Most neurologists would perish the thought that fibromyalgia has anything to do with the nervous system. Any mention of it would induce sighs and tut tuts. There is however emerging evidence linking fibromyalgia to dysfunctional central pain processing. A prominent advocate of this is anaesthesiology professor Daniel Clauw.
Another rheumatologist, Manuel Martinez-Lavin, adds another neurological perspective to fibromyalgia: the association with sympathetic hyperactivity. He makes the very plausible argument that sympathetic hyperactivity would explain the frequent association of fibromyalgia with symptoms such as anxiety, insomnia, and irritable bowel.
The tendency to see patterns has been used to good effect in neurological imaging. Many radiological diagnostic signs have been assigned names that reflect the false patterns they project on the human mind. This concept of neuropareidolia is excellently explored in this paper. Neurologists and radiologists for example talk of the hot cross bun sign in multiple system atrophy, the panda sign in Wilson’s disease, and the hummingbird sign in progressive supranuclear palsy (PSP). It seems we bring our humanity to the workplace!
Multiple sclerosis is a scourge. It frequently targets the young with devastating, often life-long, effects. It spares no parts of the central nervous system, affecting the brain, spinal cord and major nerves. There are several MS risk factors as discussed in my previous post MS risk factors: the top 6. In this post I address the treatments of MS. There are already several agents available and the most widely used are the Interferons. Other medications are the monoclonal antibodies such as Natalizumab and Alemtuzumab. Oral agents arealso gaining ascendance and include Fingolimod and Cladribine. Other drugs include Fumarate and Teriflunomide. This article gives a good overview of MS treatments. The field is however rapidly advancing and I recommend this helpful update.
MS however remains an elusive condition to treat. Current treatments may reduce episodes of relapses but seem to do little to stop the progression of the disease. Some new drugs are however breaking the mold.
A highly promising drug is Ocrelizumab. This drug excited the recent European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) as discussed in this article in Medscape. It appears to be highly effective and has the advantage of producing fewer side effects than most other agents.
Most treatments of MS are directed at the relapsing remitting form but it is hopeful that a new drug, Masitinib, may break the glass ceiling with progressive MS. Masitinib is an oral agent currently in trial stages. This piece from the MS Society gives further details on Masitinib.
An odd connection you may say but here are quite a few things that link epilepsy with music. lepsy. The first is the therapeutic effect of on epilepsy. This has been termed ‘The Mozart Effect‘ based on studies which report that listening to Mozart reduces epileptic brain discharges.
This however seems at odds with the known fact that epilepsy may be triggered by music. Music is one of several triggers of epilepsy. People with this musicogenic epilepsy may become frightened of music, a concept called musicophobia. This article in Scientific American gives an example where the music of Sean Paul is the consistent trigger for someone’s seizures. In another anecdote from NME, a Ne Yo song is the culprit.
Finally, music may be a manifestation of epilepsy. These present as musical hallucinations.
There are very few disabilities worse than paralysis from spinal cord injury. This often results from sudden catastrophes and frequently affects the young and active. It is very poignant that many incidents occur during recreational activities, and horse rising is one prominent example. Nothing exemplifies this more dramatically than the case of Christopher Reeve, famous for playing Superman.
The damage is typically catastrophic and this MRI scan shows how a fracture of the vertebrae could seriously damage the spinal cord, in this case it affects the neck. Spinal cord injuries often mean a life on a wheelchair or even worse, a bed-bound existence. Rehabilitation is often limited to maximizing potential.
There are however several scientific advances that will hopefully change the outlook for spinal cord injuries. Here are 6 rays of light at the end of the tunnel.
By delivering electrical impulses to the spinal cord, researchers have successfully got spinal cord injured subjects to make walking movements. The advantage of this procedure is that it is not invasive. It’s not yet walking, but its a step in the right direction.
3. ROBOTIC EXOSKELETON
A bit more SciFi is the use of a robotic exoskeleton. Its only one case but anything that may work is worth it.
4. SPINAL CORD REGROWTH
The future is however more futuristic if trial of regrowing the spinal cord. Its mainly in zebrafish and rats for now, but there is at least a report of using nasal cells to repair the spinal cord in man.
It must be tough having a mental health problem but does it come with some advantages? Its hard to think of any until I came across this paper in Molecular Psychiatry. It suggests that bipolar disorder is probably more common in clever people. The authors studied records of > 1 million Swedish men to test the hypothesis that creativity is associated with profound mood swings. Indeed the study found that those blessed with a high IQ are probably prone to pure bipolar disorder.
No, Will Smith has not developed chronic traumatic encephalopathy (CTE). He is however playing Nigerian-born Bennett Omalu in an upcoming film, Concussion. The Nigerian-born and trained forensic pathologist was the first to report an association between repeated head trauma and the neurodegenerative disease CTE. He relates his story in this interview.
It will be interesting to see the film portrays the great lengths the National Football League (NFL) went to discredit the hero but here is a trailer:
And talking of Nigerian doctors and the movies, Danny Glover will be playing a part in 93 days, a film about the action of a few dedicated doctors to stop the spread of the deadly ebola virus in Nigeria, Africa’s most populated country.