Neurological Disorders- Dietetics/ Nutrition, Neurology

Neurological Disorders

The nervous system comprises the brain, several nerves, and the spinal cord. Together, they have complete control over the body's functions. Neurological disorders affect the brain and the nerves found in the spinal cord and throughout the human body.

You may experience difficulties with your nervous system's functioning if you have trouble speaking, moving, breathing, swallowing, or learning. Additionally, you might experience problems with your senses, memory, or mood.

Some common neurological disorders include Alzheimer's disease and other dementias, epilepsy, cerebrovascular diseases including migraine and other headache disorders, stroke Parkinson's disease, multiple sclerosis, neuro infections, and brain tumors. Regardless of the cause, all neurological disorders result from damage to the nervous system.

What Are The Neurological Disorders?

More than 600 different neurological conditions exist. Major types consist of:

• Developmental issues with the nervous system, such as spina bifida, encephalocele, and anencephaly.
• Diseases like Huntington's and muscular dystrophy that are brought on by faulty genes.
• Degenerative diseases, such as Parkinson's and Alzheimer's, in which nerve fibers die or are damaged. 
• Seizure disorders or epilepsy, such as focal seizures, generalized seizures, and absence seizures
• Brain and spinal cord injuries due to motor vehicle accidents and catastrophic falls.
• Stroke and other blood vessel diseases that affect the brain's blood supply
• Infections like meningitis, encephalitis, or meningoencephalitis
• Cancers of the brain like meningioma, glioblastoma, oligodendroglioma etc.

Let's take a closer look at some of the common neurological disorders.

Alzheimer's Disease

Alzheimer's disease is a progressive neurologic condition that results in the death of brain cells and brain atrophy. It is the most prevalent form of dementia and is characterized by a steady decline in social, behavioral, and cognitive abilities and impairs a person's capability for independent functioning.

Although advancing age, family history, genetics, personal health, and abnormal protein deposits in the brain are thought to play a role, scientists are still unsure of the exact cause of the disease.

The disease's early symptoms include forgetting recent conversations or events. A person with Alzheimer's disease will experience severe memory loss as the condition worsens and they lose their ability to perform basic tasks.

Parkinson's Disease

Parkinson's disease is a disorder that affects both the parts of the body controlled by the nervous system and the nervous system itself. This progressive illness, which typically affects people over 65, gradually robs people of their motor skills, leaving them with a slow, awkward gait, tremors, rigid limbs, shuffling, and an unsteady balance.

The exact cause of Parkinson's disease is yet unknown.  Most cases develop spontaneously, though some are inherited. What is understood is that the "substantia nigra," a region of the brain, experiences the death of brain cells. These are the cells that produce the chemical dopamine, which aids in controlling muscle movement.

Even though there is no cure for Parkinson's disease, medication may significantly reduce your symptoms. Occasionally, your doctor may advise surgery to improve your symptoms and regulate brain regions.

Stroke

A stroke, or brain attack, occurs when blood flow to your brain is stopped. Brain tissue cannot receive oxygen and nutrients when the blood supply to a particular area of the brain is interrupted or diminished. This results in the death of the brain cells a few minutes later.

As a result, you may not be able to perform tasks controlled by that part of your brain. Your capacity to, for instance, move may be impacted by a stroke. It may also affect your ability to speak, recall, eat, control your bladder and bowel movements, and other essential bodily processes.

Epilepsy

Epilepsy is a neurological disorder characterized by abnormal brain activity. in which brain activity becomes abnormal. This results in seizures or periods of strange behavior and occasionally loss of consciousness.

Males and females of all ages, races and ethnic backgrounds can be affected by epilepsy. One seizure does not necessarily indicate epilepsy. A person is said to have epilepsy if they have had two or more seizures.

The symptoms of epilepsy can vary widely. Some people simply stare blankly for a few seconds, while others twitch their arms or legs repeatedly.

Epilepsy may be brought on by various factors, such as an imbalance of neurotransmitters, strokes, tumors, brain damage from disease or trauma, or a combination of these. However, in most cases, epilepsy has no known cause.

