Cerebral Aneurysm Prognosis

The prognosis for a patient with a ruptured cerebral aneurysm depends on the extent and location of the aneurysm, the person's age, general health, and neurological condition. Early diagnosis and treatment are important.

Source:National Institutes of Health

Cerebral Aneurysm Treatment

Emergency treatment for individuals with a ruptured cerebral aneurysm generally includes restoring deteriorating respiration and reducing intracranial pressure.

Surgery is usually performed within the first 3 days to clip the ruptured aneurysm and to reduce the risk of rebleeding.

When aneurysms are discovered before rupture occurs, microcoil thrombosis or balloon embolization may be performed on patients for whom surgery is considered too risky.

Source: National Institutes of Health

Cerebral Aneurysm Facts

A cerebral aneurysm is the dilation, bulging, or ballooning out of part of the wall of a vein or artery in the brain. Cerebral aneurysms can occur at any age, although they are more common in adults than in children and are slightly more common in women than in men.

The signs and symptoms of an unruptured cerebral aneurysm will partly depend on its size and rate of growth. For example, a small, unchanging aneurysm will generally produce no symptoms, whereas a larger aneurysm that is steadily growing may produce symptoms such as loss of feeling in the face or problems with the eyes.

Immediately before an aneurysm ruptures, an individual may experience such symptoms as a sudden and unusually severe headache, nausea, vision impairment, vomiting, and loss of consciousness.

Source:National Institutes of Health

Swallowing Disorders Prognosis

While in many cases, swallowing disorders can be partially or completely corrected, in some cases they can be life-threatening and require aggressive interventions, such as feeding tubes.

The prognosis for people with swallowing disorders that accompany other diseases depends upon the severity of those other diseases.

Source: National Institutes of Health

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Swallowing Disorders Treatment

Drug therapy, including botulinum toxin injection, may provide relief to some individuals with swallowing disorders. Surgery may also be needed in severely affected persons.

Many individuals can be helped by changing their diets and learning new feeding techniques, for example, positioning the head and neck in a certain way to help in swallowing.

Source: National Institutes of Health

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Swallowing Disorders Facts

Swallowing disorders - defined as difficulty in passing food or liquid from the mouth to the stomach - occur in all age groups, but especially in the elderly. The disorders can occur at any stage of the normal swallowing process, in which food and liquid move from the mouth, through the pharynx, into the esophagus, and finally, into the stomach.

The disorders are common in individuals with degenerative neurological disorders such as amyotrophic lateral sclerosis (ALS), postpolio syndrome, myasthenia gravis, multiple sclerosis, and Parkinson's disease, and may be the first symptom of the disease.

They may also occur after sudden neurological damage as in stroke, or head or spinal cord injury, or indicate other problems, such as the presence of cancer or heart problems. People with swallowing disorders may suffer from weight loss or dehydration and may be at risk for developing pneumonia.

Some individuals notice that the disorders get worse at times of stress or excitement.

Source:National Institutes of Health

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Multiple Sclerosis(MS)Prognosis

A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane.

The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk. MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.

Source: National Institutes of Health

Multiple Sclerosis(MS)Treatment

There is as yet no cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS.

Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third.

An immunosuppressant treatment, Novantrone (mitoxantrone ), is approved by the FDA for the treatment of advanced or chronic MS.

While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene.

Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile. Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.

If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help. Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine.

Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used.

Source: National Institutes of Health

Multiple Sclerosis(MS) Facts

An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted.

Many investigators believe MS to be an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus.

Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance.

These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis. Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or "pins and needles" sensations. Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss.

Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS.

Source: National Institutes of Health

MSA Prognosis

MSA is a progressive disorder and most patients have a life expectancy after diagnosis of about 10 years or less.

Source: National Institutes of Health

MSA Treatment

There is no specific treatment for nerve degeneration in MSA. Levodopa, used to treat rigidity and tremor in Parkinson's disease, may offer some help. However, striatonigral degeneration does not respond well to levodopa.

