In- Voluntary Voluntary

EPILEPSY
DEFINITION

• Hyper-excitation of neuron in brain leading to alter

behavior called as seizure.
• Epilepsy is defined as periodic and unpredictable
occurrence of seizure followed by spontaneous
resolution.
• It is also called as epileptic seizure.
• About 1 to 2% people have epileptic seizure
ETIOLOGY

1. Brain disease
2. Head injury
3. Degenerative disease ( disease which affect the tissue or organ eg
cancer , diabetic))
4. Convulsion
5. Neuronal chemical imbalance, trauma
TYPES OF EPILEPSY :

• Juvenile myoclonic epilepsy:

Most common up to age of 8 -20 year age group
• Benign partial epilepsy in childhood
It is common up to age 12, attack is more severe during sleep
• Solitary parenchyma cysts epilepsy (Cyst is nothing but non-cancerous
growth)

Occurs by single small cysts

• Reflex epilepsy:
In this case specific stimuli or action is responsible to evoke attack
Pathogenesis

INT: Inhibitory Neurotransmiter ENT: Excitatory Neurotransmiter

It balance the mood and maintain balance of system They overexcite the brain
SYMPTOMS

Sudden feeling of fear, dizziness

• Change in vision
• Headache
• Losing consciousness
• Confusion
• Muscle spasm
• Strange taste in mouth
• Frothing at mouth
• Sudden mood change, rapid eye movement
DIAGNOSIS

• Perform a physical examination

• Neurological examination
• Blood test
• Electroencephalogram ( ECG)
• Neuro-imaging, MRI, CT Scan
TREATMENT

NON- PHARMACOLOGICAL:

1. Regulation of salt
2. Exercise, weight reduction , limited alcohol intake, stress
reduction
PHARMACOLOGICAL :

3. Anticonvulsant drug: Carbamazepine, phenyltoin

4. Surgery: Removal area of brain causing the seizure
DEFINITION

• Parkinson’s disease (PD) is a chronic progressive disease of

the nervous system characterized by the features of
rigidity, bradykinesia and tremor.

• Experts estimate that it affects at least 1% of people over age

60 worldwide.
•Tremor. A tremor, or shaking, usually begins in a limb, often your

hand or fingers. Complaint begin in leg, arm.

•Rigid muscles. Muscle stiffness may occur in any part of your

body. The stiff muscles can be painful and limit your range of

motion.

•Bradykinesia: Refers to decreased body movement.

Causes
• Parkinson's disease is caused by a loss of nerve cells in the part of
the brain called the substantia nigra. Nerve cells in this part of the
brain are responsible for producing a chemical called dopamine
(SNS).
• Dopamine is a neurotransmitter made in your brain. It plays a role
as a “reward center” and in many body functions, including
memory, movement, motivation, mood, attention and more.
• Virus, toxins, drugs, tumors
The substantia nigra is a critical brain region for the production
of dopamine.
PATHOGENESIS:
Loss of nerve cells in substantia nigra, virus, toxins, drugs, tumors

Affects the substantia nigra

Destuction of dopamine producing neurons

Reduces the amount of available dopamine ( Inhibitory Effects )

There is increase in acetylcholine (excitatory effects )

Excitatory activity of Ach is inadequately balanced

Difficulty in controlling and initiating voluntary movements

Parkinson’s disease
SYMPTOMS

• Tremor in hands, arms, legs, jaw or head

• Muscle stiffness, where muscle remains contracted for a long time

• Slowness of movement

• Impaired balance and coordination, sometimes leading to falls

• Depression and other emotional changes

• Difficulty swallowing, chewing, and speaking

• Urinary problems or constipation

• Skin problems
DIAGNOSIS

• Physical examination, medical history

• Neurological examination
• Brain scan, blood test, x-ray
• Biopsy
TREATMENT

NON- PHARMACOLOGICAL:

1. Exercise, limited alcohol intake, tobacco , cigarette, stressful environment

PHARMACOLOGICAL :

2. Levodopa and carbidopa: Increasing the level of dopamine in the brain

3. Dopamine agonist: Increasing the level of dopamine in the brain

4. MAO-B inhibitors: Dopamine metabolism blocker

5. Brain surgery
DEFINITION

• Stroke is a brain attack it occurs when the blood flow

to an area of brain is cut off.
• It happens brain cells are deprived of oxygen and
begin to die.
• when brain cell are die due to stoke the memory and
muscle control are lost
• Stoke also called as cerebrovascular accident.
• Ischemic stoke: Due to blockage or narrowing of
arteries that provide blood to the brain
• Hemorrhagic stoke: caused due to arteries in brain
either leaking blood or burst.
ETIOLOGY

 Blockage of an artery in the brain by a clot (thrombosis) is the

most common cause of a stroke
 Stroke may occur due to a blood clot
 Blood vessel in the brain ruptures and bleeds into the surrounding
brain tissue.
 Blood accumulates in the space beneath the arachnoid membrane
that lines the brain.
Lipid peroxides are chemically
modified lipids or fatty acids,
which causes cellular stress
 (proteases) are enzymes that
break down protein
 
