write, and understand. In most cases, the tests are done by a speech-language pathologist or speech therapist (a specialist who treats speech and communication disorders).

Some people fully recover from aphasia without treatment. But most people should begin speech-language therapy to treat aphasia as soon as possible.

Treatment may be one-on-one with a speech therapist or in a group. Therapy using a computer may also be helpful.

The specific therapy depends on the type of language loss that a person has. It may include exercises in reading, writing, following directions, and repeating what the therapist says. Therapy may also include learning how to communicate with gestures, pictures, smartphones, or other electronic devices.

Family participation may be an important part of speech therapy. Family members can learn to help with recovery in many ways, such as:

• Using simpler language
• Including the person with aphasia in conversations
• Repeating or writing down key words to help communicate more clearly

How much a person recovers depends on many things, including:

• What caused the brain injury
• What part of the brain was hurt
• How badly and how much of the brain was hurt
• The age and health of the person

You can help prevent aphasia by:

• Making heart-healthy lifestyle changes to lower your chance of having:
  • A stroke
  • Heart disease
  • Vascular disease (problems with your blood vessels)
• Protecting your brain from injury:
  • Wearing the right helmet for sports safety, such as when riding a bike
  • Taking action to prevent falls
  • Always wearing your seatbelt and driving safely

NIH: National Institute on Deafness and Other Communication Disorders

A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, or malignant, with cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are metastatic, and they start somewhere else in the body and move to the brain.

Brain tumors can cause many symptoms. Some of the most common are:

• Headaches, often in the morning
• Nausea and vomiting
• Changes in your ability to talk, hear, or see
• Problems with balance or walking
• Problems with thinking or memory
• Feeling weak or sleepy
• Changes in your mood or behavior
• Seizures

Doctors diagnose brain tumors by doing a neurologic exam and tests including an MRI, CT scan, and biopsy. Treatment options include watchful waiting, surgery, radiation therapy, chemotherapy, and targeted therapy. Targeted therapy uses drugs or other substances that attack cancer cells with less harm to normal cells. Many people get a combination of treatments.

NIH: National Cancer Institute

Charcot-Marie-Tooth disease (CMT) is a group of genetic nerve disorders. It is named after the three doctors who first identified it. In the United States, CMT affects about 1 in 2,500 people.

CMT affects your peripheral nerves. Peripheral nerves carry movement and sensation signals between the brain and spinal cord and the rest of the body. Symptoms usually start around the teen years. Foot problems such as high arches or hammertoes can be early symptoms. As CMT progresses, your lower legs may weaken. Later, your hands may also become weak.

Doctors diagnose CMT by doing a neurologic exam, nerve tests, genetic tests, or a nerve biopsy. There is no cure. The disease can be so mild you don't realize you have it or severe enough to make you weak. Physical therapy, occupational therapy, braces and other devices and sometimes surgery can help.

NIH: National Institute of Neurological Disorders and Stroke

The flu, also called influenza, is a respiratory infection caused by viruses. Each year, millions of Americans get sick with the flu. Sometimes it causes mild illness. But it can also be serious or even deadly, especially for people over 65, newborn babies, and people with certain chronic illnesses.

The flu is caused by flu viruses that spread from person to person. When someone with the flu coughs, sneezes, or talks, they spray tiny droplets. These droplets can land in the mouths or noses of people who are nearby. Less often, a person may get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes.

Symptoms of the flu come on suddenly and may include:

• Fever or feeling feverish/chills
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Headaches
• Fatigue (tiredness)

Some people may also have vomiting and diarrhea. This is more common in children.

Sometimes people have trouble figuring out whether they have a cold or the flu. There are differences between them:

Sometimes people say that they have a "flu" when they really have something else. For example, "stomach flu" isn't the flu; it's gastroenteritis.

Some people who get the flu will develop complications. Some of these complications can be serious or even life-threatening. They include:

• Bronchitis
• Ear infection
• Sinus infection
• Pneumonia
• Inflammation of the heart (myocarditis), brain (encephalitis), or muscle tissues (myositis, rhabdomyolysis)

The flu also can make chronic health problems worse. For example, people with asthma may have asthma attacks while they have flu.

Certain people are more likely to have complications from the flu, including:

• Adults 65 and older
• Pregnant women
• Children younger than 5
• People with certain chronic health conditions, such as asthma, diabetes, and heart disease

To diagnose the flu, health care providers will first do a medical history and ask about your symptoms. There are several tests for the flu. For the tests, your provider will swipe the inside of your nose or the back of your throat with a swab. Then the swab will be tested for the flu virus.

Some tests are quick and give results in 15-20 minutes. But these tests are not as accurate as other flu tests. These other tests can give you the results in one hour or several hours.

