Stiff-Person syndrome (SPS), is a rare progressive autoimmune disease of the nervous system, characterized by stiffness and painful episodic spasms in the muscles of the body, especially the spine.

Coined first by doctors Frederick P. Moersch and Henry W. Woltman in 1956, it was originally known as “stiff man syndrome”, but the name underwent a change on the premise that individuals of both gender and all ages are affected by it.

It can be classified into the following types, depending on its symptoms, and severity:

• Focal stiff person syndrome
• Progressive encephalomyelitis with rigidity and myoclonus
• Jerking stiff person syndrome
• Stiff limb syndrome

Picture of Stiff Person Syndrome

Stiff Person Syndrome Signs and Symptoms

Beginning between ages 30 and 50, symptoms may either take years to develop or emerge within weeks.

Early Symptoms

• Stiffness is the earliest symptom, felt in lower back, neck, and leg muscles.
• With the progression of the disorder, severe and painful spasms may develop that may stay for few minutes to hours, and may impact a particular region or the entire body, commonly occurring in the abdominal muscles (causing the person to feel fuller), respiratory and chest muscles

The triggering factors of spasms involve, stress, cold weather, infections and sudden noise or touch.

Other symptoms

• Sleep disturbance
• Shortness of breath
• Anxiety
• Tremors
• Unintended weight loss

What Causes Stiff‑Person Syndrome

The exact cause of this disorder is not known, and among the varied theories that are proposed, one points out that it may result from an abnormal autoimmune reaction in the brain and spinal cord. GABAergic neurons control muscle movements using gamma-aminobutyric acid (GABA) as a neurotransmitter, and are produced by an enzyme, GAD (glutamic acid decarboxylase). According to several studies, in approximately 60% of people with SPS, these enzymes are blocked by antibodies, thereby lowering the levels of GABA in the CNS, ultimately causing a loss of neural inhibition.

Risk Factors

It is more likely to affect women than men. Some of the risk factors associated with certain underlying medical conditions include:

• Diabetes
• Vitiligo
• Thyroiditis
• Pernicious anemia
• Epilepsy
• Breast cancer
• Cerebellar ataxia
• Gluten sensitivity

Complications

• Walking disability involving a rigid gait
• A hunched posture
• Depression
• Skeletal fractures and muscle ruptures

Diagnosis and Tests

The diagnosis generally involves:

• Physical examination
• Antibody testing to detect the presence of high levels of GAD antibodies
• Electromyography (EMG) to record electrical activities occurring in skeletal muscles
• Lumbar puncture test to confirm the disorder

Additional laboratory tests to support the diagnosis and detect certain underlying conditions may involve:

• Hemoglobin AIC test for detecting diabetes mellitus
• Complete blood count for identifying pernicious anemia
• Test for thyroid-stimulating hormone for detecting thyroiditis

Differential Diagnosis

• Fibromyalgia
• Hyperexplexia
• Multiple sclerosis
• Dystonia
• Transverse myelitis
• Occult vascular malformations
• Neuromyotonia (Isaac’s syndrome)
• Schwartz-Jampel syndrome
• Muscular dystrophies
• Metabolic myopathies
• Lyme disease

Treatment and Management of Stiff‑Person Syndrome

Treatment, mainly directed at lowering the pain and managing the symptoms involves:

Medication

• Administration of benzodiazepines along with baclofen to reduce muscle stiffness and spasms.
• Corticosteroids such as gabapentin and tiagabine to reduce seizures; however, prolonged usage may induce various side effects such as headache and dizziness.

Immune-Modulating Therapies

Intravenous Injection of Immune Globulin

Giving immune globulin intravenously may help in reducing the stiffness and sensitivity to noise, stress and touch.

Plasmapheresis

In this procedure, unwanted substances such as toxins, and polluted plasma parts are removed from blood plasma and then the treated plasma is returned to the body. However, more research needs to be done in this area.

Image of Stiff Person Syndrome

Autologous Hematopoietic Stem Cell Transplantation or Auto-HSCT

This method, usually executed in case medicines are all ineffective, involves infusion of bone marrow stem cells that are collected from peripheral cord blood, bone marrow or umbilical cord blood so that hematopoietic functions are revived.

Physical Therapy

An affected individual is also made to undergo physical therapy, comprising of stretching, relaxation exercises and massages so as to overcome problems of voluntary movement and fine motor skills.

Prognosis and Life Expectancy

Living with SPS can be tough since treatment cannot cure the condition completely. Owing to the destruction of his normal defensive reflexes, a person suffering from SPS becomes susceptible to injuries and even death may occur due to a sudden fall. Life expectancy thus depends on how severe one’s condition is and several means are undertaken to ensure that symptoms remain within control.

The condition, rarely occurring in pregnancy can be adequately managed with proper treatment, but babies with SPS, generally do not survive beyond a few months.

Incidence and Prevalence

Though the exact incidence of the condition is not known, it is estimated that 1 in 1,000,000 people may have SPS.

ICD-9-CM Codes and ICD-10-CM Codes

The ICD-9-CM code of SPS is 333.91, and the ICD-10-CM code is G25.8.

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Parry Romberg syndrome (PRS), named after the English physician Caleb Parry, is a rare progressive disorder, characterized by slow atrophy or wasting away of facial soft tissues.  It usually affects the left half of the face, but can occur on both sides in rare cases. Sometimes, the limbs on the same side of the body as the facial atrophy may also be affected.

Other names of the disorder include hemifacial atrophy (HFA), progressive hemifacial atrophy and progressive facial hemiatrophy.

Parry Romberg Syndrome CT scan

Signs and Symptoms

The symptoms vary from person to person, ranging from mild to severe. They generally appear between ages 1 to 15, progress within the next 2 to 10 years before attaining a stable phase.

The most characteristic symptom involves leaning of the mouth, nose and other facial features towards one side, due to atrophy. Other abnormalities that occur with progression of the disease include:

Ear Abnormalities

• Unusual shrinking of the ear on the affected side
• Protrusion of the affected ear from the head

Scalp and Hair Symptoms

• Bald patches on the scalp
• Absence of hair from the middle part of eyebrows
• Unusual whitening (blanching) of hair
• Absence of eyelashes
• Whitening and falling out of facial hair

Mouth and Teeth Anomalies

• Atrophy of the upper lip or one side of tongue
• Shortening of lower jaw bone on the affected side
• Difficulty opening or closing jaws
• Twisted or raised appearance of one side of upper lip
• Abnormal or late exposure of certain teeth, presence of atrophic roots
• Inappropriate meeting of upper and lower teeth

Skin Abnormalities

• Darkening or lightening of affected skin areas indicating hyper- and hypo-pigmentation
• Development of white patches (vitiligo)

Eye Anomalies

• Sunken appearances of both eyes (enophthalmos)
• Differences in the coloration of the two eyes (heterochromia)
• Inflammation of the uvea (the iris, and middle eye portion)

Neurological Symptoms

• Migraine headaches
• Nausea and vomiting
• Sensitivity to light

Rare Symptoms

• Jerky muscle movements suggesting contralateral focal seizures
• Paresthesia or a pricking or burning sensation in the face
• Trigeminal neuralgia or severe pain in face including areas such as the mouth, nose, and cheek
• Jaw spasms

Parry Romberg syndrome CT reconstruction, soft tissues

Parry Romberg syndrome CT reconstruction bone

Causes

The exact cause of this disorder is not known, and among the varied theories, one points out that the disorder may result from an autoimmune reaction, produced by inflammation in the nerves supplying skin and fat. This theory is also supported by the fact that antinuclear antibodies have been found in the serum of some affected people.  Actually, certain proteins called antibodies are produced by the immune system to destroy any harmful foreign materials and protect the body. When the antibodies start attacking healthy tissues by mistake, they are called autoantibodies, and the process in turn generates an autoimmune reaction, leading to conditions like the PRS.

Other theories proposed as the possible causes of PRS are inflammations of the sympathetic nervous system, brain and meninges, and defects in the formation of blood vessels.

Risk Factors

It is more likely to affect women than men. Other risk factors include:

• Trauma of head or face
• Viral infections
• Heredity
• Endocrine disturbances

Complications

• Keratitis
• Atrophy of the optic nerve
• Ipsilateral atrophic changes
• Contralateral atrophic changes
• Iritis
• Facial palsy
• Trigeminal neuralgia
• Epilepsy
• Psychiatric complications

Diagnosis and Tests

• Physical examination
• Brain’s MRI or magnetic resonance imaging scans
• Lumbar puncture
• CT scan
• Autoantibodies serum test

Differential Diagnosis

• Linear scleroderma
• Idiopathic facial palsy
• Rasmussen syndrome
• Goldenhar syndrome
• Hemifacial microsomia
• Berardinelli-Seip congenital lipodystrophy
• Partial acquired lipodystrophy

Parry Romberg Syndrome

Treatment and Management

Since no treatments are available to stop the disorder from progressing, certain therapies are undertaken to manage the symptoms and associated conditions, including:

Medical Therapy

Medications that may provide relief from migraine pain and seizures include immunosuppressive drugs such as corticosteroids, azathioprine, cyclophosphamide and methotrexate.

Surgical Procedures

Micro-Vascular or Reconstructive Surgery

This surgery, done to regenerate the wasted tissues, is generally planned after one or two years of the onset of the condition when the disease has exhausted and facial growth is complete.

Microsurgical Reconstructive Surgery

In this surgery, tissues from certain body parts (such as free groin flaps or the rectus abdominis muscle) are transferred to the face to cover up the deformities.