SYMPTOMS

• Difficulty in walking , paralysis, stiff muscle, balance disorder,

fatigue,
• vertigo, blurred vision, sudden vision loss, difficulty in
speaking, speech loss, weakness, headache
DIAGNOSIS

• Physical examination
• CT scan
• Blood test
• MRT Scan
• ECG
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of cholesterol intake
2. Exercise, weight reduction , limited alcohol intake, tobacco , cigarette

PHARMACOLOGICAL :
Tissue plasminogen activator by IV to dissolving clot
Psychiatric disorders

1. Depression

2. Schizophrenia

3. Alzheimer disease
epression
DEFINITION

• Depression is a feeling of intense sadness and

unhappiness.
• It is common mental disorder found in people of age
group 20-40 years varies from few days , month or
year.
• women are more
• Child bearing age women.
ETIOLOGY
Types of depression

1. Major depression: It is nothing but the presence of depressed mood or

loss of pleasure for at least two weeks along with changes in weight, sleep
pattern, fatigue guilt feeling thought of suicide
2. Chronic major depression: Depressed mood for at least two years along
with above symptoms.
3. Recurrent or mild depression: Low grade depression
4. Seasonal affective depression : depends on season winter : limitation of
sunlight
Pathogenesis of Depression
Exact pathophysiology of depression is unknown but
hypothesis is monoamine deficiency ( eg noradrenaline ,
serotonin and dopamine )

Deregulation of serotonin and noradrenaline in the brain are strongly

Associated with depression

serotonin and noradrenaline are neurotransmitter help to

transfer message from one area of brain to another
SYMPTOMS

Indecisiveness : lack of confidence or

information.
DIAGNOSIS

• Physical examination: Speech latency, expression of

guilt
• Lab test: CBC Count, thyroid function test
• Psychological evaluation: mental health provider ask
about symptoms, thoughts
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of cholesterol intake, healthy diet, exercise, tobacco , cigarette,
medication

PHARMACOLOGICAL :
2. Selective serotonin inhibitors eg fluoxitine
3. Atypical antidepressnat , eg trazodone
4. Serotonine modulator
ELECTROCONVULSIVE THERAPY: using electric current
DEFINITION

• Schizophrenia is a severe mental disorder characterized

by profound disruption in thinking, affecting language,
sense of person
• Usually begin in late adolescence or early childhood
• It affect about 0.3 to 0.7 % of people.

Delusion : False belief भ्रम

Hallucination : Hearing voice
ETIOLOGY

1. Brain disease
2. Head injury
3. genetics
4. Imbalance of chemicals in brain
5. Cancer, diabetics
6. Environmental factor
TYPES
• Paranoid schizophrenia: people with this types are occupied with false
belief about being punished by someone. Their other thinking speech
and emotions are fairly normal.
• Disorganized schizophrenia: people with this types are confused and
have jumbled speech.
• Catatonic schizophrenia: people with this types are generally immobile
and unresponsive to the world around them.
• Undifferentiated schizophrenia: This subtype is diagnosed when the
persons symptoms doe not clearly represent one of above three.
Symptoms

(UNDERSTANDING)
DIAGNOSIS

• Physical examination: Speech latency, expression of

guilt
• Lab test: CBC Count, MRI, CT Scan
• Psychological evaluation: mental health provider ask
about symptoms, thoughts, felling
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of cholesterol intake, healthy diet, exercise, tobacco , cigarette,
medication

PHARMACOLOGICAL : This disease require life long treatment

2. antipsychotics
Eg aripiprazole, haloperidol
ELECTROCONVULSIVE THERAPY: using electric current \
Social skill training: improve communication and social interaction
 DEFINITION

• Alzheimer's disease is a progressive degenerative disorder

that attack the brains nerve cell and neuron especially in
the cerebral cortex resulting in loss of memory, thinking
and language skill, behavioral; change .
• It is a condition in which nerve cells in brain is die and
signal transmission block.
Types of AD

1. Early onset AD: Symptoms appears before age 60, less common
2. Late onset AD: most common type, occur after age 60
Pathogenesis
Due to etiological factor

Changes occurs in proteins of nerve cells of the cerebral cortex

Accumulation of Neurofibrillary tangles (abnormal accumulations of

a protein called tau that collect inside neurons) and . plaques (clusters
that form in the spaces between the nerve cells)

Granulo vascular degeneration

(Granulovacuolar degeneration involves the accumulation of large,
double membrane-bound bodies within certain neurones)

Loss of nerve cell

Loss of memory, function and AD

Symptoms
• Emotional behavior
• Impaired memory and thinking
• Confusion, misplacing item (glass, key)_
• Trouble in performing familiar task
DIAGNOSIS

• Physical examination: Medical history,

• Mental status examination: assess memory and
thinking skill
• Brain imaging: MRI
• Electroencephalogram
TREATMENT

NON- PHARMACOLOGICAL:
1. Regulation of cholesterol intake, healthy diet, exercise,
tobacco , cigarette, medication

PHARMACOLOGICAL :
2. Donepezil
3. Galantamine