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A PASSPORT TO YOUR NERVOUS SYSTEM:

A PASSPORT TO YOUR NERVOUS SYSTEM:. Rachel Maassen MD Medical Director Women ’ s Health University of Iowa Hospitals and Clinics. “ Honey, have you seen my keys? ”. Your Tour Guide: The Neurologist. Trained in the diagnosis and treatment of diseases that affect the: Central nervous system

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A PASSPORT TO YOUR NERVOUS SYSTEM:

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  1. A PASSPORT TO YOURNERVOUS SYSTEM: Rachel Maassen MD Medical Director Women’s Health University of Iowa Hospitals and Clinics

  2. “Honey, have you seen my keys?”

  3. Your Tour Guide: The Neurologist • Trained in the diagnosis and treatment of diseases that affect the: • Central nervous system • Brain • Spinal cord • Peripheral nervous system • Autonomic nervous system • Somatic nervous system • Muscles • Blood vessels that relate to the above

  4. Who Suffers from Neurological Disorders? • Over 1 billion people worldwide • Alzheimer’s: 5,000,000+ Americans • Parkinson’s: 1,000,000+ Americans • Epilepsy: 2.2 million Americans • Huntington’s: 250,000+ Americans • Muscular Dystrophy: 1 in every 5,000 to 7,000 males

  5. Your Map of the brain

  6. Cerebrum • Biggest part of the brain • Makes up 85% of the brain’s weight • The “thinking” part of the brain • Memories • Reason • Made up of two halves: • Left side: analytics • Right side: abstraction • Left and right side control each other

  7. Cerebellum • Located below the cerebrum • The balancing part of the brain • Processes input from the brain, spinal cord and sensory receptors • Aids in coordination and fluid movement of the body’s skeletal muscles

  8. Brian Stem • Composed of three structures: • Midbrain • Pons • Medulla Oblongata • Connects the brain with the spinal cord • Enables breathing

  9. Degenerative disorders

  10. Degenerative Disorders • Affect balance, movement, speech, breathing and heart function • Common causes • Alcoholism • Tumor • Stroke • Most common forms: Alzheimer’s, Parkinson’s, Huntington’s

  11. Alzheimer’s, Defined • Occurs when memory loss and other abilities are affected enough to interrupt everyday life • Most common form of dementia • Affects over five million Americans • Sixth-leading cause of death in the U.S. • More common in women than men

  12. Symptoms of Alzheimer’s • Symptoms may differ in each person and develop over time • Mild symptoms • Getting lost easily • Trouble handling money and/or paying bills • Poor judgment • Misplacing or losing things • Moodiness or personality change • First symptoms typically appear after age 60

  13. Diagnosis of Alzheimer’s • Memory screening • Physical exam can test • Reflexes • Muscle tone/strength • Walking ability • Sense of sight and hearing • Coordination • Balance • Early diagnosis is key

  14. Treatment of Alzheimer’s • No known cure • Approved medications • Donepezil (Aricept) • Rivastigmine (Exelon) • Galantamine (Razadyne) • Memantine (Namenda)

  15. Menopause and memory • Difficulty concentrating and remembering • Common complaints in menopause transistional • Maybe related to sleep disturbances, hot flashes, midlife stress • May be more intense if rapid transition (surgical) • No firm evidence of actual decline!

  16. Managing Cognitive Symptoms “memory trouble” • Maintain social network • Remain physically and mentally active • Quit smoking • Limit alcohol • Decrease cardiovascular risk (cholesterol, high blood pressure)

  17. Will hormone replacement help? • Women’s Health Initiative ( WHIMS) • In women who began HRT after age 65: Risk of dementia doubled for women using EPT and increased by half for women using estrogen only therapy • WHI study on aging: Hormones had no effect on cognition

  18. Parkinson’s, Defined • Movement disorder • Deficiency of the chemical dopamine • Affects one in 100 people over the age of 60

  19. Am I at Risk for Parkinson’s? • Age • Gender • Family history • Exposure to toxins

  20. Symptoms of Parkinson’s • Shaking of hands, arms, legs, jaw and face • Stiffness of arms, legs and trunk • Slowness in movement • Poor balance and posture • Changes in speech

  21. Diagnosing Parkinson’s • No specific test can diagnose Parkinson’s

  22. Treatment of Parkinson’s • Medication • Carbidopa-levodopa (Parcopa) • Dopamine agonists • MAO B inhibitors • Catechol O-methyltransferase (COMT) inhibitors • Anticholinergics • Amandatine • Deep brain stimulation

  23. Huntington’s, Defined: • Degenerative nerve disease • Affects approximately 30,000 Americans • An additional 250,000 Americans are at risk because of genetics • Everyone is born with the gene, but parents with HD increase risk in their children by 50%

  24. Symptoms of Huntington’s Disease • Symptoms include: • Uncontrolled movement • Clumsiness • Loss of balance • Difficulty swallowing • Difficulty with speech • Loss of interest in social activities • Typically begins in their 40s or 50s • Onset before age 20 known as juvenile Huntington’s disease

  25. Diagnosis of Huntington’s • Predictive testing • Neurological exam • Psychiatric evaluation • Brain imaging and EEG • Stages of Huntington’s • Early • Mid • Late

  26. Treatment of Huntington’s • Tetrabenazine (Xenazine) • Antipsychotic drugs (Haldol, Clozaril) • Antiseizure drugs (Klonopin) • Antianxiety drugs (Valium) • Antidepressants • Therapies (Psycho-, Speech, Physical, Occupational)

  27. Seizure Disorders

  28. Epilepsy, Defined • Brain disorder that causes recurring seizures • Fourth-most common neurological disorder in the U.S. • Affects 2.3 million adults in the US • 460,000+ children under the age of 18 • Approx. 150,000 Americans develop epilepsy each year • One in 100 people in the US will have an unprovoked seizure

  29. Symptoms and Treatment of Epilepsy • Symptoms include temporary confusion, uncontrolled movement or the arms and legs, loss of consciousness or awareness. • Treatment can range from a single type of antiepileptic medication to a more prolonged regimen or surgical option.

  30. Epilepsy and the reproductive female • Oral contraceptives are acceptable • There is a higher failure rate with certain medications, check with your provider • More of your anti-seizure medication may be needed with ocps and with pregnancy • Pregnancy is acceptable but planning required • 4 mg of folic acid should be taken 3 months prior to pregnancy • See an OBGYN prior to conception to check medication safety

  31. University of Iowa Hospitals and Clinics • Women’s Health: 2 locations • 356-2294 to schedule at the University • 467-2000 to schedule at Iowa River Landing • Neurology: 356-2456

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