Additional surgical options for severely affected patients are:

• Orthognathic surgery
• Cartilage grafts
• Bone distraction and grafts

Prognosis

The prognosis of the disorder varies from person to person. Mild cases do not create any aggravating or long term disabilities apart from some cosmetic deformities. Sometimes the condition subsides before affecting the whole face.

Incidence and Prevalence

It is estimated that 1 in 700,000 individuals may have PRS.

PRS ICD-9-CM Codes and ICD-10-CM Codes

The ICD-9-CM codes of PRS are 349.89, 351.8, while its ICD-10-CM code is G51.8

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Cryptococcal meningitis is a non-contagious, opportunistic infection that occurs when the meninges tissue covering the brain and spinal cord get infected by certain fungus. Other body parts, such as the lungs, kidney, bone marrow, urinary tract, lymph nodes and skin, may also be affected.

Causes

The disease is usually caused by the fungus, Cryptococcus neoformans, (present in the wastes of birds such as pigeons, as well as in soil), and rarely by Cryptococcus gatti (commonly found around eucalyptus trees). The mode of transmission of C. neoformans is through inhaling dust particles contaminated with dried bird droppings, with the fungus mostly affecting individuals having a weak immune system. The C. gatti fungus, on the other hand, may infect anyone.

Cryptococcal meningitis

Signs and Symptoms

Symptoms are slow and may take a few days to a few weeks to appear, generally including:

• Headache
• Hallucinations
• Nausea
• Vomiting
• Behavioral changes suggesting mental confusion
• Irritability to light
• Eye problems such as impaired vision
• Seizures

Rare symptoms may include:

• Moderate to high fever
• Stiffness and pain in neck
• Fatigue

Risk factors of C. neoformans-Induced CM

It is more likely to affect people with:

• CD4 cell counts below 100
• Aids
• Cirrhosis
• Diabetes
• Leukemia
• Lymphoma
• Sarcoidosis
• An organ transplant
• Long term steroid therapy
• Renal failure
• Systemic lupus erythematosus (SLE)
• After renal transplant (rarely)

Possible Complications

• Deafness
• Brain damage
• Coma
• Hydrocephalus
• Critical skull swelling leading to pressure on brain
• Blindness from optic neuritis
• Decreased mental capacity
• Meningoencephalitis
• Permanent cranial nerve palsies
• Hydrocephalous
• Vasculitis
• Ischemic stroke

Diagnosis and Tests

• A complete physical examination concerning the symptoms associated with the ailment
• A lumbar puncture test or spinal tap to examine a sample of cerebrospinal fluid (CSF)
• Chest x-ray
• CT scan of the head
• Examination of CSF to find out cell count, glucose, and protein
• CRAG test to look for cryptococcal antigen in CSF or blood
• Gram stains
• Blood culture
• Culture of CSF
• Sometimes a diagnostic test using a dye called India ink

Differential Diagnosis

• Tuberculous meningitis
• Lymphomatous meningitis
• Hyponatraemia

Treatment and Management

Medication

Antifungal medicines such as amphotericin B, along with flucytosine may be prescribed, with the dosage continuing for two or more weeks, as necessary. Close monitoring by the doctor is often necessary to check for any toxic effects on the kidney (nephrotoxicity).

Amphotericin B may be replaced by fluconazole, if spinal fluid tests (for CM) taken in two consecutive weeks show negative results. Fluconazole may be substituted with other alternative antifungal agents such as Itraconazole or Voriconazole.

Intravenous Therapy

In case of IV therapy, amphotericin B is combined with an antifungal medicine called 5-flucytosine and inserted intravenously.

Lumbar Drainage

Some patients with raised intracranial pressure may undergo a lumbar puncture to drain excess spinal fluid to reduce the opening pressure. However, more research needs to be done in this area.

Adjunctive Treatment

Glucocorticoids, such as dexamethasone, may reduce the possibility of blindness associated with the disease.

Treatment of CM during Pregnancy

For pregnant women who have CM, the usual drug of choice is amphotericin B as it is safer than the azole drugs, like fluconazole, itraconazole and ketoconazole, which may induce birth defects.

Can CM be Prevented

Although it is not possible to prevent initial exposure to the fungus, taking a few measures may help people more at risk of developing the infection. The drug, fluconazole reduce the chances of CM for those with CD4+ counts less than 50, but long-term use can have side effects, like thrush, vaginitis or candida infections since these yeast infections are resistant to fluconazole.

Incidence and Prevalence

With AIDS patients, its incidence lies between 2-7 cases per 1000 people, while amidst non-HIV-infected people, it occurs in 0.4 to 1.3 cases per 100,000 people. The ailment is more prevalent with adults and adolescents than children (found in less than 1% of all HIV-affected children).

Prognosis and Life Expectancy

Most patients improve with adequate treatment. Recurrence may be prevented by continuing the antifungal drugs. It has a mortality rate of around 10% and chiefly with those with HIV. In Sub-Saharan Africa, the death rate of AIDS patients having the disease is around 50-70%.  Research is being done to develop a vaccine to prevent the ailment.

ICD-9-CM and ICD-CM-10 Codes

The ICD‑CM‑9 code of cryptococcal meningitis is 321.0, while its ICD-CM-10 code is B45.1.

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Glossopharyngeal neuralgia (GPN), also known as cranial mononeuropathy or vagoglossopharyngeal neuralgia, first coined in 1921 by Harris, constitutes a rare pain syndrome resulted due to irritation of the glossopharyngeal nerve (the 9th of the 12 pairs of cranial nerves).

Signs and Symptoms

Areas that are connected to the 9th cranial nerve experience severe, electric shock-like pain that according to the International Headache Society, can be episodic (Classical GPN) or constant (Symptomatic GPN).

Pain Triggering Factors

• Chewing
• Coughing
• Drinking chilled liquids
• Laughing
• Talking
• Swallowing
• Yawning
• Feeling the gums
• Sneezing
• Clearing the throat

Glossopharyngeal Neuralgia

Characteristics of the Pain

• Lasts for a few seconds to a few minutes
• Affects one side of the throat (may be bilateral in rare cases)
• Occurs at random throughout the day
• Frequency increases over time, leading to certain disabilities
• Severe enough to rouse one from sleep

Areas Where Pain is Felt

• Back of nose and throat (nasopharynx)
• Back of tongue
• Middle ear
• Jaw
• Tonsil area
• Neck

Rare Features of GPN

• Tinnitus
• Vomiting
• Vertigo
• Swelling sensation
• Involuntary movements

Causes

Although it is not known what causes the irritation, it is believed that damage of the protective sheath of the 9th cranial nerve results in sending abnormal messages that disrupt the normal signals of the nerve, causing pain. There may be various causes:

Compression of the glossopharyngeal nerve by:

• Arteries and veins
• Abnormal growths at the base of the skull
• Tumors
• Swelling of glands
• Problems of the spinal cord such as multiple sclerosis
• Abnormally large styloid process

Irritation of the glossopharyngeal nerve by:

• Mouth infections such as tooth abscess, tooth extraction, and other dental issues
• Viral infections caused by the herpes virus and other infections such as mums, common cold
• Inflammations of the nose, ear or throat

Risk Factors

• Being over 40 years of age
• Direct blow over the neck or ear regions during sports
• An injury to the nerve and neck due to any serious accident
• Medical conditions like diabetes
• Rheumatoid conditions and musculoskeletal problems
• Elongated styloid process
• Hypertension

Complications

• Slow pulse rate
• Sudden fall in blood pressure
• Fainting (syncope)
• Seizures
• Bradycardia
• Cardiac syncope

Diagnosis and Tests

After a careful physical examination of the patient’s symptoms, if GPN is suspected, the back portion of the patient’s throat is touched with a cotton-tipped applicator to arouse pain. If pain occurs, a local anesthetic is applied to the same region and again the pain stimulus is performed. An absence of pain when the area is numb suggests GPN.

Imaging tests to detect the presence of tumors or an elongated styloid process

• CT scan of the head
• MRI of the head
• X-rays of the head or neck

Imaging tests to look for arterial or vascular compression

• MRA of the head
• CT angiogram
• X- rays of the arteries

Other imaging and blood tests

• Blood tests (sugar level) to determine the cause of nerve damage
• Electromyogram (EMG) to record muscle contractions or changes caused due to nerve stimulation
• Nerve conduction study (NCS) to record changes in nerve signals

Differential Diagnosis

• Trigeminal neuralgia
• Eagle syndrome
• Geniculate neuralgia

Treatment and Management

Treatment that is mainly directed towards reducing pain involves:

Medication

Anticonvulsants such as carbamazepine (Tegretol), oxcarbazepine (Trileptal), gabapentin (Neurontin), phenytoin (Dilantin), baclofen (Lioresal), and pregabalin (Lyrica) may be administered to block the pain and abnormal signals.

Some antidepressants and relaxants like amitriptyline or nortriptyline may also prove effective in lessening pain.

Application of a Local Anesthetic

By applying a local anesthetic called lidocaine at the back of the throat, numbness may be formed in the area, and temporary relief from swallowing difficulty can be obtained.

Sometimes pain may be relieved by injecting sterile glycerol at the nerve root.

Surgery

Surgical procedures are sought only when the patient does not respond to drug therapy.

Microvascular Decompression (MVD): MVD, the commonest treatment, providing relief to nearly 85% of patients involves a procedure called craniotomy by which a 1-inch opening is made and the blood vessel pressing the nerve is either lifted or removed.

This surgery, requiring 1 to 2 days of hospital stay includes a 5% risk of death as blood pressure and heart rate problems may emerge owing to the manipulation of the nearby vagus nerve.

