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Submitted to :DR.

MOHIT

Submitted by
PRITI SINGH B.TECH BIOTECH (MBA) SECTION :- B7703A13 REG NO. :- 3440070133

TABLE OF CONTENT

=> INTRODUCTION => TESTING EXAMINATIONS => OVERLAPPING AREAS => RELATIONSHIP TO CLINICAL NEUROPHYSIOLOGY => ABSTRACT => REFRENCES

INTRODUCTION Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle.[1] The corresponding surgical specialty is neurosurgery. A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders. Pediatric neurologists treat neurological disease in children. Neurologists may also be involved in clinical research, clinical trials, as well as basic research and translational research. TESTING EXAMINATIONS During a neurological examination, the neurologist reviews the patient's health history with special attention to the current condition. The patient then takes a neurological exam. Typically, the exam tests mental status, function of the cranial nerves (including vision), strength, coordination, reflexes and sensation. This information helps the neurologist determine if the problem exists in the nervous system and the clinical localization. Localization of the pathology is the key process by which neurologists develop their differential diagnosis. Further tests may be needed to confirm a diagnosis and ultimately guide therapy and appropriate management. many symptoms that may occur would involve: Tension,sleep loss, headaches and dizziness Clinical tasks GENERAL CASELOAD Neurologists are responsible for the diagnosis, treatment, and management of all the above conditions. When surgical intervention is required, the neurologist may refer the patient to a neurosurgeon. In some countries, additional legal responsibilities of a neurologist may include making a finding of brain death when it is suspected that a patient is deceased. Neurologists frequently care for people with hereditary (genetic) diseases when the major manifestations are neurological, as is frequently the case. Lumbar punctures are frequently performed by neurologists. Some neurologists may develop an interest in particular subfields, such as dementia, movement disorders, headaches, epilepsy, sleep disorders, chronic pain management, multiple sclerosis or neuromuscular diseases.

OVERLAPPING AREAS There is some overlap with other specialties, varying from country to country and even within a local geographic area. Acute head trauma is most often treated by neurosurgeons, whereas sequelae of head trauma may be treated by neurologists or specialists in rehabilitation medicine. Although stroke cases have been traditionally managed by internal medicine or hospitalists, the emergence of vascular neurology and interventional neurologists has created a demand for stroke specialists. The establishment of JCAHO certified stroke centers has increased the role of neurologists in stroke care in many primary as well as tertiary hospitals. Some cases of nervous system infectious diseases are treated by infectious disease specialists. Most cases of headache are diagnosed and treated primarily by general practitioners, at least the less severe cases. Similarly, most cases of sciatica and other mechanical radiculopathies are treated by general practitioners, though they may be referred to neurologists or a surgeon (neurosurgeons or orthopedic surgeons). Sleep disorders are also treated by pulmonologists. Cerebral palsy is initially treated by pediatricians, but care may be transferred to an adult neurologist after the patient reaches a certain age. In the United Kingdom and other countries, many of the conditions encountered by older patients such as movement disorders including Parkinson's Disease, stroke, dementia or gait disorders are managed predominantly by specialists in geriatric medicine. Clinical neuropsychologists are often called upon to evaluate brain-behavior relationships for the purpose of assisting with differential diagnosis, planning rehabilitation strategies, documenting cognitive strengths and weaknesses, and measuring change over time (e.g., for identifying abnormal aging or tracking the progression of a dementia). RELATIONSHIP TO CLINICAL NEUROPHYSIOLOGY In some countries, e.g. USA and Germany, neurologists may specialize in clinical neurophysiology, the field responsible for EEG, nerve conduction studies, EMG and evoked potentials. In other countries, this is an autonomous specialty (e.g. United Kingdom, Sweden). OVERLAP WITH PSYCHIATRY Although many mental illnesses are believed to be neurological disorders affecting the central nervous system, traditionally they are classified separately, and treated by psychiatrists. In a 2002 review article in the American Journal of PsychiatryThere are strong indications[citation needed] that neurochemical mechanisms play an important role in the development of, for instance,

bipolar disorder and schizophrenia. Also, "neurological" diseases often have "psychiatric" manifestations, such as post-stroke depression, depression and dementia associated with Parkinson's disease, mood and cognitive dysfunctions in Alzheimer's disease and Huntington disease, to name a few. Hence, there is no sharp distinction between neurology and psychiatry on a biological basis this distinction has mainly practical reasoning and strong historical roots (such as the dominance of Freud's psychoanalytic theory in the first three quarters of the 20th century which has since then been largely replaced by the focus on neurosciences aided by the tremendous advances in genetics and neuroimaging.)

XPC

INITIATION

CODON

MUTATION

IN

XERODERMA

PIGMENTOSUM

PATIENTS WITH AND WITHOUT NEUROLOGICAL SYMPTOMS ABSTRACT Two unrelated xeroderma pigmentosum (XP) patients, with and without neurological abnormalities respectively, had identical defects in the XPC DNA nucleotide excision repair (NER) gene. Patient XP21BE, a 27 y/o woman, had developmental delay and early onset of sensorineural hearing loss. In contrast, patient XP329BE, a 13 y/o boy, had a normal neurological examination. Both patients had marked lentiginous hyperpigmentation and multiple skin cancers at an early age. Their cultured fibroblasts showed similar hypersensitivity to killing by UV and reduced repair of DNA photoproducts. Cells from both patients had a homozygous c.2T>G mutation in the XPC gene which changed the ATG initiation codon to arginine. Both had low levels of XPC message and no detectable XPC protein on Western blotting. There was no functional XPC activity in both as revealed by the failure of localization of XPC and other NER proteins at the sites of UV-induced DNA in a sensitive in vivo immunofluorescence assay. XPC cDNA containing the initiation codon mutation was functionally inactive in a post-UV host cell reactivation assay. Microsatellite markers flanking the XPC gene showed only a small region of identity (~30kBP), indicating that the patients were not closely related. Thus, the initiation codon mutation resulted in DNA repair deficiency in cells from both patients and greatly increased cancer susceptibility. The neurological abnormalities in patient XP21BE may be related to close consanguinity and simultaneous inheritance of other recessive genes or other gene modifying effects rather than the influence of XPC gene itself

REFRENCES 1. http://en.wikipedia.org/wiki/Neurology 2.http://en.wikipedia.org/wiki/Neurological_disorder 3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684809/?tool=pmcentrez 4. http://en.wikipedia.org/wiki/Neurological_disorder 5. http://www.ncbi.nlm.nih.gov/pmc/ 6. http://www.ncbi.nlm.nih.gov/pubmed/?term=neurological+culture 8. http://www.ncbi.nlm.nih.gov/ 9. http://www.ncbi.nlm.nih.gov/ - 43k