Category Archives: Brain Diseases

Cranial Arteritis – What It is and Diagnosis

Cranial Arteritis – What It is and Diagnosis
Cranial Arteritis – What It is and Diagnosis

Cranial arteritis is a term used rarely. The disease is most often called GCA (Giant-Cell Arteritis) or temporal arteritis. The term refers to an inflammation of the blood vessels in the head especially the branches of the external carotid artery.

Basically it’s a form of vasculitis that usually causes inflammation of the small vessels that supply the larger arteries. Arteries of the head and neck are affected most often including the axillary arteries, the thoracic aorta and the vertebral arteries.

The occlusion of the ophthalmic artery is the most serious complication and it can cause blindness and irreversible ischema if it is not treated immediately. The exact cause of the condition is still unknown. Scientists believe it is due to a faulty immune response. The use of high large amounts of antibiotics and severe infections were linked to the disorder. The condition may spread following polymyalgia rheumatic. The GCA is rare in African descendants and almost always appears in people over age 50.

The Signs and Symptoms Might Include:

Headache,Fever, bruits, tongue and jaw claudication, tenderness and sensitivity to the scalp, acute tinnitus, reduced visual acuity and diplopia.

In 50% of the case the disorder coexists with polymyalgia rheumatica characterized by stiffness and pain in the muscles.

For a correct diagnosis the doctor will examine the head of the patient and if the patient has GCA there will be thick tender artery on one side of the head, most often over the temples. Also the scalp usually is sensitive. Then blood tests are used and might include hematocrit or hemoglobin, C-creative protein, liver function test and sedimentation rate. Because blood tests alone won’t be enough for a diagnosis a tissues sample from the artery involved will be necessary too. Other tests might include MRI, duplex ultrasound and PET scan.

Receiving the treatment immediately is crucial to preventing severe complications and problems like stroke or blindness. Corticosteroids are administered orally, most often even before biopsy. Often aspirin is recommended. Usually there is improvement a few days after the treatment start. But the treatment might require medicine to be taken for 1 to 2 years. And the doses of corticosteroids will be cut back really slow.

Because of the long-term treatment with corticosteroids the bones might get frailer and the chance of fracture will increase. Therefore taking calcium and D vitamin supplements is often recommended. Also patients should quit smoking and the bones will be examined with a DEXA scan or a BMD (bone mineral density) test. Other medicine that suppresses the immune system might also be used.

After a long treatment of 1 to 2 years long, most of the people recover completely. Unfortunately the condition might return later. Aneurysm or other damage in the blood vessels might also occur and in the future that damage could cause a stroke.

Any symptom of temporal arteritis or throbbing ache should be taken seriously as a warning sign and a specialist should be consulted immediately or else permanent visual impairment might occur. The specialist assistance of a neurologist could help the patient understand the condition better.

So far there is no method of preventing this condition.

Chorea Athetosis and Hemiballismus – Details, Causes

Chorea Athetosis and Hemiballismus – Details, Causes

There three disorders are very similar and they belong to a group of disorders called the hyperkinectic disorders that also include dyskinesia and dystonia. They describe abnormal involuntary non-stereotypical movement disorders. As they are pretty similar it is very important to differentiate them and for a better understanding of these conditions you might need the specialist assistance of a neurologist.

Chorea Athetosis

From the very beginning it’s important to understand that all three disorders involve abnormal involuntary non-stereotypical movement. The difference consists in the muscles affected, speed and style.

Chorea involves rapid, non-stereotypical,jerky, involuntary, repetitive, dance-like movements. The moves involve the distal muscle group more than the proximal.

Unlike chorea, athetosis is a slow non-stereotypical, repetitive, involuntary, writing movement that usually affects the upper limbs.

Ballismus is also a rapid non-stereotypical, involuntary, repetitive and relatively more violent move that affects the proximal muscle group more than the distal.

Many times athetosis and chorea occur together and that is called choreoathetosis.

The involuntary movements might merge into semipurposeful or purposeful acts that could mask them.

Chorea is a progressive neurological disorder that is caused most often by Huntington’s disease. Rheumatic fever can also cause what is called the Sydenham’s chorea. Rarely, it might appear during pregnancy. The type of chorea that appears during pregnancy is called chorea gravidarum. Other causes might involve Wilson’s disease, neuroacanthocytosis and Transmissible spongiform encephalopathies.

As there is no cure for the disease there is no standard course of treatment and is symptomatic. The treatment depends on the type of chorea and there are a few medicines that can control it.

In the case of Huntington’s-related chorea the supportive treatment uses Tetrabenazine. In the case of Sydenham’s chorea the treatment involves valproic acid, Haloperidol and carbamazepine. If Wilson’s disease is causing chorea the treatment will involve chlorpromazine, haloperidol and pimozide.

The athetosis is usually caused by Huntington’s disease or marbling. In rare cases it is caused by trauma or stroke. Sometimes it might be caused by complications at birth especially neonatal jaundice and intranatal asphyxia. There are meny treatments used to help people with athetosis and most often drugs are used but sometimes surgery might be required.

The most common drugs used to treat athetosis are haloperidol, tetrabenazine, congentin, thiopropazate, artane and diazepam. The surgery might involve cutting a part of the posterior spinal roots or the removal of a part of the cerebral motor cortex. Surgery can produce immediate effects and is very beneficial on short term but they are not lasting too long. Retraining movements for the affected person is also a part of the treatment of athetosis.

Hemiballismus is a very rare disorder which can result from many various causes such as amyotrophic lateral sclerosis, stroke, vascular malformations, tuberculomas, traumatic brain injury, nonketotic hyperglycemia, neoplasms, demyelinating plaques and complications from HIV infections.

The treatment focuses on anything that causes the manifestations and symptoms of the disorder and it might include dopamine blockers, ITB therapy, botulinum injections, anticonvulsants, antipsychotics, tetrabenazine or functional neurosurgery.

Because the disorder is very rare the researchers and specialists know very little about it and there many unanswered questions. For an instance they try to explain the differences between this disorder in animals and humans. Also they try to understand why certain treatments help people with hemiballismus when they are very likely to do more harm.

Here Is A Clean Example Of A Girl Suffering From Chorea Athetosis and Hemiballismus