THE TREATMENT OF

NERVOUS SYSTEM
DAMAGE
Hudabia Zaman
233730949
Prevalence
• According to a thorough examination of the Global Burden of Disease study,
stroke, Alzheimer disease and other dementias, and migraine were the three most
debilitating neurological conditions in the US in 2017. With the exception of
traumatic brain injury incidence, spinal cord injury prevalence, deaths, and
disability-adjusted life years, and encephalitis disability-adjusted life years, the
absolute numbers of incident, prevalent, and fatal cases and disability-adjusted
life years of neurological disorders increased across all US states from 1990 to 2017
(Leasure et al., 2022).
Prevalence (cont.)
• In the UK, neurological problems impact almost 10 million people. The brain,
spinal cord, cranial and peripheral nerves, the autonomic nervous system, the
nerve roots, the neuromuscular plate, and the muscles are all parts of the nervous
system that are affected by neurological illnesses. More than 600 different
neurological conditions exist. The majority are disorders caused by faulty genes,
such Huntington's disease or muscular dystrophy issues with the development of
the neurological system, such as spinal cord injury, degenerative disorders like
Alzheimer's or Parkinson's, and diseases of the blood arteries supplying the brain,
such stroke, brain tumors, such as epilepsy, convulsive diseases like epilepsy, and
infections like meningitis (Garad, 2012)
Etiology (Alyssa, 2022)
• DEFICIENCIES: One of the most typical causes of nerve injury is a vitamin B12 deficiency. A lack
of this vitamin, which is crucial for the health of the nervous system, can lead to issues with
movement and feeling. Additionally, discomfort and nerve damage might result from vitamin B6
deficiency. Overindulging in alcohol, eating poorly, or having a medical condition that interferes
with nutrient absorption can all lead to nutritional deficiencies.
• MOTOR NEURON DISEASES: Nerve damage can result from motor neuron illnesses like ALS,
which over time cause the nerves to deteriorate and lose their functionality. As a result, the
affected area may experience numbness, twitching, paralysis, weakening, or muscle atrophy.
The specific signs and where they appear will vary depending on the type of motor neuron
disease.
• CHRONIC KIDNEY DISEASE: Another frequent reason for nerve injury is chronic renal illness.
Although the precise causes are uncertain, one idea postulates that kidney disease may result in
electrolyte imbalances that negatively impact nerve cells' ability to operate. According to a
different notion, the kidneys' inability to effectively eliminate toxins from the blood causes
damage to nerves and tiny blood arteries.
Etiology (cont.)
• HORMONAL IMBALANCES: Additionally, hormonal abnormalities can harm
nerves by changing normal metabolic processes. One illustration of this is
diabetes, which, as a result of excessive blood sugar levels, can harm the nerves.
Nerve harm and pain can also result from other hormonal abnormalities like
hypothyroidism or menopause. Particularly hypothyroidism can slow metabolism,
which causes fluid retention. This makes tissues swell and puts pressure on
peripheral nerves.
• DIABETES: Diabetes is the most frequent factor in nerve injury. By making the
nerves enlarge and press up against blood vessels, diabetes can harm the nerves.
This can result in a loss of sensation or weakening in the affected area because
sensory nerves are most likely to be impacted. However, although it is less
frequent, diabetes can also harm the autonomic and motor nerves.
Etiology (cont.)
• INFECTIOUS DISEASE: Infectious conditions that cause inflammation and/or gradually
weaken the immune system, like HIV/AIDS, herpes viruses, hepatitis C, and Lyme disease, can
harm the nerves. This can cause a number of symptoms, including a loss of feeling or
weakness in the affected area. While chronic infections develop gradually yet are progressive
and frequently lethal, acute infections typically start out fast.
• CANCER: By encroaching upon or pressing against the nerves, cancer can harm them.
Neuropathy is another sign of some cancers, including lymphoma and multiple myeloma.
This may result in numbness or weakness in the area that is being impacted. Additionally,
dietary deficits brought on by cancer might decrease nerve function. In some situations,
cancer therapies like chemotherapy and radiation can also cause pain and nerve damage.
• AUTOIMMUNE DISEASE: Nerve damage and suffering can be brought on by autoimmune
disorders such lupus, inflammatory bowel disease, Guillain-Barre syndrome, and multiple
sclerosis. This is due to the possibility that these autoimmune diseases will lead the immune
system to target the nerves and harm them. This may result in numbness or weakness in the
area that is being impacted.
