Neurology Health Dictionary

The branch of PATHOLOGY that covers the reasons for and consequences of disorders of the NERVOUS SYSTEM (see also NEUROLOGY).... neuropathology

Sti?ness, resistance to movement. The term is often used in NEUROLOGY – for example, limb rigidity is a sign of PARKINSONISM. Smooth rigidity is described as being ‘plastic’ and jerky rigidity as ‘cogwheel’.... rigidity

Psychology is the scienti?c study of behaviour. It may be applied in various settings including education, industry and health care. Clinical psychology is concerned with the practical application of research ?ndings in the ?elds of physical and mental health. Training in clinical psychology involves a degree in psychology followed by postgraduate training. Clinical psychologists are speci?cally skilled in applying theoretical models and objective methods of observation and measurement, and in therapeutic interventions aimed at changing patients’ dysfunctional behaviour, including thoughts and feelings as well as actions. Dysfunctional behaviour is explained in terms of normal processes and modi?ed by applying principles of normal learning, adaption and social interaction.

Clinical psychologists are involved in health care in the following ways: (1) Assessment of thoughts, emotions and behaviour using standardised methods. (2) Treatment based on theoretical models and scienti?c evidence about behaviour change. Behaviour change is considered when it contributes to physical, psychological or social functioning. (3) Consultation with other health-care professionals about problems concerning emotions, thinking and behaviour. (4) Research on a wide variety of topics including the relationship between stress, psychological functioning and disease; the aetiology of problem behaviours; methods and theories of behaviour change. (5) Teaching other professionals about normal and dysfunctional behaviour, emotions and functioning.

Clinical psychologists may specialise in work in particular branches of patient care, including surgery, psychiatry, geriatrics, paediatrics, mental handicap, obstetrics and gynaecology, cardiology, neurology, general practice and physical rehabilitation. Whilst the focus of their work is frequently the patient, at times it may encompass the behaviour of the health-care professionals.... clinical psychology

An institution providing treatment for sick and injured persons. This may be done on an inpatient or outpatient basis. A hospital provides investigative and therapeutic services which are not available on a domiciliary basis.

Hospitals are broadly divided into general hospitals (available in each district in the United Kingdom) and hospitals specialising in particular ailments (e.g. ophthalmology; ear, nose and throat; neurology, etc.). In addition there are teaching hospitals which have the dual function of patient care and the education of medical sta?. (See NATIONAL HEALTH SERVICE (NHS).)

In the UK all patients are entitled to hospital care provided by their NHS trust when referred by their GENERAL PRACTITIONER (GP) or admitted via the Accident & Emergency department. (In exceptional cases, patients with severe mental illness can be compulsorily admitted by the authorities.) Admission will depend on clinical priority, as demand commonly exceeds supply of beds in some localities. Private hospital care is available under the care of a consultant of choice, provided that the patient is covered by appropriate private medical insurance or can pay direct the substantial hospital and medical fees.

The future development of hospital medicine is controversial, but the long-term future may well see many fewer, much better equipped, highly specialised hospitals for patients requiring high-technology-based treatments. These might be backed up with a range of smaller general (or halfway) hospitals caring for patients with less demanding clinical needs who nevertheless require some bed-based care. Many more patients requiring routine specialist treatment will be treated as day patients than is the case now, and there will (or should) be much greater emphasis (with appropriate resources) on PREVENTIVE MEDICINE.

Britain is experimenting with a prototype ‘virtual hospital’. The project will target hospital patients who need to remain under the care of specialists but whose condition can be managed at home. Suitable NHS patients will be provided with monitoring equipment that enables them, for example, to read their own blood pressure, lung and heart functions, with the results transferred electronically to the o?ce of relevant specialists who will prescribe and monitor treatment.... hospital

n. (in neurology) see epilepsy.... absence

adj. (in neurology) describing a neuron (nerve cell) that has two processes extending in different directions from its cell body.... bipolar

n. (in neurology) a collection of neurons (nerve cells) whose activities control a particular function. The respiratory and cardiovascular centres, for example, are regions in the lower brainstem that control the movements of respiration and the functioning of the circulatory system, respectively.... centre

