Fact file 5: Neurology

Author(s):  
Daisy Fancourt

Neurology focuses on diagnosing and treating conditions affecting the nervous system, which encompasses the brain and peripheral nervous system (involving the nerves and nerve cell clusters that connect the brain to the limbs and organs) and the muscular system. Some neurological conditions are present from birth, such as cerebral palsy; while some develop during childhood, such as Duchenne muscular dystrophy; and others typically affect older people, such as Alzheimer’s and Parkinson’s diseases. Neurology also deals with acquired brain injuries, strokes, and cancers affecting the brain and spine....

Neurosurgery describes the surgical treatment and management of various disease processes that target the brain, spinal cord, and peripheral nervous system. The specialty is wide and varied as increasing numbers of neurological conditions can now be improved following neurosurgery; for example, some types of epilepsy respond to the insertion of a vagal nerve stimulator, Parkinson’s disease symptoms can be diminished with a deep brain stimulator, and intractable back pain may be improved following spinal surgery. Practitioners must be equipped with the knowledge and skills to care for these patients and meet their immediate and long-term needs.


The author, after commenting on the opinions of Le Gallois and Cruveilhier relating to the functions of the spinal marrow, adverts to a property or function of the medulla oblongata and spinalis, which he considers as having escaped the notice of these and all other physiologists; namely, that by which an impression made upon the extremities of certain nerves is conveyed to these two portions of the nervous system, and reflected along other nerves to parts different from those which received the impression. He distinguishes muscular actions into three kinds: first, those directly consequent on volition; secondly, those which are involuntary, and dependent on simple irritability; and thirdly, those resulting from the reflex action above described, and which include those of the sphincter muscles, the tonic condition of the muscles in general, the acts of deglutition, of respiration, and many motions, which, under other circumstances, are under the guidance of the will. Volition ceases when the head or brain is removed; yet, as he shows by various experiments, movements may be then excited in the muscles of the limbs and trunk, by irritations applied to the extremities of the nerves which remain in communication with the spinal marrow: but these actions cease as soon as the spinal marrow is destroyed. Hence the author concludes that they are the effect of the reflex Action of the spinal marrow, which exists independently of the brain; and, indeed, exists in each part of the organ independently of every other part. He considers that this reflex function is capable of exaltation by certain agents, such as opium and strychnine, which in frogs produce a tetanic and highly excitable state of muscular irritability. Hence he is led to view the reflex function as the principle of tone in the muscular system. He considers that certain poisons, such as the hydrocyanic acid, act by destroying this particular function. The effects of dentition, of alvine irritation, and of hydrophobia, of sneezing, coughing, vomiting, tenesmus, &c. &c., are adduced as exemplifications of the operation of the same principle when in a morbid state of exaltation.


1999 ◽  
Vol 147 (3) ◽  
pp. 645-658 ◽  
Author(s):  
Derek J. Blake ◽  
Richard Hawkes ◽  
Matthew A. Benson ◽  
Phillip W. Beesley

Duchenne muscular dystrophy is a fatal muscle disease that is often associated with cognitive impairment. Accordingly, dystrophin is found at the muscle sarcolemma and at postsynaptic sites in neurons. In muscle, dystrophin forms part of a membrane-spanning complex, the dystrophin-associated protein complex (DPC). Whereas the composition of the DPC in muscle is well documented, the existence of a similar complex in brain remains largely unknown. To determine the composition of DPC-like complexes in brain, we have examined the molecular associations and distribution of the dystrobrevins, a widely expressed family of dystrophin-associated proteins, some of which are components of the muscle DPC. β-Dystrobrevin is found in neurons and is highly enriched in postsynaptic densities (PSDs). Furthermore, β-dystrobrevin forms a specific complex with dystrophin and syntrophin. By contrast, α-dystrobrevin-1 is found in perivascular astrocytes and Bergmann glia, and is not PSD-enriched. α-Dystrobrevin-1 is associated with Dp71, utrophin, and syntrophin. In the brains of mice that lack dystrophin and Dp71, the dystrobrevin–syntrophin complexes are still formed, whereas in dystrophin-deficient muscle, the assembly of the DPC is disrupted. Thus, despite the similarity in primary sequence, α- and β-dystrobrevin are differentially distributed in the brain where they form separate DPC-like complexes.


1994 ◽  
Vol 87 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Makoto Uchino ◽  
Hitoo Teramoto ◽  
Hiroaki Naoe ◽  
Teruhisa Miike ◽  
Kowashi Yoshioka ◽  
...  

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