By Dr. Kavita.V MD
Neurological disorders are medical diseases which affect the nervous system which includes brain, spinal cord and nerves. Since the nervous system controls the activity of the entire human body, neurological diseases can cause disturbances in routine activities such as moving, speaking, swallowing, breathing, learning, memory, senses, or mood. While we always look for physical signs and symptoms of neurological disorders, it is important to understand that most of the neurological disorders present with subtle emotional symptoms which could be mood swings or emotional outbursts.
When our family members suffer from neurological disorders, we may be perplexed as to why this is happening. The brain and spinal cord are surrounded by protective membranes. During our daily activities, these membranes which provide insulation to the brain and spinal cord are subjected to wear and tear. Even a small disturbance to a structural neuron can cause a dysfunction.
Neurological disorders may be due to genetic defects, structural or anatomic defects, degenerative changes, vascular problem, cancers, injury, infections, or seizure disorders. According to the World Health Organisation, neurological disorders affect millions of people around the world. This includes around 24 million individuals suffering from Alzheimer’s disease and 326 million individuals suffering from migraine.
An array of diagnostic modalities is available to diagnose neurological disorders. A neurophysician orders for investigations after careful analysis of the presenting history and physical examination of the patient. A few patients may present with acute illness at emergency and may need immediate lifesaving intervention. Imaging modalities like Computed tomography (CT scan), Magnetic resonance imaging (MRI) helps in identifying the part of the nervous system affected. Invasive procedures like Lumbar puncture provide a lot of useful information which helps and guides the physician in treatment. The other diagnostic modalities include Electroencephalography (EEG), arteriogram, electromyography (EMG), Neurosonogram, PET CT scan etc. Automated interpretations of EEG signals are available for diagnosis and treatment of Seizure disorders.
Many neurological problems are caused by heterogenous gene mutations. Diagnosis of such diseases is too long and complex. The advent of next generation sequencing has revolutionized genetic testing and has indeed shortened the ‘diagnostic odyssey’ for many of these patients. Neurogenetics has developed enormously in recent years even in developing countries and thus helped in unravelling the human genome. Genetic testing using targeted capture which can be followed by next-generation sequencing seems to be more efficient, cost-effective, and helps in molecular diagnosis in many refractory cases. Diagnostic genetic testing can be done by the use of gene panels and exome sequencing.
Computer aided diagnosis (CAD) is available for diseases like Parkinson’s disease, Alzheimer’s, Epilepsy, stroke and Multiple sclerosis. Artificial intelligence (AI) learning techniques have been formulated using available patient data, physiological signals, multiple imaging evidence. CAD and AI have helped Neurologists to analyse and interpret patient symptoms with imaging studies. In addition, new tools are being developed to support diagnosis of neurological disorders by means of facial-expressions-monitoring.
The primary treatment of neurological disorders is medical. The treatment depends on the type of disorder. The treatment options may vary from corticosteroids, drugs which help in decreasing inflammation, Dopamine affecting drugs etc. It is important to understand that treatment for a neurological disorder is usually long-term and possible medication side effects need to be kept in mind. Medication side effects related to the treatment of neurological disorders depends on the type of medication. In some instances, it may be possible to develop dependence to the medication.
Abrupt discontinuation of the medication can result in withdrawal symptoms. Depression and neurological disorders are interrelated. Due to the debilitating nature of many neurological diseases, many patients suffer from depression. Depression needs to be addressed, since the recovery may become challenging without proper professional assistance.
Effective therapy of a few neurological disorders has failed due medications which are not capable of crossing blood-brain-barrier (BBB). Nanotheranostics has emerged, which is capable of using accurate diagnosis together with effective and targeted delivery of nanoparticles across BBB. Nanotheranostics, is a multifunctional nanosystem with dual capability of both diagnostics and therapeutic modality.
Regardless of how long a person is suffering from a neurological disorder, it is important to understand that treatment options and rehabilitation measures are always available. Centres of excellence in Neurological diseases provide holistic treatment options for patients.
(The author is Chief of Lab – Technical Operations, Metropolis Healthcare Ltd. (Tamil Nadu, Andhra Pradesh &Telangana). Views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)