Nerve Rhizotomy: If the blood vessel compressing the nerve cannot be traced or is difficult to remove, then this procedure is carried out. To detect the root fibers of the vagus nerve causing pain, a small incision is made at the back of the skull using a stimulation probe and finally the concerned fibers are severed.

Both these operations may provide 96% long-term relief, but there may be side effects such as hoarseness, swallowing difficulty (dysphagia), and loss of taste sensation.

Percutaneous Stereotactic Radiofrequency Rhizotomy (PSR): This is a minimally invasive outpatient procedure that uses an electrode with current to damage some of the pain-causing nerves.

Radiation

Gamma Knife Radiosurgery or Stereotactic Radiosurgery: Aiming to destroy the affected nerve root to block the transmission of pain signals to the brain, it is done by delivering highly focused radiation beams at the root of the nerve. This noninvasive outpatient procedure, usually done on aged patients who are incapable of tolerating surgeries, provides relief from pain gradually. Consequently, patients remain on medication for some time to handle the pain as the radiation takes effect.

Other Modes of Management
Lifestyle changes like avoiding repeated late night sitting, limitless use of electronic gadgets, heedless consumption of caffeinated beverages or smoking

• Homeopathy, Ayurveda, acupuncture, and yoga practiced under efficient guidance
• Message therapy (for muscle stress and spasms)
• Psychotherapy and counseling to overcome stress

How to Prevent GPN

Although there are no known ways to prevent the syndrome, following a low-salt and low-fat diet, along with natural supplements such as magnesium, iron, and other important nutrients, may help in keeping the protective covering of the nerve intact, reducing the chances of damage.

Incidence and Prevalence

The incidence of GPN is estimated to be between 0.2- 0.7 per 1000,000 people per year. Amidst this, around 10% of individuals are misdiagnosed as trigeminal neuralgia.

Prognosis

With some patients, the pain syndrome goes away after proper treatment following an initial attack. In more serious cases, the attacks recur and are followed by short or long remission periods. The recovery depends on the underlying ailment that causes pain and the effectiveness of the initial treatment.

Glossopharyngeal Neuralgia vs. Trigeminal Neuralgia

Though GPN is often misdiagnosed with trigeminal neuralgia due to both being facial pain syndromes, they can be distinguished on the basis of the location of pain. While the pain of GPN typically concerns ear and throat, trigeminal Neuralgia causes pain in lips, eyes, nose, scalp, and forehead.

GPN ICD-9-CM Code and ICD-10-CM Code

The ICD-9-CM code of GPN is 352.1, and ICD 10 CM is G52.1.

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Transient global amnesia Definition

Transient global amnesia (TGA) refers to an abrupt, temporary loss of memory that cannot be associated to more common neurological disorders such as stroke or epilepsy.

Transient global amnesia ICD9 Code

The ICD9 Code for this disorder is 437.7.

Transient global amnesia Incidence

The annual incidence of TGA has been estimated to vary between 23 and 32 cases in every 100,000 individuals in the United States. The disorder is most common in individuals aged between 56 and 75 years. The average age of onset of the disease has been reported to be around 62.

Transient global amnesia Symptoms

Movies and soaps often feature characters, even protagonists, suffering from temporary loss of memory. TGA is mainly characterized by a similar inability to remember the recent past and form new memories on a temporary basis. Once that problem is confirmed, doctors should rule out other possible causes of amnesia.

At the time of an episode of TGA, the ability of a person to recall recent happenings simply goes away. Sufferers cannot remember their surroundings and how they got there. They may also be unable to answer when asked to recall things happening within a day, month or even a year.

While individuals suffering from TGA tend to remember who they are and recognize the people around them, the loss of memory about recent events can be quite disturbing for them.

During the episode of memory loss, patients may also exhibit other physical symptoms although they can be variable in nature. The most common physical symptoms include:

• Panics
• Sweats
• Racing heartbeat
• Stomach upset
• Headache

If the physical problems are not reported at the time of memory loss, patients are not likely to report them again as they are unlikely to remember them at a later time.

Transient global amnesia Causes

The underlying cause of TGA is not known as yet. According to medical researchers, there is apparently a link between the disorder and a history of migraines. However, the underlying factors that can cause both conditions have not been completely understood.

Some events that are commonly reported and suspected to be the trigger factors for TGA include:

• Sexual intercourse
• Strenuous physical activity
• Mild head trauma
• Sudden immersion in hot or cold water
• Medical techniques, such as endoscopy or angiography
• Severe emotional distress, as might occur due to overwork, conflict or bad news

This condition is supposed to arise as a consequence of some types of trauma, physical activities like sexual activity or physical horseplay or medical techniques like catheterization. Extremely bad and traumatic news can also cause severe mental trauma and lead to TGA.

Transient global amnesia Risk Factors

The most apparent risk factors for this disorder are:

Age

Those aged 50 and above are more susceptible to TGA than younger individuals.

History of migraines

In people having migraines, the risk of TGA is much more than those without migraines. Those suffering from migraine headaches seem to be predisposed to this disease.

It is interesting to note that high cholesterol and high blood pressure are not risk factors for TGA, despite being associated closely to strokes. Being male or female does not seem to make any difference and there is probably no sexual predilection for the disease.

According to certain theories, pressure on the large veins located in the back portion of the head might lead to an emergence of this condition.

Transient global amnesia Diagnosis

Physicians base the diagnosis of TGA on the following symptoms:

• Abrupt onset of memory loss, confirmed by a familiar person
• Ability to remember personal identity, despite memory loss
• Episode of memory loss lasting for not more than 24 hours
• Normal cognition, such as the ability to follow simple directions and make out and name familiar things
• No sign of seizures at the time of amnesia
• Gradual coming back of memory
• No history of recent head injury or active epilepsy
• No signs that indicate damage to the nerves of a particular brain area, such as defective word recognition, involuntary movement or paralysis of a particular limb

Patients also commonly tend to ask same type of questions repetitively, such as “How did I get here?” or “What am I doing here?”

Although TGA is not a harmful condition, physicians are unable to easily differentiate the disease from life-threatening disorders that may also lead to abrupt loss of memory. Sudden amnesia is in fact, much more likely to result from a seizure or stroke than due to TGA. The exact cause of abrupt loss of memory can only be determined by a medical assessment.

Transient global amnesia – Testing and Diagnostic Tests

The diagnosis of the condition is based on the exclusion of more severe disorders, such as head injury, seizure or stroke that can lead to some form of memory loss.

The diagnostic tests for this disorder include:

Physical examination

The process starts with a neurological test and checking the following:

• Balance
• Coordination
• Gait
• Posture
• Reflexes
• Sensory function
• Muscle tone
• Muscle strength

Doctors may also ask questions to test memory, judgment and thinking capacity of affected individuals.

Brain and imaging tests

These include detecting abnormalities in the circulation and electrical activity of the brain. The most common tests out of these are painless and take less than 2 hours to be performed.

These tests include the following:

Magnetic resonance imaging (MRI)

The process involves radio waves and a magnetic field to construct cross-sectional, detailed images of the brain. These images can be combined by an MRI machine to render 3-D pictures that can be viewed from a variety of different angles.

Electroencephalogram (EEG)

This technique records the electrical activity of the brain’s through electrodes that are firmly attached to the scalp. Epileptic individuals often suffer from changes in their brain waves even when they do not suffer from seizures.

Computerized tomography (CT)

The process makes use of special X-ray equipment known as CT machines that obtain and combine images from various angles to get cross-sectional images of the skull and brain. CT scans can show abnormalities in brain structure, which include broken, narrowed or overstretched blood vessels and signs of strokes in the past.

Transient global amnesia Differential Diagnosis

The differential diagnosis for TGA includes isolating its symptoms from those of other disorders than can give rise to similar problems. These include:

• Head injury
• Nonconvulsive epilepsy
• Hysterical amnesia
• Korsakoff psychosis
• Cardioembolic Stroke
• Basilar Artery Thrombosis
• Lacunar Syndromes
• Complex Partial Seizures
• Migraine Variants
• Frontal Lobe Epilepsy
• Posterior Cerebral Artery Stroke
• Syncope and Related Paroxysmal Spells
• Temporal Lobe Epilepsy
• Various causes of acute confusional states like dementia, drug or alcohol intoxication and hypoglycemia

Physical examination as well as assessment of clinical history of sufferers is usually helpful in confirming the disorder.

TGA can generally be distinguished from Complex partial seizures on clinical grounds, as they are related with affected ability to perform complicated tasks and altered consciousness.

Transient global amnesia Treatment

The condition does not require any medical treatment. It tends to disappear on its own and is confirmed to result in no after effects. Once the condition is detected, cure only involves providing reassurance to sufferers and scheduling for them at least one follow-up visit with a neurologist.

Patients with this disease do not need any dietary restrictions. However, they should avoid all activities that can lead to an increase in intrathoracic pressure.

Transient global amnesia Prognosis

Luckily, TGA is a rare and apparently harmless condition. Episodes of this disorder are generally temporary and unlikely to occur again. The memory is usually fine after an episode of TGA.

Transient global amnesia Complications

Although the condition is not known to directly give rise to any complications, it can result in mental distress in sufferers. The loss of memory can be disturbing in patients and they are likely to worry about a recurrence of the disorder. Symptoms like abrupt memory loss can often indicate a more acute underlying disorder. Although TGA does not indicate any severe underlying disorder as a cause, it can difficult to get rid of the fear of a possible severe cause like a stroke or a tumor. Patients can be reassured by going through a neurological exam and getting good test results. Persistent anxiety can be reduced through counseling or psychotherapy. TGA is not a risk factor for stroke.