n. 1. (in neurology) the formation of nerve tracts by fibres coming together into one pathway from different regions of the brain. 2. (in ophthalmology) the ability of the eyes to turn inwards and focus on a near point so that a single image is formed on both retinas. The closer the object, the greater the degree of convergence.... convergence

n. 1. (in neurology) the phenomenon that occurs when a neuron receives, through a number of different synapses, impulses that are not powerful enough individually to start an *action potential but whose combined activity brings about some *depolarization of the membrane. In this facilitated state any small additional depolarization will suffice to trigger off an impulse in the cell. 2. (in education and group therapy) the process of running, leading, or controlling a group discussion.... facilitation

n. (in neurology) see nerve impulse.... impulse

That branch of medicine involved in the treatment of injuries, deformities or individual diseases by operation or manipulation. It incorporates: general surgery; specialised techniques such as CRYOSURGERY, MICROSURGERY, MINIMALLY INVASIVE SURGERY (MIS), or minimal access (keyhole) surgery, and stereotactic sugery (see STEREOTAXIS); and surgery associated with the main specialties, especially cardiothoracic surgery, gastroenterology, GYNAECOLOGY, NEUROLOGY, OBSTETRICS, ONCOLOGY, OPHTHALMOLOGY, ORTHOPAEDICS, TRANSPLANTATION surgery, RECONSTRUCTIVE (PLASTIC) SURGERY, and UROLOGY. Remotely controlled surgery using televisual and robotic techniques is also being developed.

It takes up to 15 years to train a surgeon from the time at which he or she enters medical school; after graduating as a doctor a surgeon has to pass a comprehensive two-stage examination to become a fellow of one of the ?ve recognised colleges of surgeons in the UK and Ireland.

Surgery is carried out in specially designed operating theatres. Whereas it used to necessitate days and sometimes weeks of inpatient hospital care, many patients are now treated as day patients, often under local anaesthesia, being admitted in the morning and discharged later in the day.

More complex surgery, such as transplantation and neurosurgery, usually necessitates patients being nursed post-operatively in high-dependency units (see INTENSIVE THERAPY UNIT (ITU)) before being transferred to ordinary recovery wards. Successful surgery requires close co-operation between surgeons, physicians and radiologists as well as anaesthetists (see ANAESTHESIA), whose sophisticated techniques enable surgeons to undertake long and complex operations that were unthinkable 30 or more years ago. Surgical treatment of cancers is usually done in collaboration with oncologists. Successful surgery is also dependent on the skills of supporting sta? comprising nurses and operating-theatre technicians and the availability of up-to-date facilities.... surgery

Cerebrospinal fever. Inflammation of the pia mater and arachnoid covering of the brain and spinal cord. A notifiable disease. Hospitalisation. Diagnosis is difficult without a lumbar puncture. Caused by a wide range of virus, bacteria, protozoa and fungi. Three most common bacterial causes in England and Wales are N. Meningotidis, H. influenzae and streptococcus-like infection with sore throat; then fever, vomiting, headache and mental confusion; half-open eyes when asleep, delirium, sensitive to light, possibly drifting into coma. Sometimes onset is gradual over 2-3 weeks. Treatment by hospital specialist.

Poor housing and passive smoking suspected. Its association with non-germ meningitis, and inflammatory drugs is well recognised. Also caused by injury or concussion.

Commence by cleansing bowel with Chamomile enema.

Cerebrospinal relaxants indicated: Passion flower (cerebral), Black Cohosh (meningeal), Ladyslipper (spinal meningeal). (A.W. & L.R. Priest)

If patient is cold, give Cayenne pepper in honey to promote brisk circulation.

Aconite and Gelsemium. “For irritation of the meninges of the brain and spinal cord Aconite is indispensible. Combined with Gelsemium for restlessness it is an exceptional remedy. Tincture Aconite (5-15 drops) with Gelsemium (3-10 drops) hourly. Also used in combination with other agents as may be dictated by the course of the disease. (W.W. Martin MD., Kirksville, Mo., USA)

Crawley root. Decoction: 1 teaspoon to half a pint water, simmer 20 minutes. Dose: 1 teaspoon or more 3-4 times daily for children over 6 months. A powerful diaphoretic and sedative. (Dr Baker, Adrian, Michigan, USA)

Lobelia and Echinacea. Equal parts, Liquid Extract 30 drops in water every 3 hours. (Dr Finlay Ellingwood)

Lobelia, alone. Hypodermic injections of Lobelia in five cases of epidemic spinal meningitis, with complete recovery in every case. Dose: 10 drops hourly until symptoms abate, then twice daily. (Dr A.E. Collyer, Ellingwood Therapeutist)

Ecclectic School. Echinacea commended.