Most people with the flu recover on their own without medical care. People with mild cases of the flu should stay home and avoid contact with others, except to get medical care.

But if you have symptoms of flu and are in a high risk group or are very sick or worried about your illness, contact your health care provider. You might need antiviral medicines to treat your flu. Antiviral medicines can make the illness milder and shorten the time you are sick. They also can prevent serious flu complications. They usually work best when you start taking them within 2 days of getting sick.

The best way to prevent the flu is to get a flu vaccine every year. But it's also important to have good health habits like covering your cough and washing your hands often. This can help stop the spread of germs and prevent the flu.

Centers for Disease Control and Prevention

Chances are you've bumped your head before. Often, the injury is minor because your skull is hard and it protects your brain. But other head injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury.

Head injuries can be open or closed. A closed injury does not break through the skull. With an open, or penetrating, injury, an object pierces the skull and enters the brain. Closed injuries are not always less severe than open injuries.

Some common causes of head injuries are falls, motor vehicle accidents, violence, and sports injuries.

It is important to know the warning signs of a moderate or severe head injury. Get help immediately if the injured person has:

• A headache that gets worse or does not go away
• Repeated vomiting or nausea
• Convulsions or seizures
• An inability to wake up
• Dilated (enlarged) pupil in one or both eyes
• Slurred speech
• Weakness or numbness in the arms or legs
• Loss of coordination
• Increased confusion, restlessness, or agitation

Doctors use a neurologic exam and imaging tests to make a diagnosis. Treatment depends on the type of injury and how severe it is.

NIH: National Institute of Neurological Disorders and Stroke

Mental disorders (or mental illnesses) are conditions that affect your thinking, feeling, mood, and behavior. They may happen over a short period of time or come and go. Some can be chronic (long-lasting). They can affect your ability to relate to others and function each day..

There are many different types of mental disorders. Some common ones include:

• Anxiety disorders, including panic disorder, obsessive-compulsive disorder, and phobias
• Depression, bipolar disorder, and other mood disorders
• Eating disorders
• Personality disorders
• Post-traumatic stress disorder (PTSD)
• Psychotic disorders, including schizophrenia

There is no single cause for mental illness. A number of factors can contribute to risk for mental illness, such as:

• Your genes and family history
• Your life experiences, such as stress or a history of abuse, especially if they happen in childhood
• Biological factors such as chemical imbalances in the brain
• A traumatic brain injury (TBI)
• Prenatal (before birth) exposure to viruses, toxic chemicals, or other substances such as alcohol and drugs.
• Use of alcohol or recreational drugs
• Having a serious medical condition like cancer
• Having few friends, and feeling lonely or isolated

Mental disorders are not caused by character flaws. They have nothing to do with being lazy or weak.

Mental disorders are common. Many Americans will be diagnosed with a mental disorder at some time in their life.

The steps to getting a diagnosis include:

• A medical history
• A physical exam and possibly lab tests, if your provider thinks that other medical conditions could be causing your symptoms
• A psychological evaluation. You will answer questions about your thinking, feelings, and behaviors.

Treatment depends on which mental disorder you have and how serious it is. You and your provider will work on a treatment plan just for you. It usually involves some type of therapy. You may also take medicines. Some people also need social support and education on managing their condition.

In some cases, you may need more intensive treatment. You may need to go to a psychiatric hospital. This could be because your mental illness is severe. Or it could be because you are at risk of hurting yourself or someone else. In the hospital, you will get counseling, group discussions, and activities with mental health professionals and other patients.

Movement disorders are neurologic conditions that cause problems with movement, such as:

• Increased movement that can be voluntary (intentional) or involuntary (unintended)
• Decreased or slow voluntary movement

There are many different movement disorders. Some of the more common types include:

• Ataxia, the loss of muscle coordination
• Dystonia, in which involuntary contractions of your muscles cause twisting and repetitive movements. The movements can be painful.
• Huntington's disease, an inherited disease that causes nerve cells in certain parts of the brain to waste away. This includes the nerve cells that help to control voluntary movement.
• Parkinson's disease, which is disorder that slowly gets worse over time. It causes tremors, slowness of movement, and trouble walking.
• Tourette syndrome, a condition which causes people to make sudden twitches, movements, or sounds (tics)
• Tremor and essential tremor, which cause involuntary trembling or shaking movements. The movements may be in one or more parts of your body.

Causes of movement disorders include:

• Genetics
• Infections
• Medicines
• Damage to the brain, spinal cord, or peripheral nerves
• Metabolic disorders
• Stroke and vascular diseases
• Toxins

Treatment varies by disorder. Medicines can cure some disorders. Others get better when an underlying disease is treated. Often, however, there is no cure. In that case, the goal of treatment is to improve symptoms and relieve pain.