Transient global amnesia Prevention

No standard preventive approaches for TGA tend to exist as the cause of the disease is unknown and its rate of recurrence is low. In case an episode of TGA occurs after a specific activity like swimming in very cold waters or working out severely, it is better to consult a doctor about what can be done. Physicians may recommend limitation or avoidance of activities that seem to trigger loss of memory in sufferers.

If you have a friend or a family member who enters a state of confusion about recent events from normal awareness, it is important that you seek medical attention on an immediate basis. Call an ambulance if the person is too disoriented or suffering from some other problems apart from mental confusion.

References:

http://en.wikipedia.org/wiki/Transient_global_amnesia

http://www.mayoclinic.com/health/transient-global-amnesia/DS01022

http://emedicine.medscape.com/article/1160964-overview

http://edition.cnn.com/HEALTH/library/transient-global-amnesia/DS01022.html

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Transverse myelitis (TS) is a condition characterized by the inflammation of the spinal cord, which often affects the myelin or the insulating substance that covers nerve cell fibers. The disorder may cause injury to the spinal cord and result in reduced or absent sensations below the point of injury.

Transverse myelitis Symptoms

The signs and symptoms of this disease generally develop fast over a period of few hours and tend to worsen over a period of few days. In less frequent cases, the signs and symptoms have a gradual progression over several days to weeks. Both sides of the body are commonly affected, although not always.

The typical signs usually include:

Pain

Pain related with this disorder often arises suddenly in the back or neck, based on the part of the spinal cord that is affected. The sharp, acute sensations may also radiate around the abdomen or down the arms and legs.

Weakness in arms and legs

Some people affected with mild fatigue note that they are dragging or stumbling one foot. They may also experience heaviness in their legs as they move about. Others may suffer from acute paralysis.

Unusual sensations

Some individuals with mild fatigue also notice that their legs feel heavier with movement or that they tend to stumble or drag their feet about at the time of walking. Others may also experience acute weakness as a result of the condition.

Bowel and bladder problems

Some patients may suffer from problems like difficulty in urination, urinary incontinence, constipation and increased urge to urinate.

Transverse myelitis Incidence

Around 33,000 Americans suffer from some form of disability as a result of TM. The incidence rate peaks in individuals in the age groups 10-19 years and 30-39 years. Only a few studies have examined the rate of incidence of TM. However, it has been estimated that around 1,400 new cases of TM are detected every year in the United States.

Transverse myelitis Causes

The disorder occurs as a result of immune system dysfunction known as autoimmunity in which the immune system of the body acts against the own tissues of the body. It is not known what leads to the immune system disorder that leads to TM. However, doctors and researchers have identified a number of trigger factors for this disease. These include:

Neuromyelitis optica

Also known as Devic’s disease, it is a disorder that results in swelling and loss of myelin in the region surrounding the optic nerve (the nerve transmitting information from the eyes to the brain) and the spinal cord. The symptoms of TM related with Neuromyelitis optica are generally manifested in both sides of the body. The damage to the myelin of the optic nerve and the symptoms arising as a consequence (including temporary loss of vision and pain in eye with ocular movement), may arise simultaneously or at other times. Some patients of Neuromyelitis optica, however, may not suffer from any ocular problems. They may only experience recurrent cases of TM.

Autoimmune disorders

Autoimmune conditions that affect other systems of the body are possible contributory factors in some TM patients. These disorders include:

Sjogren’s Syndrome

It leads to acute dryness of the eyes and the mouth along with various other problems.

Lupus

It can affect multiple systems of the body.

TM related with an autoimmune condition may suggest the presence of Neuromyelitis optica, which arises more often in individuals with other autoimmune disorders than in those without.

Infections

Viral infections of the gastrointestinal tract or the respiratory tract have been regarded as the possible trigger factors for TM. In the majority of cases, the inflammatory condition arises after an individual has recovered from the viral infection.

Multiple sclerosis

It is an autoimmune condition in which the immune system attacks and destroys the myelin surrounding the nerves in the brain and the spinal cord. TM may be the first symptom of Multiple sclerosis (MS); it may also stand for a recurrence of symptoms. TM, which arises as a symptom of MS, generally affects only one side of the body.

Mycoplasma pneumonia

It is a comparatively mild type of Pneumonia that is caused by a bacterium. Mycoplasma pneumonia may act as a trigger factor for the mechanisms of immune system that cause TM.

Vaccinations

Vaccinations for infectious diseases, such as Diphtheria-tetanus, measles-mumps-rubella and Hepatitis B, have been identified as trigger factors for TM in rare cases.

Transverse myelitis Diagnosis

The diagnosis of TM depends on a number of factors, such as:

• Medical history of patients
• Symptoms experienced by them
• Clinical evaluation of nerve function
• Results of medical tests

Various medical tests may be carried out to detect and confirm the presence of TM. The exams may indicate inflammation of the spinal cord and help ensure the absence of other similar conditions. Such tests may include the following:

Magnetic Resonance Imaging (MRI)

This test makes use of radio waves and a magnetic field to create 3D or cross-sectional images of soft tissues. An MRI exam can reveal spinal cord inflammation and detect other probable causes of the symptoms that include blood vessel malformations and abnormalities resulting in spinal cord compression.

Lumbar puncture

Also referred to as Spinal tap, the technique involves use of a needle to extract a small quantity of cerebrospinal fluid or CSF (a protective fluid surrounding the brain and the spinal column) from the spinal column. In some TM sufferers, there may be unusually high amounts of immune system proteins or white blood cells in the CSF which can indicate inflammation of spinal cord. Doctors may also test spinal fluid for some forms of cancer or viral infections.

Blood tests

This involves an examination to detect the presence of antibodies associated with Neuromyelitis optica, a disease characterized by swelling n the ocular nerve or in the spinal cord. Those with a positive antibody exam are more susceptible to multiple attacks of TM and need treatment for prevention of such problems in future.

Other blood tests can help detect infections that may contribute to TM or help rule out other possible causes of the condition.

Transverse myelitis Differential Diagnosis

The differential diagnosis for TM mainly involves telling its symptoms apart from those of three conditions like:

• Infarction of the spinal cord (generally as a result of insufficiency of the anterior spinal artery)
• Acute trauma of the spinal cord
• Acute compressive lesions of the spinal cord, like Epidural metastatic tumor

Transverse myelitis Treatment

The treatment of TM involves use of various medications, therapies and processes that address the severe signs and symptoms of the disorder. These include:

Medications

These involve:

Intravenous steroids

Following diagnosis, patients are likely to be administered steroids through an arm vein over a period of several days. Steroids are useful in decreasing the swelling in the spinal column.

Analgesics or pain-relievers

TM patients commonly suffer from chronic pain as an associated complication. Medicines that may reduce pain associated with damage to the spinal cord involve common pain-relieving drugs such as Ibuprofen (Advil, Motrin and others), Acetaminophen (Tylenol and others) and Naproxen (Aleve, Naprosyn and others).

Medicines to cure other complications

Physicians may also prescribe other drugs, as required, to cure health problems like urinary or bowel dysfunction, depression, muscle spasticity or other complications that are associated to TM.

Therapies

These include:

Plasma exchange therapy

Those who show no positive response to intravenous steroids may undergo plasma exchange therapy. This therapeutic procedure involves replacing the plasma with special types of fluids and removing the straw-colored fluid in which blood cells can be found suspended.

Non-drug therapies

Other therapies that focus on long-term recovery and care include:

Physical therapy

It is beneficial in increasing the strength and improving the coordination of TM sufferers. Physical therapists are likely to teach patients ways to use supportive devices like braces, canes or wheelchairs, if necessary.

Psychotherapy

Psychotherapists can use talk therapy to cure patients of behavioral problems that may possibly be associated to TM or other emotional difficulties such as depression or anxiety or sexual dysfunction.

Occupational therapy

Those suffering from TM can find benefit from this therapy and learn about new ways to perform daily activities like cleaning the house, bathing or cooking foods.

Transverse myelitis Home Treatment

It includes lifestyle measures that can help manage the complications of TM. These include:

Avoiding bowel problems

Adhering to a fiber-rich diet and drinking lots of fluids can help prevent constipation and prevent bowel problems.

Maintaining bone strength

TM patients are at a higher risk of developing osteoporosis due to restricted activity. Patients should consult doctors about ideal Vitamin D and calcium supplements that can improve their bone health.

Transverse myelitis Prognosis

It is difficult to predict the course of this disease. Patients usually have a worse outcome when they experience a faster onset of symptoms.

Although the majority of TM sufferers manage at least partial recovery from the condition, complete recovery may take a full year or even more.  Recovery depends strongly on the cause. Those with neuromyelitis optica have a worse outcome. However, most patients manage to recover with treatment even in such situations.

Following an episode of the disease, around one-third of TM sufferers belong to each of the three categories:

No or slight disability

Such patients have only very little residual symptoms.

Moderate disability

These sufferers can move about but may experience tingling, numbness, bowel and bladder problems and difficulty in walking.

Severe disability

Some patients may need supportive devices like wheelchairs on a permanent basis and need ongoing assistance, along with care, with daily activities.

Transverse myelitis Complications

Although TM patients generally suffer from only one severe episode of the disorder, the associated complications often linger. These include:

Pain

It is one of the most common long-term complications of the disease that can be debilitating for sufferers.

Muscular spasms

Patients may experience painful spasms or tightness or stiffness of muscles, particularly in their legs and buttocks, along with lingering effects of the disease.

Sexual dysfunction

It is a common complication associated with TM. Affected males may suffer from difficulty in having erections or orgasms. Affected women may also be unable to have an orgasm.