Dopamine and anticholinergic drugs may be prescribed to treat spasms. Orthostatic hypotension may be treated with flucortisone and other drugs that raise blood pressure. Increased dietary fiber intake or use of laxatives may relieve constipation, and drugs or a penile implant may help with male impotence.

A routine of stretching and exercise can help retain muscle strength and range of movement. An artificial feeding tube or breathing tube may be surgically inserted for management of swallowing and breathing difficulties.


Source: National Institutes of Health

MSA Facts

Multiple system atrophy (MSA) refers to three slowly progressive related disorders that affect the central and autonomic nervous systems. The disorders are characterized by their foremost symptoms: olivopontocerebellar atrophy (OPCA), which primarily affects balance, coordination, and speech; a parkinsonian form (striatonigral degeneration), which can resemble Parkinson's disease because of slow movement and stiff muscles; and a form with predominant autonomic nervous system involvement (formerly Shy-Drager syndrome, now called MSA with orthostatic hypotension).

In all three forms of MSA, the patient can have orthostatic, or postural, hypotension-an excessive drop in blood pressure when the patient stands up, which causes dizziness or momentary blackouts. Other symptoms may include stiffness and rigidity, loss of balance and coordination, impaired speech, breathing and swallowing difficulties, blurred vision, male impotence, constipation, and urinary difficulties.

Most patients develop dementia late in the course of the disease, which is usually diagnosed in persons over age 50. MSA is twice as common in men as in women.

Source: National Institutes of Health

DBS Prognosis

Although most patients still need to take medication after undergoing DBS, many patients experience considerable reduction of their PD symptoms and are able to greatly reduce their medications. The amount of reduction varies from patient to patient but can be considerably reduced in most patients.

The reduction in dose of medication leads to a significant improvement in side effects such as dyskinesias (involuntary movements caused by long-term use of levodopa). In some cases, the stimulation itself can suppress dyskinesias without a reduction in medication.

Source: National Institutes of Health

DBS Treatment

Unlike previous surgeries for PD, DBS does not damage healthy brain tissue by destroying nerve cells. Instead the procedure blocks electrical signals from targeted areas in the brain. Thus, if newer, more promising treatments develop in the future, the DBS procedure can be reversed.

Also, stimulation from the neurostimulator is easily adjustable—without further surgery—if the patient’s condition changes. Some people describe the stimulator adjustments as "programming."

Source: National Institutes of Health

DBS Facts

Deep brain stimulation (DBS) is a surgical procedure used to treat a variety of disabling neurological symptoms—most commonly the debilitating symptoms of Parkinson’s disease (PD), such as tremor, rigidity, stiffness, slowed movement, and walking problems.

The procedure is also used to treat essential tremor, a common neurological movement disorder. At present, the procedure is used only for patients whose symptoms cannot be adequately controlled with medications.

DBS uses a surgically implanted, battery-operated medical device called a neurostimulator—similar to a heart pacemaker and approximately the size of a stopwatch—to deliver electrical stimulation to targeted areas in the brain that control movement, blocking the abnormal nerve signals that cause tremor and PD symptoms.

Before the procedure, a neurosurgeon uses magnetic resonance imaging (MRI) or computed tomography (CT) scanning to identify and locate the exact target within the brain where electrical nerve signals generate the PD symptoms.

Some surgeons may use microelectrode recording—which involves a small wire that monitors the activity of nerve cells in the target area—to more specifically identify the precise brain target that will be stimulated. Generally, these targets are the thalamus, subthalamic nucleus, and globus pallidus.

The DBS system consists of three components: the lead, the extension, and the neurostimulator. The lead (also called an electrode)—a thin, insulated wire—is inserted through a small opening in the skull and implanted in the brain. The tip of the electrode is positioned within the targeted brain area.

