Anatomy Review

1. Anatomy Review • Central Nervous System • Peripheral Nervous System • Meninges • Blood Brain Barrier

2. Bacterial Meningitis • 1. Neisseria meningitidis • 15% mortality due to Rx delays • Infants, young adults • Fatigue, overcrowding • Death due to ___________ shock • Treatment: • Vaccine does not cover all strains • 2. Hemophilus influenzae • Commonest cause of meningitis prior to vaccine development • H. influenzae type B (Hib) • 30-50% carrier rate in children • Fatal without treatment • Seizures, mental retardation common in survivors • Largest cause of mental retardation in U.S.A. and world-wide

3. Meningitis (cont.) • 3. Streptococcus pneumoniae • Commonest adult cause of bacterial meningitis • Spreads from other sites • 40% mortality rate • Viral Meningitis • Self limiting, non-fatal • Enterovirus and mumps virus most common

4. Rabies • _______________ inclusions seen in brain • Re-emerging in U.S.A. with ______ as carriers • Fatal encephalitis • 20-60 day incubation • Virus travels to CNS slowly and replicates slowly • Agitation, confusion, hallucinations • Death within days of ______ symptoms • _______________ seen as throat muscles are infected and spasm • Vaccination can be used to “cure”

5. Tetanus ____________________ Anaerobic, endospore former Found in soil, manure Vaccine is available (10 yr) ___________ wounds _____________ paralysis, respiratory failure Antitoxin and antibiotics for treatment Botulism _______________ ___________ paralysis, respiratory failure Botulotoxin in contaminated canned goods (honey fed to infants) Wounds may rarely be infected Antitoxin (Ab) will neutralize preformed toxin Bacterial Nerve Diseases

6. Viral Nerve Diseases — Poliomyelitis • Poliovirus (____________) • Affinity for CNS motor neurons • Fever, back pain, muscle spasms • Young/old may suffer permanent paralysis • Virus is excreted in human feces, problem in developing nations • Vaccines are available • Eradication target year – soon!