Transverse myelitis Pictures

The following images show the internal appearance of TM sufferers.

Picture 1 – Transverse myelitis

Picture 2 – Transverse myelitis Image

If you are experiencing the signs and symptoms of Transverse myelitis yourself, or have a family member exhibiting them, get in touch with a doctor immediately and seek medical care on an emergency basis. Various neurological disorders can result in problems similar to that of TM. Naturally, prompt diagnosis and treatment is very important for faster recovery from this disorder and ensure avoidance of any possible associated complications.

References:

http://www.mayoclinic.com/health/transverse-myelitis/DS00854

http://www.ninds.nih.gov/disorders/transversemyelitis/detail_transversemyelitis.htm

http://en.wikipedia.org/wiki/Transverse_myelitis

http://radiopaedia.org/articles/transverse-myelitis

http://www.wisegeek.com/what-is-transverse-myelitis.htm

The post Transverse myelitis appeared first on Prime Health Channel.

Torticollis Definition

It refers to a twisted neck condition in which the head of sufferers is tipped to one side and the chin is turned to the other.

The disorder is also referred to as “Loxia” or “Wry Neck.”

Torticollis ICD9 Code

The ICD9 Code for this disease is 723.5.

Torticollis Incidence

The incidence of this disorder is calculated to be around 3 in every 10,000 individuals. Approximately 90% of all cases of Torticollis are idiopathic in nature and 10-20% are from defined factors. However, the exact incidence of the condition is unknown as the disorder has been misdiagnosed and many sufferers go undiagnosed.

Idiopathic Torticollis affects women two times more than men.

Torticollis Symptoms

The signs and symptoms of this condition include the following:

• Headache
• Neck pain
• Head tremor
• Stiffness of the neck muscles
• Limited range of motion of the head
• Shoulder that is higher on one side of the body
• Inflammation of the neck muscles (possibly present at birth)

Torticollis Causes

The condition has a genetic association. It may either be inherited, as a result of changes in the genes, or acquired – which arises due to damage to the muscles, upper spine or nervous system.

If the condition arises without a known cause, it is referred to as Idiopathic Torticollis.

Torticollis may occur in childhood or adulthood. Congenital Torticollis, which is present as a birth defect, may arise if the head of an affected baby was in an abnormal position during growth in the womb. It may also develop if the muscles are injured or the blood supply to the neck is interrupted.

Torticollis Types

The condition has been classified into different types, which are based on the basis of the positions of the neck and head such as:

Rotational Torticollis

The head of patients rotates along the longitudinal axis.

Laterocollis

The head of sufferers is tipped towards the shoulder.

Anterocollis

It is characterized by forward flexion of the neck and head.

Retrocollis

It is marked by backward hyperextension of the head and neck.

Torticollis is categorized into the following two types:

Congenital Musclar Torticollis

The cause of the disorder is unclear. It is a birth defect and an abnormal fetal position within the uterus is supposed to result in damage to the sternocleidomastoid muscle located in the neck.

Acquired Torticollis

It is also referred to as Noncongenital Muscular Torticollis and can arise due to various causes like enlarged cervical glands, cerebellar tumors or adenitis.

It is further divided into the following subtypes:

Spasmodic Torticollis

It is Torticollis characterized by recurrent but transient contraction of the neck muscles and particularly the muscles of the sternocleidomastoid.

Acquired Torticollis in Infants

As the name suggests, it is Torticollis developing in infants who spend a long time on their back on play mats or in strollers or car seats. In infants, the condition is almost always preventable.

Torticollis Risk Factors

The factors that increase susceptibility to this condition include:

Age

The onset of this disorder is most frequent in individuals aged between 30 and 50 years.

Gender

The risk of development of the disease is higher in females than males.

Gene

The condition is supposed to have a genetic association as 5% of all individuals affected by the disease report of having at least one family member with Torticollis. However, a family history of the disorder may also indicate an Inherited Generalized Dystonia.

The risk of development of this disease is also increased due to the following factors:

• Any infection
• Use of some medicines
• An injury to the neck or head
• Exposure to carbon monoxide or heavy metals

Torticollis Diagnosis

The tests to be conducted to rule out the possible causes of neck and head pain may include the following:

• MRI (Magnetic Resonance Imaging) scan of the brain
• CT scan of the neck
• Electromyogram (EMG) to check which muscles are the most damaged

X-rays may be conducted to rule out spinal abnormalities such as cervical disc disease or other underlying disorders. There are no standard laboratory exams for this disease. Doctors may also perform using contrast media and imaging techniques may be performed.

In case physicians may suspect, DNA testing may be conducted to detect particular Genetic Dystonia. They may also perform to rule out Ophthalomopathies as the probable cause.

A physical examination of sufferers may reveal the following problems:

• Shortening of the neck muscles
• Pulling and turning of the entire head to one side, in particularly acute cases
• Tilting of the head towards the affected side with the chin pointing to the opposite side

Torticollis Differential Diagnosis

During differential diagnosis, the symptoms of the condition must be distinguished from those of other disorders like:

• Epilepsy
• Tetanus
• Radiculopathy
• Anterior horn disease
• Cerebral palsy
• Myasthenia gravis
• Cervical adenitis
• Labyrinthine disease
• Parkinson disease
• Cervical osteomyelitis
• Multiple sclerosis
• Spinal cord neoplasms
• Fractures of the cervical spine
• Retropharyngeal space infection
• Conversion disorder (a mental disorder with psychogenic torticollis)

Doctors must ensure that patients are actually exhibiting the symptoms of Torticollis and not of any of the above-mentioned conditions.

Torticollis Treatment

The treatment of Congenital Torticollis (the form of the disorder present at birth) includes stretching the shortened muscle of the neck. In infants as well as very young children, passive stretching and positioning are implemented. These treatment options are often successful, particularly if they are initiated within 3 months after the birth of sufferers.

In preschool years, operative procedures may be used to correct the problems of the neck muscle. This is true for cases in which other treatment options fail to bring about an improvement in the condition of patients.

Torticollis that results from damage to the spine, muscles or the nervous system is cured by identifying the cause of the condition. The curative measures involve:

• Use of massage, application of heat or traction to the cervical spine, in order to help provide relief from neck and head pain.
• Neck braces and stretching exercises to help cure muscular spasms.
• Possible use of drugs, including the anticholinergic drug baclofen.
• Injecting Botulinum toxin (Botox) to provide possible temporary relief from Torticollis, although repeat injections are generally required after every 3 months.
• Spinal surgery, which might be needed in cases where the condition arises as a result of a dislocated vertebrae. In certain sufferers, operation involves brain stimulation or destruction of some of the nerves in the neck muscles.

Torticollis and Medicines

The medications that are useful for curing or managing the signs and symptoms of the disease include:

Paracetamol

Full-strength painkillers are often enough in curing the disease. Two 500 mg tablets, administered for four times every day, are recommended for adult sufferers.

Anti-inflammatory painkillers

These include over-the-counter (OTC) drugs like Ibuprofen, or prescription medicines such as Naproxen or Diclofenac that can be used alone or along with Paracetamol. However, certain patients find these more effective than Paracetamol.

These types of medications may not be suitable for people suffering from health problems like:

• Kidney failure
• High blood pressure
• Heart failure
• Asthma
• Stomach ulcers

Painkillers

Strong painkillers like Codeine are a curative option if anti-inflammatory medications are not that effective or suitable. However, consumption of Codeine commonly gives rise to the side-effect of constipation. This can be prevented by the consumption of plenty of fluids or foods rich in fiber.

Muscle relaxants

Diazepam and other muscle relaxants are occasionally prescribed for a few days in cases where the stiffness in the neck muscles is acute in form.

Torticollis – Alternative Treatment

Alternative treatment options for this disorder may include:

Heat packs

Application of heat packs can help provide relief from stiffness in the affected muscles in some sufferers.

Firm support

A firm support in the form of a pillow at the time of sitting or sleeping can also help the affected region and prevent worsening of the condition.

Proper posture

Correct posture can help patients suffering from head or neck pain arising due to this condition. Sitting upright, not with a stooped back or head flexed forward, can help prevent further deterioration of the disease.

Exercises

Exercises such as pilates, Yoga or Alexander technique can improve the posture of the neck. However, the actual worthiness of these workouts in curing neck pain is uncertain.

Torticollis Prognosis

With proper medical treatment, the condition has a good outcome. The signs and symptoms often improve within one to two days. However, the problems may take up to a week to resolve completely. The symptoms occasionally persist longer or recur at a later time without any apparent reason.

The disease may be easier to cure in infants and in children. If the disorder turns chronic in nature, patients may experience tingling and numbness as a result of pressure on the nerve roots located in the neck. The muscle itself may get enlarged and become hypertrophic as a result of exercise and persistent stimulation.

In the majority of cases, the condition may persist for a lifetime and can lead to postural deformity and limited movement. Following operation, the mobility of the neck may not fully return to normal. Some patients may suffer from numbness on the rear section of the head extending to the top.

Torticollis Complications

The complications associated with this disorder may include inflammation of muscles due to continuous tension or symptoms of nervous system problems as a result of pressure on the roots of nerve. Long-term changes in the posture of the neck and head can also result in Scoliosis or Spinal Stenosis and/or spinal radiculopathies.

Torticollis Recovery Time

Work restrictions for affected individuals may be based on the acuteness of the disease, manifested by problems like limited range of motion. Patients may need to eliminate or reduce operating heavy machinery, driving any other tasks that involve the motions of the head and neck.

Torticollis Prevention

There is no specific way to prevent the development of this disorder. However, early treatment may prevent a worsening of the condition.