Muscular Dystrophy

A muscular dystrophy is a group of diseases that leads to progressive muscle mass loss and weakness. In muscular dystrophy, abnormal genes (mutations) prevent the body from making the necessary proteins for building healthy muscle.

Different types of muscular dystrophy exist. However, the two most prevalent types that affect children are Becker and Duchenne muscular dystrophy. The most prevalent type's symptoms start in childhood, primarily in boys. Other types don't show up until later in life.

Muscular dystrophy has no known cure. However, treatments and medication can help control symptoms and slow the progression of the illness.

Meningitis

Meningitis is a condition resulting from the inflammation of the meninges, the membranes that surround the brain and spinal cord. It is usually caused by infection of the fluid surrounding the brain and spinal cord.

The swelling resulting from meningitis typically triggers symptoms such as fever, headache, and a stiff neck.

Some cases of meningitis get better on their own in a few weeks. Others can be fatal and require emergency treatment.

How Common Are Neurological Disorders?

Neurological disorders affect hundreds of millions of people worldwide. For example, more than 6 million people suffer from strokes annually, and more than 80% of these fatalities occur in low- and middle-income nations.

More than 10% of the world's population suffers from migraines, and epilepsy affects more than 50 million people worldwide.

Likewise, the number of people with dementia is estimated to be 47.5 million globally, with 7.7 million new cases yearly. Alzheimer's disease is the most common cause of dementia and may be to blame for 60-70% of cases.

What Causes Neurological Disorders?

Despite being protected by strong membranes housed in the bones of the skull and spinal vertebrae and chemically separated by the blood-brain barrier, the brain, and spinal cord are incredibly vulnerable if compromised. And even though the nerve usually lies deep beneath the skin, they are still susceptible to injury.

Many neurological conditions are inherited or congenital. This means they were present at birth. Some disorders can be acquired. This implies that they develop after birth. Idiopathic neurological disorders do not have a known cause. A disease can be categorized as idiopathic by excluding other accepted diagnoses.

The specific causes of neurological disorders can vary, but they may include brain injury, nerve injury, or spinal cord injury. They may also include congenital abnormalities or disorders, genetic disorders, malnutrition, lifestyle, or environmental health problems.

Structural and electrochemical disruption can affect individual neurons, the neural circuits, and the nerves they form. Neurological disorders may also occur due to infection or due to an immune response to it.

Many bacterial (like Neisseria meningitides, Mycobacterium tuberculosis), viral (e.g., Human Immunodeficiency Virus, West Nile Virus, Enteroviruses, Zika, etc), parasitic (e.g., Chagas, malaria), and fungal (like Aspergillus, Cryptococcus, etc) infections can affect the nervous system.

What Are The Symptoms Of Neurological Disorders?

Neurologic disorders involve the brain, spinal column, and nerves. Therefore, the symptoms depend on where the damage occurs. Affected areas may control:

• Sensation
• Movement
• Communication
• Hearing
• Vision
• Emotion
• Thinking

Combinations or clusters of these symptoms are present in specific disorders. For instance, cerebral palsy typically manifests more physically, while ADHD is more likely to influence behavior.

Many neurologic disorders emerge during the early years of development. Some may be diagnosed at birth, while others appear or are diagnosed much later in life.

When To Speak With A Doctor?

A neurologist is a qualified doctor who treats and manages brain and nervous system disorders, including those that affect the spinal cord and nerves. A doctor who operates on the brain, spinal cord, and nerves is known as a neurosurgeon. Both are experts and understand the structure, function, and diseases that affect the nerves and nervous system.

Sometimes deciding whether to see a specialist can be challenging, but many symptoms need a doctor's visit. Common signs and symptoms for which you may want to set up an appointment with a neurologist (or be referred to one) are:

• Forgetfulness or memory disturbances.
• Seizures.
• Loss of consciousness.
• Vision issues.
• Disturbance in taste or smell.
• Tremors.
• Gait imbalance.
• Deafness, tinnitus in the ears, and vertigo.
• Weakness, cramps, spasms, and twitching of the muscles.
• Headache, back or neck pain.
• Asymmetries in the face (one side of the face doesn't match the other, your eyelids droop, you can't smile fully, etc.)
• Feelings of numbness and tingling.
• A slowness while moving.
• Any body part may experience burning or electric shock-like pain.
• Swallowing difficulties, inability to shrug shoulders or turn your neck, hoarseness of voice, and problems moving your tongue.

