Neurological disease
tsmith | June 23, 2011As I've laid out this week (part 1, part 2, part 3), the realization that a fairly simple, toxin-carrying bacterium could cause a "complex" and mysterious disease like hemolytic uremic syndrome came only with 30 years' of scientific investigation and many false starts and misleading results. Like many of these investigations, the true cause was found due to a combination of hard work, novel ways of thinking, and simple serendipity--being able to connect the dots in a framework where the dots didn't necessarily line up as expected, and removing extraneous dots as necessary. It's not an easy…
purepedantry | April 16, 2009There is a fascinating case study in Current Biology.
de Gelder et al. discuss a patient -- referred to as TN to protect his privacy -- who had two sequential strokes that damaged his brain. The parts of the brain that were damaged included the primary visual cortex in both hemispheres -- rendering the patient blind. However, the patient could still respond to some visual stimuli through a phenomenon called blindsight.
Even more interesting, the patient could still navigate around visual objects, while reporting being unable to see them and having no memory for what they were.
I have…
purepedantry | March 24, 2009I have been reading more on the Natasha Richardson story overnight, and it appears the story has moved into blame-placing mode. (For the original discussion of the story, read this.)
Possible places to lay the blame (that I have read thus far):
The absence of mandatory helmet laws
Canadian medicine's failure to administer rapid CTs
Quebec's inadequate air ambulances
Inadequate patient education
More on these under the fold.
I said before about mandatory helmet laws (and many others said in the comments of the previous post) that while I don't have a problem with mandatory helmet laws for…
purepedantry | March 23, 2009So I am way behind the news cycle on this, but I wanted to comment briefly on actress Natasha Richardson's death as a result of an epidural hematoma. From everything I read, she seemed like a very good actress, a very decent woman, and an excellent wife and mother, so I was saddened to read the story. I wish the best to her husband, Liam Neeson, and family.
Epidural hematomas from head injuries are a serious problem -- both to diagnose and to treat, so I want to spend a little bit of time talking about what they are and how to prevent them.
Hematomas are pools of blood caused in the brain…
purepedantry | March 6, 2009I caught this story (with an accompanying video) over at Mind Hacks and Neuron Culture about this poor woman from the UK who fell unconscious from a viral infection in her brain stem. Using fMRI, a doctor at Cambridge named Adrian Owen showed that she still had residual brain functions such as response to light. The woman has since recovered from her condition and can interact, though she still faces substantial impairment.
The thing is that people are continuing to use the term persistent vegetative state to describe her condition. I think this is misusing the term. A better description…
purepedantry | February 9, 2009There was a case like Terry Schiavo's in Italy that is triggering a genuine constitutional crisis.
Eluana Englaro, who had been on a feeding tube in a persistent vegetative state, for 17 years passed away last night after her father ordered her feeding tube removed. But this was not before Silvio Berlusconi attempted to pass an emergency law banning the removal. The law triggered a crisis because the Italy's President Giorgio Napolitano refused to sign it arguing that it was unconstitutional.
Englaro's passing may not be the end of the issue, however. Berlusconi and his party seem to…
purepedantry | January 28, 2009Researchers at Boston University have done an autopsy on another former football player and found evidence of severe neurological damage that would likely lead to dementia later in life:
Leading medical experts at the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) reported today that nine-year NFL veteran, former Tampa Bay Buccaneer Tom McHale was suffering from chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by head trauma, when he died in 2008 at the age of 45.
In addition, the CSTE has discovered early…
purepedantry | May 22, 2008I don't know if everyone caught this in the news, but Senator Edward Kennedy has been diagnosed with a glioma. Regardless of one's politics, this is a real bum rap, and my deepest sympathy goes out to him and his family (who have already had enough tragedy to deal with).
I thought I would summarize briefly what gliomas are and what is probably going to happen.
Gliomas are the most common primary tumors of the brain. Primary means that they originate from brain cells as opposed to cells from some other portion of the body that migrate to the brain. They are called gliomas because they…
purepedantry | March 20, 2008CNN has a story about a Navy neurologist who tried using mirrors to help soldiers from Iraq with phantom pain. Phantom pain is pain in amputees that is perceived to originate in the amputated limb. What causes it is not exactly clear although many theories exist. However, it is often refractory to pain medication (this is common in so-called central pain or pain originating in the brain), so it can be really difficult to make these patients feel better.
Dr. Jack Tsao, the Navy neurologist, had the idea that if you used a mirror to show the image of the opposing, intact limb where the…
purepedantry | March 4, 2008The NYTimes has a slide show of "migraine" art provided by Oliver Sacks from his book Migraine. They attempt to illustrate what a migraine aura looks like.
Neat. I would put one up on my wall if I didn't feel so horrible that it was the pictorial prelude to someone's intense pain.
purepedantry | January 17, 2008
In neuroscience, we spend a lot of time studying the normal function of the nervous system, and we spend a lot of time studying disease processes that can impair this function. What we don't typically do is study how functional recovery can happen. Functional recovery is how an neurological impaired individual uses existing pathways to compensate for the injury -- thereby improving overall function. The lack of study in this area is unfortunate, particularly because in some cases the brain can show an amazing ability to compensate for injuries.
(Just as an aside, I want to distinguish…
purepedantry | September 18, 2007A boy from Britain who had a case of viral meningitis had to undergo surgery to drain the fluid from his brain. When he awoke and recovered, he had a new accent:
William McCartney-Moore of York was struck down with viral meningitis last March and needed brain surgery after doctors found he had a rare strain called empyaema. "He lost everything," said his mother, Ruth. "He couldn't read or write, he couldn't recognise things, he had no recollection of places he'd been to and things he'd done and he'd lost all his social skills. He went from being such a bright, lovely, wonderful eight-year-…
purepedantry | May 14, 2007Science has an article this week (sadly behind a subscription wall) about a rare disease called Mobius syndrome. Mobius syndrome is a developmental disorder of facial muscle innervation with a variety of presentations; however, the presentation often includes facial paralysis and difficulty in smiling:
The syndrome is named for Paul Julius Mobius, a German neurologist who published an early description of it in 1888. (He was also the grandson of August Ferdinand Mobius, the mathematician of Mobius strip fame.) According to a statement developed at the conference, the syndrome's defining…