Torticollis Pictures

The following images show the physical appearance of patients of this disorder.

Picture 1 – Torticollis

Picture 2 – Torticollis Image

If you suspect yourself, or a friend or a family member, to be having this disorder and the symptoms do not show any improvement you should get in touch with a medical care provider and seek early diagnosis and treatment. Torticollis that arises after an illness or injury may be acute in nature. Due to this reason, it is best to seek medical treatment on an early basis.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/000749.htm

http://www.mdguidelines.com/torticollis

http://en.wikipedia.org/wiki/Torticollis

http://www.patient.co.uk/health/Torticollis.htm

The post Torticollis appeared first on Prime Health Channel.

Thoracic Outlet Syndrome (TOS) refers to a rare condition, which is actually a group of disorders collectively termed together, characterized by tingling and numbness of the fingers, a weak grip and pain in the shoulder and neck.

Thoracic Outlet Syndrome ICD9 Code

The ICD9 Code for this condition is 353.0.

Thoracic Outlet Syndrome Incidence

There is no exact statistics regarding the incidence of this condition due to a difficulty in diagnosing TOS, variety of factors contributing to the disease as well as similarity of its symptoms with those of other disorders. As per medical reports, 3-80 out of per thousand in a population are affected by this disease on an annual basis. Some medical researchers, however, are of the opinion that Vascular TOS is rare enough to affect only one out of every million individuals.

Thoracic Outlet Syndrome Types

TOS encompasses three uncommon but interrelated syndromes. These are:

Neurogenic TOS

It occurs due to compression of the nerves located in the base of the neck.

Vascular TOS

It develops due to compression of the veins and the arteries under the arm or collarbone.

Nonspecific type TOS

It occurs due to nerve compression of less specific origin and accounts for most surgical cure for TOS in the United States. It is also referred to as Common TOS or Disputed Neurogenic TOS. The cause for the latter name is the fact that some doctors do not believe in its existence while others suspect it to be a common condition.

Thoracic Outlet Syndrome Symptoms

The typical signs and symptoms of this disorder include:

• Weakness of the hand muscles
• Tingling and pain in the shoulders and neck (which is worsened by carrying some heavy object)
• Numbness, tingling and pain in the ring and pinky fingers as well as in the inner forearm
• Symptoms of poor circulation in the forearm or hand (characterized by swollen arm, cold hands or bluish color)

Thoracic Outlet Syndrome Causes

Trauma (injury) is the common causative factor for this syndrome. The condition may arise from an irritating incomplete additional rib (known as cervical rib) above the normal first rib. It may also arise as a result of a direct injury to the neck. A rudimentary rib leads to a narrowing of the space below the clavicle (collar bone) and can compress the brachial plexus or lead to an intermittent compression of the subclavian vein corresponding with the movement of the arm.

However, some ribs are normally asymptomatic. Due to this reason, the symptoms of TOS are not automatically explained by the presence of a cervical rib.

The majority of cases of TOS arise in childhood. This indicates that the compression occurs over a period of time as the ligaments and muscles in the region go through changes with use or age. Many TOS sufferers are women in early or mid-adult stages of their life. In such women, the following problems may act as contributory factors:

• Large breasts
• Sagging of the shoulders
• Poor muscle tone (Hypotonia)

TOS may also occur as a consequence of an injury occurring from an auto accident. 1% of the population, who are supposed to be born with anomalous and cervical first ribs, suffer from neck trauma due to repetitive stress or injury. They are supposed to be pre-disposed to Thoracic Outlet Syndrome.

Thoracic Outlet Syndrome Risk Factors

The varied factors that increase the risk of development of TOS include:

Being female

The disorder affects women three times more than men. However, TOS resulting from the compression of the subclavian vein is more common in males.

Being within 20-50 years

The symptoms of TOS generally manifest in sufferers between 20 and 50 years of age.

Lifting heavy objects

The condition mostly affects individuals in certain professions, such as carpentry, construction, repairing and other jobs that require lifting heavy objects all through the day.

Being an athlete

Athletes who suffer injuries to the shoulder or neck during contact sports like football or rugby may also develop this disease.

Thoracic Outlet Syndrome Diagnosis

Health care providers are likely to ask patients questions about their symptoms and their medical history. Sufferers may also be asked to lift some heavy object and doctors look for a possible paleness of hand. In some cases, the following tests may be recommended to confirm the presence of the disease:

• MRI of the supraclavicular/brachial region and the cervical spine
• X-ray
• CT angiogram
• Electromyography (EMG)
• Vascular tests like brachial artery angiography
• Venography or non-invasive vascular exams like Doppler ultrasonography
• Nerve conduction velocity study

Medical tests may also be conducted to rule out the presence of other problems, such as a damaged nerve or carpal tunnel syndrome as a consequence of problems in the cervical spine or the spinal section in the neck.

Thoracic Outlet Syndrome Differential Diagnosis

The differential diagnosis of TOS involves isolating its symptoms from those of other disorders characterized by similar signs. These include:

• Tendonitis
• Epicondylitis
• Fibromyalgia
• Multiple sclerosis
• Myofascial pain
• Superior sulcus tumor of the lung
• Acute coronary syndrome
• Superficial Thrombophlebitis
• Ulnar neuropathy
• Rheumatoid arthritis
• Rotator cuff injuries
• Spinal cord injuries
• Carpal tunnel syndrome
• Cervical disc herniation
• Repetitive motion syndrome
• Aneurysm of the subclavian artery

Doctors and nurses must make sure that patients are not actually complaining about symptoms produced by any of the above disorders and are indeed suffering from TOS itself.

Thoracic Outlet Syndrome Treatment

The treatment for TOS can be of two types:

Conservative treatment

A conservative curative approach is effectual in the majority of cases, particularly in those individuals in whom the disorder is detected in the early stages. This type of treatment may involve:

Physical therapy

Patients are taught exercises to strengthen their shoulder muscles, improve their posture and also make their range of motion better. When performed over time, these workouts can ease the pressure on the nerves and the blood vessels in the thoracic duct.

Relaxation

Sufferers are taught various techniques, such as deep breathing, that can help them to relax, maintain a proper posture and prevent them from tensing their shoulders.

Medicines

If patients complain of painful sensations, which are true in most cases of TOS, physicians may prescribe analgesics (pain-relieving drugs), anti-inflammatory drugs (like Ibuprofen or Aspirin) or muscle-relaxants to reduce inflammation and encourage relaxation of muscles.

Surgical treatment

If conservative methods of cure fail to improve the symptoms or if patients are complaining of signs of acute nerve damage (such as excruciating pain or worsening muscular fatigue), physicians may recommend surgical treatment. This type of treatment is also recommended to individuals diagnosed with true neurogenic TOS or other problems for which operative methods are the only treatment option. These operative procedures are carried out by specialists in vascular or thoracic surgery.

The most common operative approaches for the treatment of TOS include:

Transaxllary approach

In this process, an incision is made in the chest to access the first rib. A part of the first rib is then removed to provide relief from compression. This surgery is advantageous in the sense that surgeons can gain easy access to the first rib without disturbing the blood vessels or the nerves in any way. However, surgeons have a restricted access to the nerves and vessels in the region. The blood vessels and nerves hide from view the cervical ribs and the most fibrous bands that may be contributing to compression.

Anterior supraclavicular approach

This method helps in repairing the compressed blood vessels. An incision is made just under the neck to expose the brachial plexus area. Surgeons then look for signs of trauma or any fibrous bands that may contribute to the compression close to the first rib. They may also be able repair any blood vessels that have been compressed.

If the artery is narrowed, physicians may suggest other alternatives like Angioplasty.

Thoracic Outlet Syndrome Home Remedies and Management

Following diagnostic confirmation, doctors or physiotherapists instruct patients certain lifestyle modification measures and exercises that can be performed at home. These can support and strengthen the muscles around the thoracic outlet.

Some general measures to avoid undue stress on the muscles and shoulders around the thoracic outlet include:

• Taking frequent breaks at work
• Maintaining proper posture
• Practicing relaxation techniques

Local application of hot or cold packs can also help reduce the symptoms of the disease. Correction of the muscular imbalance of the shoulder girdle or abnormal posture may help restore functioning in sufferers. The problems are best addressed by a particular strengthening and stretching program of the shoulder and neck girdle.

Thoracic Outlet Syndrome Prognosis

The symptoms may be eased in certain patients by conducting surgeries to break up tight fibrous bands and removing the extra rib. In more than half of all sufferers, surgery can be successful. A few patients complain about recurrence of symptoms even after surgery.

Patients may be asked to change or avoid activities such as bearing weights directly over the shoulder or lifting heavy objects. They can gain improvement in their condition by working with hands and arms above shoulder level. Ergonomically correct computer stations, workstations and chairs can help reduce repetitive work activities as well as awkward postures that may have acted as contributory factors for the occurrence of the early-stage symptoms.

Thoracic Outlet Syndrome Complications

The complications may arise due to any of the surgical methods conducted for the treatment of TOS. The nature of complications depends on the type of operation and the use of anesthesia.

The risks associated to surgical cure may include:

• Lung collapse
• Infection
• Hemorrhage
• Leaks from the lymphatic system
• Damage to the blood vessels or nerves, resulting in weakness of muscles

All operative approaches for the treatment of TOS pose an acute risk of trauma to the brachial plexus. In rare cases, long-term pressure on the brachial plexus nerves can result in atrophy of the muscles innervated by it.