The extension is an insulated wire that is passed under the skin of the head, neck, and shoulder, connectng the lead to the neurostimulator. The neurostimulator (the "battery pack") is the third component and is usually implanted under the skin near the collarbone. In some cases it may be implanted lower in the chest or under the skin over the abdomen.

Once the system is in place, electrical impulses are sent from the neurostimulator up along the extension wire and the lead and into the brain. These impulses interfere with and block the electrical signals that cause PD symptoms.

Source: National Institutes of Health

Chorea Prognosis

The prognosis for individuals with chorea varies depending on the type of chorea and the associated disease. Huntington's disease is a progressive, and ultimately, fatal disease. Syndenham's chorea is treatable and curable.

Source: National Institutes of Health

Chorea Treatment

There is no standard course of treatment for chorea. Treatment depends on the type of chorea and the associated disease.

Treatment for Huntington's disease is supportive, while treatment for Syndenham's chorea usually involves antibiotic drugs to treat the infection, followed by drug therapy to prevent recurrence. Adjusting medication dosages can treat drug-induced chorea.

Metabolic and endocrine-related choreas are treated according to the cause(s) of symptoms.

Source:National Institutes of Health

Chorea Facts

Chorea is an abnormal voluntary movement disorder, one of a group of neurological disorders called dyskinesias, which are caused by overactivity of the neurotransmitter dopamine in the areas of the brain that control movement.

Chorea is characterized by brief, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next. Chorea often occurs with athetosis, which adds twisting and writhing movements. Chorea is a primary feature of Huntington's disease, a progressive, hereditary movement disorder that appears in adults, but it may also occur in a variety of other conditions.

Syndenham's chorea occurs in a small percentage (20 percent) of children and adolescents as a complication of rheumatic fever. Chorea can also be induced by drugs (levodopa, anti-convulsants, and anti-psychotics) metabolic and endocrine disorders, and vascular incidents.

Source: National Institutes of Health

Diabetic Neuropathy Prognosis

The prognosis for diabetic neuropathy depends largely on how well the underlying condition of diabetes is handled. Treating diabetes may halt progression and improve symptoms of the neuropathy, but recovery is slow.

The painful sensations of diabetic neuropathy may become severe enough to cause depression in some patients.

Source:National Institutes of Health

Diabetic Neuropathy Treatments

The goal of treating diabetic neuropathy is to relieve discomfort and prevent further tissue damage. The first step is to bring blood sugar levels under control by diet and medication. Another important part of treatment involves taking special care of the feet.

Analgesics, low doses of antidepressants, and some anticonvulsant medications may be prescribed for relief of pain, burning, or tingling. Some patients may find that walking regularly, taking warm baths, or using elastic stockings may help relieve leg pain.

Source: National Institutes of Health

Diabetic Neuropathy Facts

Diabetic neuropathy is a peripheral nerve disorder caused by diabetes. The symptoms of diabetic neuropathy are often slight at first. In fact, some mild cases may go unnoticed for a long time. Numbness, pain, or tingling in the feet, or legs may, after several years, lead to weakness in the muscles of the feet.

Occasionally, diabetic neuropathy can flare up suddenly and affect specific nerves so that an affected individual will develop double vision or drooping eyelids, or weakness and atrophy of the thigh muscles. Nerve damage caused by diabetes generally occurs over a period of years and may lead to problems with the digestive tract and sexual organs, which can cause indigestion, diarrhea or constipation, dizziness, bladder infections, and impotence.

The loss of sensation in the feet may increase the possibility for foot injuries to go unnoticed and develop into ulcers or lesions that become infected.

Source:National Institutes of Health

Wallenberg’s Syndrome Prognosis

The outlook for someone with Wallenberg’s syndrome depends upon the size and location of the area of the brain stem damaged by the stroke. Some individuals may see a decrease in their symptoms within weeks or months.

Others may be left with significant neurological disabilities for years after the initial symptoms appeared.