Before the Doctor comes. As onset is rapid, often less than 5 hours, an anti-inflammatory is justified. Teas or decoctions from any of the following: Catmint (Catnep), Prickly Ash berries, Pleurisy root, Boneset, Wild Cherry bark, Bugleweed (Virginian), Ladyslipper. When temperature abates and patient feels better: Chamomile tea or cold Gentian decoction with pinch Cayenne.

Hydrotherapy. Hot baths make patient feel worse. Sponge down with cold water.

Protective throat spray: equal parts, Tincture Myrrh and Tincture Goldenseal.

Protective gargle: 10-20 drops Tincture Myrrh and Goldenseal to glass of water.

Garlic. Dr Yan Cai, Department of Neurology, Ren Ji Hospital (affiliated to Shanghai Second Medical University), China, referred to the extensive use of Garlic in Chinese folk medicine and his hospital’s experience with Garlic products – diallyl trisulphide in particular – to treat viral infections including crypotococcal meningitis for which disease results were impressive.

Garlic appears to be a reliable preventative.

Diet. Fast as long as temperature is elevated; with fruit juices, red beet juice, carrot juice or herb teas. Note. GPs and other practitioners may help stop meningitis claiming lives by giving massive doses of Echinacea before they are admitted to hospital.

Note: The infection is often difficult to diagnose. At the end of each year (November and December) when the peak in cases approaches, every feverish patient with headache should be suspected, especially where accompanied by stiff neck.

The above entry is of historic interest only; more effective orthodox treatment being available. ... meningitis

n. (in neurology) an impairment in the performance of precise movements. These are dependent upon the normal function of the whole nervous system, and incoordination may result from a disorder in any part of it, especially the *cerebellum. See apraxia; ataxia; dysmetria.... incoordination

(in neurology) the pause of a few milliseconds between the time that a nerve impulse reaches a muscle fibre and the time that the fibre starts to contract.... latent period

n. (pl. opercula) 1. a plug of mucus that blocks the cervical canal of the uterus in a pregnant woman. When the cervix begins to dilate at the start of labour, the operculum, slightly stained with blood, comes away as a discharge (‘show’). 2. (in embryology) a plug of fibrin and blood cells that develops over the site at which a developing fertilized ovum has become embedded in the wall of the uterus. 3. (in neurology) one of the folded and overlapping regions of cerebral cortex that conceal the *insula on each side of the brain. 4. (in dentistry) a flap of gingival tissue that overlies the crown of a partially erupted tooth.... operculum

(PD). Paralysis agitans. First described by James Parkinson, 1817. His description is as apt today as when it appeared in his book “Essay on the Shaking Palsy”. He wrote: “It is characterised by involuntary tremulous motion, with lessened muscular power in parts not in action and even when supported. There is a tendency to bend the trunk forward and to pass from a walking to a running pace. The senses and intellect are uninjured.”

Added to the above are:– muscular rigidity, loss of reflexes, drooling – escape of saliva from the mouth. Muscles of the face are stiff giving a fixed expression, the back presents a bowed posture. The skin is excessively greasy and the patient is unable to express emotional feelings. Loss of blinking. Pin- rolling movement of thumb and forefinger.

Causes: degeneration of groups of nerve cells deep within the brain which causes a lack of neurotransmitting chemical, dopamine. Chemicals such as sulphur used by agriculture, drugs and the food industry are suspected. Researchers have found an increase in the disease in patients born during influenza pandemics.

Treatment. While cure is not possible, a patient may be better able to combat the condition with the help of agents that strengthen the brain and nervous system.