Thoracic Outlet Syndrome Prevention

If left untreated for years, TOS can cause permanent neurological damage. Due to this reason, it is important to deal with the symptoms on an early basis or prevent the development of the condition altogether. Those susceptible to TOS due to involvement in risk-prone professions or athletic activities should avoid lifting heavy objects or performing repetitive movements.

If you, or anyone, in your family is constantly experiencing the symptoms of Thoracic Outlet Syndrome, it is important to see a doctor for early diagnosis and treatment and ensuring a faster recovery.

References:

http://www.mayoclinic.com/health/thoracic-outlet-syndrome/DS00800

http://www.mdguidelines.com/thoracic-outlet-syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002406/

http://en.wikipedia.org/wiki/Thoracic_outlet_syndrome

The post Thoracic Outlet Syndrome appeared first on Prime Health Channel.

What is Spinal cord injury?

Spinal cord injury (SCI) is the name given to any injury to the spinal cord resulting from causes other than disorders, such as trauma.

Spinal cord injury ICD9 Code

The ICD9 Code for the disorder ranges from 952.0 – 952.9.

Spinal cord injury Statistics

Approximately 8 out of every 10,000 individuals in the United States are affected by this condition every year.

Spinal cord injury Types

Injuries of the spinal column are classified into two categories:

Complete Spinal cord injury

In a complete Spinal cord injury, the cord fails to relay messages under the level of injury. Due to this reason, patients are paralyzed below the level of trauma.

Incomplete Spinal cord injury

In an incomplete Spinal cord injury, affected individuals experience some sensation and have the ability of movement in the area under the region of injury.

Spinal cord injury Causes

This type of injury generally arises after a hit or blow that dislocates or fractures the vertebrae – or the bone disks that constitute the spine. It may also arise as a result of a knife or gunshot wound that cuts or penetrates the spinal cord. Additional damage generally occurs over a period of days or weeks due to inflammation, accumulation of fluids and bleeding in and around the spinal cord. The majority of such injuries do not sever the spinal cord. Rather, they result in damage when bits of vertebrae press down on the sections of the nerves that transport signals or tear into cord tissue.

A non-traumatic Spinal cord injury may result from factors like:

• Arthritis
• Cancer
• Inflammation
• Infections
• Disk degeneration of the spine

The injury arises due to the following factors:

• Motor vehicle accidents (responsible for 45% of all cases)
• Acts of violence (17%)
• Falls (18%)
• Sports injuries (12%)

Spinal cord injury Risk Factors

The condition generally arises due to an accident or trauma. Anyone can suffer from this disorder. However, certain factors may predispose an individual to this type of injury. These include:

Being male

Injuries of the spinal cord affect many males. Traumatic spinal cord injuries are found to affect only about20 percent females in the United States.

Being young

These injuries are mainly seen in individuals aged between 16 and 30 years of age. In people under the age of 65 years, motor accidents are the main cause of injuries of the spinal cord. In older adults, falls are responsible for most injuries of this type.

Engaging in potentially injurious activities

Diving into extremely shallow water or engaging in sports activities without wearing proper safety gear or taking adequate precautions can increase susceptibility to spinal cord injuries.

Having a bone or joint disorder

An injury of the spinal cord may also originate from a comparatively minor injury if affected people are already suffering from another disorder that affects the joints or bones, such as Osteoporosis or Arthritis.

Spinal cord injury Symptoms

Any type of injury of the spinal column may lead to one or more of the following signs and symptoms:

• Loss of movement
• Loss of bladder or bowel control
• Exaggerated spasms or reflex activities
• Loss of sensation, including the ability to feel heat, cold and touch
• Changes in sexual sensitivity, sexual function and fertility
• Difficulty in breathing, coughing or clearing secretions from the lungs
• Pain or acute stinging sensation resulting from damage to the nerve fibers in the spinal cord

The symptoms of emergency cases of injury of the spinal column after an accident may involve:

• Loss of bladder or bowel control
• Impaired breathing after injury
• Difficulty in walking and maintaining balance
• Odd positioning or twisting of the neck or back
• Extreme back pain or pressure in the back, neck or head
• Weakness, paralysis or incoordination in any area of the body
• Tingling, numbness or loss of sensation in the fingers, hands, toes or feet

Injurious conditions of the spinal cord may also lead to Paralysis. When the injury affects the hands, arms, trunk, pelvic organs and legs, Quardiplegia or Tetraplegia may occur. If the injury affects all or part of the pelvic organs, legs and trunk, Paraplegia may originate.

Spinal cord injury Diagnosis

In an emergency setting, physicians may be able to differentiate an injury to the spinal cord with the aid of inspection, testing movement and sensory function, and asking patients some questions about the accident that might have resulted in the injury.

However, emergency diagnostic exams may be required if the injured individual is not completely awake, complains of neck pain and has obvious symptoms of neurological injury or weakness. Such tests may involve the following:

X-rays

Medical professionals generally recommend X-rays for people who are suspected of suffering from an injury of the spinal cord after an accident or trauma. These tests can show various problems in the spinal column, such as degenerative changes, tumors, fractures or other issues.

Computerized tomography (CT) scan

Problems in the spinal column can be better detected with a CT scan than an X-ray exam. CT scan makes use of computers to construct a series of cross-sectional images that can specify problems in the spinal disks or bones.

Magnetic resonance imaging (MRI)

MRI scans make use of radio waves as well as a strong magnetic field to render computer-generated images. These scans are extremely assistive in assessment of the condition of the spinal column and detecting blood clots, herniated disks or other lumps that could be pressing on the spinal cord.

When some of the inflammation may have reduced a few days following the actual injury, a physician is likely to carry out a neurological exam to assess the level and wholeness of the trauma. This includes a pinprick on the region, testing the ability of affected individuals to sense light touch and also determining their muscle strength.

Spinal cord injury Differential Diagnosis

The differential diagnosis of this disorder involves distinguishing the signs of a spinal cord injury from those of Spinal abscess, which leads to difficulties that are similar in nature.

Spinal cord injury Treatment and Rehabilitation

The cure for this disorder aims at preventing further injury to the spinal cord as well as empowering sufferers to return to a productive and active life.

Spinal cord injury management mainly aims at providing relief from any type of pressure on the spinal cord as well as stabilization and realignment of any dislocations or fractures. This may be done with the aid of traction and/or surgical intervention. Before any surgical intervention, sufferers must be stabilized.

Skeletal traction may be the initial choice for the treatment of dislocations or fractures of the neck (cervical) vertebrae. Crutchfield tong, which is a tight-fitting tong, may be placed on the head to realign the neck vertebrae with the help of weighted traction. In order to assist in maintaining spinal alignment, special beds such as Kinetic therapy bed or Stryker frame may be used until the stabilization of the vertebrae. These beds allow patients to turn safely from one side to another without disturbing proper alignment of the injured spine. Physicians may administer Corticosteroid medications to reduce inflammation in the spinal cord.

The damages to the spinal cord cannot be reversed. As yet, researchers are constantly trying to develop new treatment measures, including prostheses and drugs that may promote regeneration of the nerve cells or better the function of the nerves that persist after a Spinal column injury.

Spinal column injury sufferers are generally admitted to ICU (Intensive Care Unit) for treatment. Treatment basically includes:

Medications

The drug Methylprednisolone (Medrol) is usually a curative option for an acute spinal cord injury. If the medication is administered within eight hours of injury, it can bring about mild improvement in the condition of some patients. It seems to yield benefit by lowering damage to nerve cells and reducing swelling close to the injured spot.

Immobilization

Patients may require traction to stabilize the spine and bring it into proper alignment. In some cases, traction is performed by securing metal braces (affixed to a body harness or weights) to the skull of patients to avoid the movement of their heads. In certain patients, a rigid neck collar may be effectual. A special bed may also be effective in immobilizing the body.

Surgery

Operative treatment is often necessary for removal of bone fragments, herniated disks, fractured vertebrae or any foreign objects that seem to be pressing on the spinal column. Operation may also be required to stabilize the spine and avoid the risk of any pain or deformity in the future.

Experimental treatments

Researchers are still trying to find out ways that can stop the destruction of cells, promote nerve regeneration and manage swelling in patients. Patients or their family members should ask physicians about the availability of these types of treatment options.

Spinal cord injury Recovery

The outcome is based on the extent and location of the injury to the spinal column. Between 10-20% people with traumatic spinal cord injury tend to die prior to hospitalization. Death is possible even after hospitalization, especially in cases where the breathing muscles suffer paralysis.

In others, recovery of sensation or movement within one week generally indicates eventual recovery of the majority of functions. However, this may take 6 months or even more. Serious cases of injury reduce life expectancy in sufferers. In such patients, Pneumonia is the main cause of death. Mental adjustment to this type of disability can be slow in nature. In affected individuals under 25 years of age, the rate of suicide is higher than average.

Spinal cord injury Complications

The complications of injury in the spinal column include:

• Loss of bowel control
• Loss of bladder control
• Problems in muscle tone
• Nerve pain
• Depression
• Sexual health issues, such as changes in ejaculation (in men) and lubrication (in women)
• Difficulties in breathing and coughing
• Circulatory problems, ranging from low blood pressure to inflammation of the extremities

A rehabilitation team is likely to assist patients develop strategies to address the changes resulting from injury to the spinal column.

Spinal cord injury Prevention

The following measures can reduce the risk of injury to the spinal column and even avoid the occurrence of the condition altogether.

Driving safely

As car crashes are one of the major causes of this type of injury, it is important to wear a seat belt every time while riding in or driving a car. It is important for parents to ensure that their children wear a seat belt or use a proper seat safe for their age and weight. Children who are less than 12 years old should always ride in the rear seat to prevent health hazards due to air-bag injuries.