Source: National Institutes of Health

Wallenberg's Syndrome Treatment

Treatment for Wallenberg's syndrome is symptomatic. A feeding tube may be necessary if swallowing is very difficult. Speech/swallowing therapy may be beneficial. In some cases, medication may be used to reduce or eliminate pain.

Some doctors report that the anti-epileptic drug gabapentin appears to be an effective medication for individuals with chronic pain.

Source: National Institutes of Health

Wallenberg’s Syndrome Facts

Wallenberg’s syndrome is a neurological condition caused by a stroke in the vertebral or posterior inferior cerebellar artery of the brain stem. Symptoms include difficulties with swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes (nystagmus), and problems with balance and gait coordination.

Some individuals will experience a lack of pain and temperature sensation on only one side of the face, or a pattern of symptoms on opposite sides of the body – such as paralysis or numbness in the right side of the face, with weak or numb limbs on the left side. Uncontrollable hiccups may also occur, and some individuals will lose their sense of taste on one side of the tongue, while preserving taste sensations on the other side.

Some people with Wallenberg’s syndrome report that the world seems to be tilted in an unsettling way, which makes it difficult to keep their balance when they walk.

Source: National Institutes of Health

Krabbé Disease Prognosis

Infantile Krabbé disease is generally fatal before age 2. Prognosis may be significantly better for children who receive umbilical cord blood stem cells prior to disease onset or early bone marrow transplantation. Persons with juvenile- or adult-onset cases of Krabbé disease generally have a milder course of the disease and live significantly longer.

Source: National Institutes of Health

Krabbé Disease Treatment

There is no cure for Krabbé disease. Results of a very small clinical trial of patients with infantile Krabbé disease found that children who received umbilical cord blood stem cells from unrelated donors prior to symptom onset developed with little neurological impairment.

Results also showed that disease progression stabilized faster in patients who receive cord blood compared to those who receive adult bone marrow. Bone marrow transplantation has been shown to benefit mild cases early in the course of the disease. Generally, treatment for the disorder is symptomatic and supportive. Physical therapy may help maintain or increase muscle tone and circulation.

Source: National Institutes of Health

Krabbé Disease Facts

Krabbé disease is a rare, inherited degenerative disorder of the central and peripheral nervous systems. It is characterized by the presence of globoid cells (cells that have more than one nucleus), the breakdown of the nerve’s protective myelin coating, and destruction of brain cells. Krabbé disease is one of a group of genetic disorders called the leukodystrophies.

These disorders impair the growth or development of the myelin sheath, the fatty covering that acts as an insulator around nerve fibers, and cause severe degeneration of mental and motor skills. Myelin, which lends its color to the “white matter” of the brain, is a complex substance made up of at least 10 different enzymes. Each of the leukodystrophies affects one (and only one) of these substances. Krabbé disease is caused by a deficiency of galactocerebrosidase, an essential enzyme for myelin metabolism.

The disease most often affects infants, with onset before age 6 months, but can occur in adolescence or adulthood. Symptoms include irritability, unexplained fever, limb stiffness, seizures, feeding difficulties, vomiting, and slowing of mental and motor development. Other symptoms include muscle weakness, spasticity, deafness, and blindness.

Source: National Institutes of Health

Dementia Prognosis

There are many disorders that can cause dementia. Some, such as Alzheimer’s disease or Huntington’s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment.

People with moderate or advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing, and dressing.

Source:National Institutes of Health

Dementia Treatment

Drugs to specifically treat Alzheimer’s disease and some other progressive dementias are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease.

This may improve an individual’s quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia.

Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking.

Source: National Institutes of Health

Dementia Facts

Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships.

They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia.

Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness.

Some of the diseases that can cause symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease.

Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brain’s oxygen supply is either reduced or cut off entirely), and heart and lung problems.

Although it is common in very elderly individuals, dementia is not a normal part of the aging process.

Source: National Institutes of Health