Tea. Equal parts: Valerian, Passion flower, Mistletoe. 1 heaped teaspoon to each cup water; bring to boil; simmer 1 minute; dose: half-1 cup 2-3 times daily.

Gotu Kola tea. (CNS stimulant).

Tablets/capsules. Black Cohosh, Cramp bark, Ginseng, Prickly Ash, Valerian.

Formula. Ginkgo 2; Black Cohosh 1; Motherwort 2; Ginger 1. Mix. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 1-3 teaspoons in water or honey. Fava Bean Tea.

Case report. Two patients unresponsive to Levodopa treatment reported improvement following meals of fresh broad beans. (Vicia faba) The beans contain levodopa in large amounts. (Parkinson Disease Update Vol 8, No 66, p186, Medical Publications, PO Box 24622-H, Philadelphia, USA) See also: BROAD BEANS. L-DOPA.

Nacuna Pruriens. Appropriate. Essential active constituent: L-dopa. (Medicinal plants and Traditional Medicine in Africa, by Abayomi Sofowora, Pub: John Wiley)

Practitioner. To reduce tremor: Tincture Hyoscyamus BP. To reduce spasm: Tincture Belladonna BP. To arrest drooling: Tincture Stramonium BP.

Diet. It is known that people who work in manganese factories in Chile may develop Parkinson’s disease after the age of 30. Progress of the disease is arrested on leaving the factory. Two items of diet highest in manganese are wheat and liver which should be avoided, carbohydrates in place of wheat taking the form of rice and potatoes.

Supplements. Daily: B-complex, B2, B6, niacin. C 200mg to reduce side-effects of Levodopa. Vitamin E 400iu to possibly reduce rigidity, tremors and loss of balance.

Treatment of severe nerve conditions should be supervised by neurologists and practitioners whose training prepares them to recognise serious illness and to integrate herbal and supplementary intervention safely into the treatment plan.

Antioxidants. Evidence has been advanced showing how nutritional antioxidants, high doses of Vitamin C and E, can retard onset of the disease, delaying the use of Levodopa for an average of 2 and a half years. (Fahn S., High Dose Alpha-tocopherol and ascorbate in Early Parkinson’s Disease – Annals of Neurology, 32-S pp128-132 1992)

For support and advice: The Parkinson’s Disease Society, 22 Upper Woburn Place, London WC1H 0RA, UK. Send SAE. ... parkinson’s disease

n. (pl. ganglia) 1. (in neurology) any structure containing a collection of nerve cell bodies and often also numbers of synapses. In the *sympathetic nervous system chains of ganglia are found on each side of the spinal cord, while in the *parasympathetic system ganglia are situated in or nearer to the organs innervated. Swellings in the posterior sensory *roots of the spinal nerves are termed ganglia; these contain cell bodies but no synapses. Within the central nervous system certain well-defined masses of nerve cells are called ganglia (or nuclei); for example, the *basal ganglia. 2. an abnormal but harmless swelling (cyst) that sometimes forms in tendon sheaths, especially at the wrist.... ganglion

(in neurology) the time of recovery needed for a nerve cell that has just transmitted a nerve impulse or for a muscle fibre that has just contracted. During the refractory period a normal stimulus will not bring about excitation of the cell, which is undergoing *repolarization.... refractory period

n. 1. (in neurology) a bundle of nerve fibres at its emergence from the spinal cord. The 31 pairs of *spinal nerves have two roots on each side, an anterior root containing motor nerve fibres and a posterior root containing sensory fibres. The roots merge outside the cord to form mixed nerves. 2. (in dentistry) the part of a *tooth that is not covered by enamel and is normally attached to the alveolar bone by periodontal fibres. 3. the origin of any structure, i.e. the point at which it diverges from another structure. Anatomical name: radix.... root

n. (in neurology) the point at which a stimulus begins to evoke a response, and therefore a measure of the sensitivity of a system under particular conditions. A *thermoreceptor that responds to an increase in temperature of only two degrees is said to have a much lower threshold than one that will only respond to a change in temperature of ten degrees or more. In this example the threshold can be measured directly in terms of degrees.... threshold

adj. (in neurology) describing a neuron that has one main process extending from the cell body. Compare bipolar.... unipolar