Checking the depth of water before diving

It is also important to avoid diving into shallow water that can increase the risk of this type of injury. One should avoid diving into an aboveground pool, pools that are less than 9 feet deep and water of uncertain depth.

Preventing falls

It is best to use a step stool with a grab-bar to get objects located in high regions. Other measures to avoid falls include placing nonslip mats in shower, tub and on tile floors; adding handrails along stairways; and installing window guards and placing safety gates to block stairs to prevent falls in young children.

Taking proper precautions while playing sports

It is recommended to always wear safety gear and protect head during sports activities. Baseball players should not slide headfirst, nor should football players tackle by using the top of the helmet. For fresh moves in gymnastics, one should always use a spotter.

Not driving while being drunk

It is always recommended not to drive under the effect of drugs or while being intoxicated. One should not ride with a driver who has been drinking.

If you are experiencing severe trauma to the head or neck after an activity, you should seek immediate medical evaluation for possible Spinal cord injury. Early determination and treatment can help you avoid further complications and reverse the condition while it is still in the early stages.

References:

http://www.nlm.nih.gov/medlineplus/spinalcordinjuries.html

http://www.mdguidelines.com/spinal-cord-injury

http://www.mayoclinic.com/health/spinal-cord-injury/DS00460

http://en.wikipedia.org/wiki/Spinal_cord_injury

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Dementia with Lewy Bodies (DLB) is a type of dementia that is closely associated with Parkinson’s and Alzheimer’s diseases. The condition is anatomically characterized by presence of clumps of ubiquitin and alpha-synuclein in neurons, tiny, spherical deposits of protein that are found in the neurons or nerve cells. These protein deposits are detectable during postmortem brain histology.

DLB is the 2nd most common form of Progressive Dementia just after Alzheimer’s disease, and is known to cause progressive decline in one’s mental abilities. It affects nearly 1.3 million people only in United States.

Lewy Body Dementia History

The Lewy bodies were first discovered by the German scientist Friedrich Heinrich Lewy. The condition was named after him.

Lewy Body Dementia Causes

The factors that lead to the development of Dementia with Lewy Bodies are not clearly understood at present. A genetic connection with PARK11 gene is suspected, although no strong evidence has been found which indicate that DLB is an inherited condition. As in Alzheimer’s, the risk of DLB is heightened with the inheritance of ε4 allele of apolipoprotein E or APOE.

In some cases, Alzheimer’s disease and dementia with Lewy bodies may coexist in certain patients. Nearly 75% of old people having Parkinson’s disease will eventually develop dementia after ten years.

Lewy Body Dementia Symptoms

Although the specific symptoms of DLB that may be seen in an individual patient can vary, the core features of the condition remain more or less the same. These include fluctuating cognitive patterns with great variability in attention span and alertness on an hour to hour or day to day basis, recurrent episodes of visual hallucinations as well as motor aspects of Parkinson’s disease. The various suggestive signs are sleep behavior disorder with REM or rapid eye movement and also the abnormalities observed in SPECT or PET scans. Under the influence of REM, patients may feel compelled to act out their dreams.

The Parkinson’s features might include:

• Reduced arm-swing while walking
• Shuffling gait
• Blank expression
• Reduced facial expressions
• Ratchet-like cogwheeling movements
• Stiffness of movements
• Sialorrhea
• Low speech volume
• Loss of memory
• Extreme confusion
• Difficulty in swallowing

Episodes of tremors are less frequent in DLB cases than in Parkinson’s. DLB patients frequently experience difficulty in judging distances and have issues with:

• Syncope
• Orthostatic hypotension
• Transient loss of consciousness

They also have frequent periods of:

• Drowsiness
• Lethargy
• Disorganized speech
• Staring out into space for a long time

A very distinctive and critical clinical feature the patients display is an acute hypersensitivity to antiemetic and neuroleptic medications that affect the cholinergic and dopaminergic systems. Usage of these drugs can make the patients catatonic, lose all cognitive functions and/or develop life-impending muscle rigidity. Hence drugs like haloperidol, thioridazine or chlorpromazine should only be used with much caution and discrimination.

The visual hallucinations experienced by DLB patients generally involve seeing animals and people that are not actually there. Delusional misperceptions may incorporate reduplicative paramnesia or other elaborate misinterpretations. The hallucinations might not necessarily be disturbing to the patients. In fact, in some cases these visions can be amusing or insightful. A patient may even be aware of the fact that these visions are not real. Individuals having this form of dementia may also experience vision problems, have double vision, or misinterpret what they see. An example of this would include mistaking a heap of socks for a bunch of snakes.

Lewy Body Dementia Diagnosis

It might be difficult to diagnose DLB. Proper detection of DLB is important as this condition is known to induce intolerance towards certain medications. The diagnosis is made based on the persistent symptoms of visual hallucinations as well as stiffness and trembling associated with Parkinson’s. A doctor may recommend an EEG test if the symptoms are accompanied by seizure-like episodes. Brain scans and imaging tests may show cerebral degeneration which can help in evaluating the condition. However, it is not possible to detect the Lewy bodies until after the death of a sufferer.

Lewy Body Dementia Differential Diagnosis

A number of health conditions might show symptoms that are similar to that of DLB. The differential diagnosis of Dementia with Lewy Bodies include disorders such as:

• Hydrocephalus
• Vascular dementia
• Intracranial tumors
• Parkinson’s disease
• Lacunar Syndromes
• Alzheimer’s disease
• Prion-Related Diseases
• Cerebrovascular events
• Parkinson-Plus Syndromes
• Progressive Supranuclear Palsy
• Temporal and Frontal Lobe Dementia
• Cortical Basal Ganglionic Degeneration
• Dementia with progressive supranuclear palsy

Lewy Body Dementia Treatment

No cure for DLB exists at present. Treatment procedures are palliative, with the main goal being managing the motor, cognitive and psychiatric symptoms of the condition. Acetylcholinesterase inhibitors like galantamine, rivastigmine and donepezil are mainly used for dealing with the cognitive problems of dementia with Lewy bodies. These medications can also be partially effective in minimizing the motor and psychiatric issues of the patient. Symptoms of hallucinations may be reduced with appropriate medications; however it can be difficult to try convincing the patient that nothing is actually there in reality. Sometimes providing reassurance or alternative distractions work better than telling the person about his or her hallucinatory experiences. Doctors normally avoid giving antipsychotic drugs for the hallucinatory symptoms as the motor symptoms could be worsened by neuroleptic sensitivity.

Researchers are currently of the opinion that the cholinesterase inhibitor medications that are used to manage Alzheimer’s disease might also be used in the treatment of DLB with positive results, even though they are not licensed for such use yet. National Institute of Clinical Excellence (NICE) believes that the usage of these drugs should be considered when it comes to treating DLB patients having non-cognitive symptoms. Recent studies reveal that the drug memantine can improve the general functioning of the DLB patients, although further conclusive studies are needed to confirm this. Patients experiencing symptoms like stiffness and rigidity because of Parkinsonism might benefit from the various anti-Parkinson’s disease medications like Levodopa, although these drugs can eventually make confusion and hallucinations worse. Mobility aids and physiotherapy sessions can help to alleviate these issues.

Rapid eye movement can be managed by administering Clonazepam, and orthostatic hypotension can be controlled by antihypotensive medications or table salt. Injecting botulinum toxins in the patient’s parotid glands can help to reduce sialorrhea. Medications like modafinil and methylphenidate helps in improving daytime alertness.

As in many cases treatment with drugs can aggravate the symptoms of DLB, doctors also recommend trying various non-drug approaches. The environment in which a patient is housed should be kept free of noise and clutter. This helps them to focus as well as function effectively. Family members or caregivers should also deal patiently with the individual affected by DLB and try to make him or her feel safe. Breaking tasks into small, easier steps and focusing on success also helps to alleviate the confidence level of patients. A definite routine and structural environment helps DLB sufferers to relate to things better.

Lewy Body Dementia Complications

Dementia with Lewy bodies is a progressive disorder whose signs and symptoms do worsen over time. The swallowing problems may eventually give rise to nutritional problems in patients. Immobility and dysphagia can cause pneumonia. Prolonged bed rest can give rise to decubitus ulcers. Severe dementia can occur at the later stages of this condition, ultimately leading to death.

Lewy Body Dementia Prognosis

Like Parkinson’s disease and Alzheimer’s disease, DLB is a neurodegenerative condition that leads to progressive intellectual as well as functional deterioration. It affects a person’s overall job performance in workplace, and may force him or her to take an early retirement. An individual with this condition also eventually loses his or her ability to drive a vehicle. The person loses his or her independence over time. DLB eventually shortens the life expectancy of the patient. No remedial measure is known to slow or stop the rate of progression of DLB.  Physical and mental disabilities gradually increase with time, and death can occur after a period of about 8 years.

Lewy Body Dementia Epidemiology

DLB has been known to affect European, Asian and African population. The condition is slightly more common in men than in women. The potentiality of being affected by this form of dementia increases with age.

DLB is a progressive form of dementia that gradually makes an individual helpless both mentally and physically. The condition cannot be fully cured; however treatment can help to manage the various symptoms associated with this condition. Regular care from family members or other caregivers is needed by a DLB patient for general functioning in day-to-day life.

References:

http://emedicine.medscape.com/article/1135041-overview

http://www.mayoclinic.com/health/lewy-body-dementia/DS00795

http://www.webmd.com/mental-health/dementia-lewy-bodies

http://www.ninds.nih.gov/disorders/dementiawithlewybodies/dementiawithlewybodies.htm

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