Neurology

Neurology and Psychology

Neurologists diagnose and treat diseases affecting the brain, spinal cord, peripheral nerves and muscles.
Disorder thought processes or emotions are treated by psychiatrists.
Most of the time, the two specialties overlap, particularly in relation to dementia or psychosomatic symptoms.

Test allows earlier prenatal detection of Down's syndrome.

Epilepsy
Not all memory problems are caused by Alzheimer's.

Down's syndrome

By PEGGY PECK, UPI Science News

WASHINGTON, Aug. 1 (UPI) -- A new test may permit pregnant women to find

out if they are carrying a child with Down's syndrome during the first

trimester of pregnancy, up to two months earlier than possible with current

detection methods.

According to a study in the August issue of Obstetrics and Gynecology the

new screening test, called Ultrascreen made by NTD Laboratories, Huntington

Station, N.Y., correctly identified more than 90 percent of the Down's

syndrome cases when used as a first trimester screening tool.

Lead author David Krantz said that is a better accuracy record than the

current testing method, which can identify only about 60 percent of Down's

syndrome cases. He said, too, that the older test, called triple testing

because it tests for three biochemical markers of the disorder, is done

during the second trimester.

"Women are anxious to learn about Down's syndrome earlier in pregnancy,"

Krantz said, adding that this knowledge allows pregnant women more options

including abortion.

He said the new test was a combination of two technologies: ultrasound

imaging of the fetus and a blood test. "The ultrasound screening is done

between 10 and 14 weeks and it measures the amount of fluid behind the neck

of the fetus," said Krantz. This type of ultrasound screening is called

nuchal translucency measurement.

The blood test measures the amount of two chemicals called free beta hCG

and PAPP-A in blood taken from the pregnant woman. In the study more than

10,000 women were screened but only about 6,000 had both parts of the test.

"To put it simply, a high amount of fluid behind the neck, high free beta

hCG and low PAPP-A indicate Down's syndrome," said Krantz.

Down's syndrome is caused by a chromosomal abnormality, usually an extra

copy of chromosome 21. It is one of the most common birth defects with an

incidence of about 1 in 700 live births, but the incidence increases as the

women age. By age 40 years the incidence is about 1/40 live births, and

about 20 percent of all Down's syndrome children are born to women older

than 35 years.

In the study, the authors concluded that use of this testing method "is

feasible, results in improved Down's syndrome detection compared with

currently used second-trimester protocols, and provides substantial

advantages to clinicians and patients."

The test maker NTD Laboratories employed Krantz and another co-author,

Terrance W. Hallahan. Another co-author, James N. Macri, owns several

patents related to free beta hCG testing.

Epilepsy

Epilepsy affects 1-3% of the worlds population. Epilepsy is a medical brain disorder causing a tendency to develop fits or seizures. It affects men more than women.

Epilepsy can occur as a result of underlying brain damage, a structural brain lesion, haemorrhage, head injury or because of addiction to alcohol. It could affect people of different ages.
Normal epilepsy causes a recurrent convulsions with stiffness of muscles, either in a specific part, different parts or all over of the body.
Some have seizure ( fits ) several times each day, whilst others have intervals of one or two years between each attack.
Mild types of epilepsy may result in numbness in the face or hands, involving momentary loss of awareness. Its severe types may result in a major convulsions and complete loss of movement control, then a complete loss of consciousness.
Seizure may last for several seconds to few minutes. Although it can last as long as 30 minutes whence it might result in life loss.

Diagnosis

Diagnosis is based on finding the brain lesions responsible for the seizure using different methods:

General physical and neurological examination.
Electroencephalogram.
CT Scan.
Electromagnetic resonance .
Blood and spinal fluid tests.

Treatment

The most important cures are that which involve the treatment of the causes of epilepsy like brain tumor, internal haemorrhage in the brain, or hemorrhage disorder.
The most effective treatment is anticonvulsant medications. Approximately 20 anticonvulsants are available.
It is usually necessary to continue medication for several years after seizures are fully controlled.
Surgical removal of the brain lesion is especially functional when the lesions are contained in a single, surgically accessible area.

Not all memory problems are caused by Alzheimer's.

By PEGGY PECK, UPI Science News
WASHINGTON, July 10 (UPI) -- Researchers from Denmark say that less than
half of the persons referred for Alzheimer's assessments because of memory
problems actually have progressive dementia.
Instead, Dr. Gunhild Waldemar said at the World Alzheimer Congress 2000 in
Washington, D.C., many of these persons have treatable conditions that mimic
dementia.
Waldemar and her colleagues at the Memory Disorders Research Unit of the
Neuroscience Center at Copenhagen University Hospital reported on 785
consecutive patients referred over a period of 40 months. She said 43
percent of them had progressive dementia but the remaining patients had
"potentially reversible conditions that were the primary cause of memory
deficits in about 20 percent of the patients."
Another 20 percent had "stable, mild cognitive disorder that might
progress but it was unlikely," she said. The remaining 20 percent were just
"healthy, worried adults."
Waldemar says her research underlines the need for early assessment by
trained diagnosticians. She says that patients referred to the Copenhagen
center are subjected to a wide array of tests and exams including physical
examination, clinical history, X-rays and more sophisticated imaging studies
that show changes in the brain, as well as standard laboratory tests.
Although depression was the main non-Alzheimer cause for memory problems,
she says that poor nutrition or thyroid disease can also mimic Alzheimer's
disease.
Understanding just who is and who isn't afflicted by early Alzheimer
disease is becoming more important said Dr. Ronald C. Peterson a dementia
researcher from the Mayo Medical School, Rochester. He said many researchers
are zeroing in on a population now labeled as having mild cognitive
impairment, or MCI. Persons with this condition can still function very well
and may only need minor help such as notes to remind them of important
telephone numbers but many of them do progress to Alzheimer's disease.
He says that he and other researchers now think that this group should be
targeted for an intervention that will prevent progression. He said, for
example, that treatments targeting amyloid plaque, such as an experimental
vaccine now being tested in humans, might be most useful in "people with
this very early stage disease."
Tomorrow morning vaccine researchers are scheduled to unveil data from the
first human study of that vaccine. That study, a safety study, was conducted
in a small number of patients with advanced disease.
Regardless of the progress of such new treatments, Peterson says, "we have
to refine the population so persons whose cognitive difficulties are caused
by reversible conditions are identified and treated and we are left with
only those patients who are most likely to have some pathology in the
brain." Studies such as the one by Waldemar help in that refining process he
said because it offers some hard numbers on prevalence.
Another investigator who is targeting MCI is Dr. David Bennett of the
Alzheimer's research center at Rush-Presbyterian-St. Luke's Medical Center
in Chicago. Bennett has been following a group of nuns, priests and brothers
over the last 7 years to track the development of Alzheimer's and compare it
to normal aging. Called the Religious Orders Study Bennett said he has
collected data on more than 750 volunteers.
Importantly all volunteers volunteer their organs for autopsy after they
die, so Bennett has already accumulated autopsy data from more than 100
brains. What he found is that the brains of patients with MCI are very
similar to those of patients who were diagnosed with Alzheimer's at the time
of death. In both cases the brains were riddled with "plaque and tangles"
that characterize Alzheimer's disease.
Bennett said this finding suggests that the number of persons with
Alzheimer's disease in the United States is "actually more than the 4
million figure currently used. I'm not willing to say how much more, but the
increase is significant." He said that finding has important public health
implications because it suggests that current "estimates of funds needed to
care for these people are too low, and the facilities needed to care for
them are too few."

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