How Do Neurologists Make A Medical Diagnosis Of Neurological Disorders?

Your neurologist will ask for information about your past health conditions, medication usage, family medical history, and current symptoms. Additionally, a neurologic examination will be performed, including tests of your:

• Balance, reflexes, coordination, and gait.
• Mental well-being
• Muscle power.
• Sensation.
• Speech, hearing, and vision.

To better understand the severity of your condition or monitor your medication levels, your neurologist may also order blood, urine, or other tests. Common tests for neurological disorders include:

• Magnetic resonance imaging (MRI), Computed tomography (CT), ultrasound, and X-rays.
• Electroencephalography (EEG): This test measures the electrical activity of your brain and is used to identify tumors, encephalitis, brain injuries, seizures, and other conditions.
• Angiography: Angiography can identify blocked, damaged, or abnormal blood vessels in your head, neck, or brain. It can find things like blood clots and aneurysms.
• Cerebrospinal fluid (CSF) analysis: A sample of the fluid surrounding your brain and spinal cord must be removed for this test. The test can find signs of multiple sclerosis, infection, brain bleeding, and metabolic disorders.
• Biopsy: This is the process of taking tissue samples from your body. Brain, nerve, or muscle tissue can all be biopsied.
• Electromyography (EMG): This test captures the electrical activity of the muscles and is used to identify motor neuron diseases like amyotrophic lateral sclerosis, spinal nerve root compression, and disorders of the nerves and muscles.
• Positron emission tomography (PET):  This imaging examination can diagnose epilepsy, brain tumors, dementia, and Alzheimer's disease, as well as detect tumors.

How To Get The Most Out Of Your Visit With The Neurologist?

Prepare right for your neurological appointment. This involves:

1. Bringing a list of the essential issues you want to discuss with your doctor.
2. Talking about any new symptoms you're experiencing or any changes to old ones.
3. Discussing any changes to your general health.
4. Bringing copies of any test results, such as any lab work that was ordered by healthcare professionals other than your neurologist, or a CD with images.
5. Logging your symptoms in a diary can be used to note symptoms such as the day and time they happened, the duration, trigger, severity, symptoms, and any steps you took to end the event. This is especially helpful if you suffer from a condition like headaches, epilepsy, or Parkinson's disease.
6. Bringing a list of all the medications you currently take. Make sure to include all over-the-counter and prescription drugs and vitamins, herbal and dietary supplement products.
7. Letting your neurologist know of any past treatments that didn't work or had unwanted side effects.
8. Listing any known allergies that you have.
9. Bringing a family or relative to the appointment will help you review the conversation with your neurologist, ask questions, and serve as a reminder for scheduling tests and follow-up appointments.

If you have any additional concerns, find out if you should make another appointment.

The Bottom Line

A wide range of diseases encompasses neurological disorders. Some are congenital, emerging before birth, while others are inherited. If you have frequent or severe headaches, memory disturbances, seizures, etc., these symptoms suggest you should see a neurologist.

To learn more about Vitamin D deficiency and its connection to neurological disorders, please read our article on VITAMIN D DEFICIENCY AND NEUROLOGICAL DISORDERS.

References

• Mental Health: Neurological Disorders.” Mental Health: Neurological Disorders, www.who.int/news-room/questions-and-answers/item/mental-health-neurological-disorders  Accessed 28 Oct. 2022.
• Thakur KT, Albanese E, Giannakopoulos P, et al. Neurological Disorders. In: Patel V, Chisholm D, Dua T, et al., editors. Mental, Neurological, and Substance Use Disorders: Disease Control Priorities, Third Edition (Volume 4). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016 Mar 14. Chapter 5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK361950/  doi: 10.1596/978-1-4648-0426-7_ch5   

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