Neurological Diseases

Neurological diseases arise due to problems in our nervous system.
Main Conditions:

• Stroke – Paralysis – Hemiplegia
• Multiple Sclerosis (MS)
• Polyneuropathy – Neuropathy
• Parkinson’s Disease
• Facial Paralysis – Bell's Palsy
• Muscular Diseases

Stroke - Paralysis - Hemiplegia

What is a stroke?
According to the World Health Organization, a stroke is a clinical syndrome characterized by the rapid onset of symptoms and signs of focal cerebral dysfunction due to non-vascular causes. In cases where the stroke leads to coma or subarachnoid hemorrhage, the loss of function may become global.

What are the causes of a stroke?
The risk of stroke doubles every decade after the age of 55. While men experience strokes more frequently, women have a higher mortality rate from strokes. Based on lesion pathology, strokes are classified into two main groups:

• Ischemic stroke: Caused by a reduction or blockage of blood flow to the brain, leading to depletion of neuronal energy sources (O2 and glucose). The most common causes include fatty deposits in the arteries (atherosclerosis), thrombosis (blood clots), or embolism (clots traveling from other parts of the body). Prolonged disruption of blood flow can result in permanent neuronal damage. Ischemic strokes account for approximately 60–80% of all strokes.
• Hemorrhagic stroke: Results from the rupture of a blood vessel in the cranial cavity, causing bleeding either inside or outside the brain tissue. High blood pressure, arteriovenous malformations, and aneurysms are leading causes.

Symptoms and Signs of Stroke
Symptoms vary depending on the affected area and artery. Early recognition and immediate hospital intervention can significantly reduce the extent of damage.

• Face: Sudden asymmetry in the face. Ask the person to smile and check for unevenness.
• Arms: Sudden weakness, tremor, or inability to raise both arms equally.
• Speech: Difficulty speaking or slurred speech.
• Time: Immediate medical attention is crucial if any of these symptoms are observed.

Diagnosis of Stroke
Diagnosing a stroke involves neurological examinations, blood tests, and brain imaging (CT or MRI). Conditions such as high or low blood sugar or brain tumors can mimic stroke symptoms.

Treatment of Stroke
A comprehensive physiotherapy evaluation is essential to tailor goals based on the brain's affected area and specific symptoms.

• Right hemiplegia: Associated with intact visuo-motor perception and memory but difficulties in speech, reading, writing, and emotional regulation.
• Left hemiplegia: Linked to issues in spatial perception, orientation, and neglect of the left side of the body.
• Brainstem involvement: May lead to movement loss on both sides, balance issues, dizziness, and speech difficulties.

Physiotherapists design acute and chronic rehabilitation programs, incorporating patient education, prevention of complications, and specific therapies like passive joint movement, strengthening exercises, gait training, and neuromuscular facilitation techniques such as Bobath or Brunnstrom approaches. Additional supportive treatments like electrotherapy, massage, and acupuncture may also be included.

Multiple Sclerosis (MS)

What is MS?
MS is a relapsing and progressive inflammatory demyelinating disease of the central nervous system, affecting the brain and spinal cord. It damages the myelin sheath of nerve cells, impairing communication and forming hardened plaques in affected areas.

Causes of MS
The exact cause of MS is unknown. Potential factors include genetic predisposition, environmental triggers, autoimmune processes, and viral infections. MS is more common in women and typically occurs between ages 20–40.

Symptoms and Signs of MS
Symptoms vary depending on the location and size of the lesions. Common problems include:

• Sensory issues: Pain, numbness, paresthesia, and balance problems.
• Visual problems: Blurred vision, optic neuritis, and double vision.
• Motor symptoms: Spasticity, weakness, tremors, and ataxia.
• Cognitive and emotional issues: Depression, memory loss, and decision-making difficulties.

Diagnosis of MS
Diagnosis requires clinical history, neurological examinations, cerebrospinal fluid (CSF) analysis, and imaging studies (MRI).

Treatment of MS
Physiotherapy focuses on symptom management through tailored exercise programs, including strengthening, balance training, and relaxation techniques. Additional interventions like aquatherapy, yoga, and cognitive rehabilitation are often recommended.

Polyneuropathy

What is Polyneuropathy?
Polyneuropathy refers to widespread damage to peripheral nerves caused by a common underlying process. It can involve:

• Neuropathy: Affects the nerve cell body.
• Axonopathy: Targets the axons.
• Myelinopathy: Impacts the myelin sheath.

Causes of Polyneuropathy
It can be hereditary or acquired due to metabolic disorders (diabetes), immune dysfunction (Guillain-Barré Syndrome), infections, toxins, or cancer.

Symptoms and Diagnosis
Common symptoms include muscle weakness, sensory loss, and autonomic dysfunction. Diagnosis involves EMG, nerve biopsies, and blood tests.

Treatment
Rehabilitation includes strength training, coordination exercises, and ergonomic adjustments.

Parkinson’s Disease

What is Parkinson’s Disease?
Parkinson’s disease is a chronic, progressive neurodegenerative disorder caused by the loss of dopamine-producing neurons in the brain.

Causes
The exact cause is unknown, but it may involve genetic and environmental factors. Secondary causes include toxic exposure, brain injury, and some medications.

Symptoms
Symptoms include tremors, rigidity, bradykinesia, and postural instability. Non-motor symptoms include sleep disorders, depression, and cognitive decline.

Treatment
Treatment involves medication (e.g., levodopa), surgical options, and physiotherapy. Physiotherapy aims to improve mobility, posture, and balance.

Facial Paralysis – Bell’s Palsy

What is Facial Paralysis?
Facial paralysis occurs when the facial nerve is damaged, impairing facial muscle movement. Causes include infections, trauma, or idiopathic factors.

Symptoms and Treatment
Symptoms include asymmetry, inability to close the eye, and drooling. Early intervention with physiotherapy, including massage, exercises, and electrotherapy, can enhance recovery.