Etiology (cont.)
• TRAUMA: The nerves can be crushed by trauma, such as a vehicle accident or a
fall, and suffer damage. This may result in numbness or weakness in the area that
is being impacted. In some situations, additional causes including surgery,
herniated discs, carpal tunnel syndrome, or bone spurs can potentially squish or
compress nerves.
• DRUGS/TOXINS: The nerves can be harmed by some treatments, including
chemotherapy and HIV therapies. Nerve injury has also been linked to excessive
alcohol drinking. Finally, nerve injury can also result through unintentional
consumption of poisons including arsenic, lead, and mercury. This may result in
numbness or weakness in the area that is being impacted.
• Psychological factors: depression, anxiety and psychosis.
Diagnosis
• Computed tomography (CT scan)
• Lumbar puncture (spinal tap) to check for infection of the spinal cord and brain, or to measure the pressure of the
cerebrospinal fluid (CSF)
• Magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA)
• Angiography to take pictures of the brain's blood vessels
• Electroencephalography (EEG) to look at brain activity
• Electromyography (EMG) to test nerve and muscle function
• Electronystagmography (ENG) to check for abnormal eye movements, which can be a sign of a brain disorder
• Evoked Potentials (or evoked response), which looks at how the brain responds to sounds, sight, and touch
• Magnetoencephalography (MEG)
• Myelogram of the spine to diagnose nerve injury
• Nerve conduction velocity (NCV) test
• Neurocognitive testing (neuropsychological testing)
• Polysomnogram to see how the brain reacts during sleep
• Single photon emission computed tomography (SPECT) and positron emission tomography (PET) scan to look at
brain metabolic activity
• Biopsy of the brain, nerve, skin, or muscle to determine if there's a problem with the nervous system
Treatment
• Central Nervous System: While neurosurgeons cannot change the initial damage
to the brain or spinal cord, they can stop secondary damage from happening. The
spinal cord and brain can be released from pressure through surgery. By doing
this, damage is stopped from spreading to other regions.
• Peripheral Nervous System Injuries: The majority of patients recover within
three to six months, but depending on the absence of clinical improvement and
the results of other tests such an ultrasound and electromyography, surgery may
be required. The peripheral nervous system has a higher potential for nerve
regeneration. This is due to the unique sheath, or lining, these neurons have,
which is composed of Schwann cells. These cells are not found in the central
nervous system. Damaged nerves can recover and regain functionality with the aid
of Schwann cells. Damaged nerves can typically regenerate at a pace of 1 inch per
month, or 1 millimeter every day.
Treatment (cont.)
If there is a substantial amount of scar tissue or a space between the cut nerve endings,
surgery is required. In order to improve the function of the nerve, a surgical treatment called
neurolysis removes scar tissue from around and occasionally from inside the nerve. Cut
nerve ends are stitched together using ultrafine sutures or glue during direct nerve repair,
also known as primary neurorrhaphy. With nerves commonly taken from the patient's leg,
cadaver nerves, or synthetic conduits that may be coated with biological components to
promote nerve regeneration, nerve grafting fills wider gaps. In neurotization or nerve
transfers, a healthy nerve is sacrificed by being severed and used as a source of neurons to
hot-wire a more significant damaged nerve near where it enters the paralyzed muscle. This
shortens the recovery period for the muscle and avoids scarring at the site of the injury. To
restore injured nerves, a neurosurgeon may employ one or several surgeries. Not every
patient should undergo nerve surgery. The younger individuals with good general health
who have these treatments have the greatest results. Patients who smoke, are fat, have
diabetes, poor circulation, or have already received radiation therapy perform worse.
Prognosis
A research has shown that the most glaringly obvious negative prediction was a
long duration of symptoms. Young age and early diagnosis appear to indicate
positive results. Personality disorders and emotional disorders had varying
predictive power. In some cases, litigation and state benefits were found to be poor
predictors, but in others, they had no effect on the outcome (Gelauff & Stone, 2016).
References
• Alyssa. (2022, April 26). What are the most common causes of nerve damage? Premier
Neurology & Wellness Center. Retrieved January 12, 2023, from
https://premierneurologycenter.com/blog/what-are-the-most-common-causes-of-nerve-
damage/
• Garad, P. (n.d.). Neurological disorders. Retrieved 2012.
• Gelauff, J., & Stone, J. (2016). Prognosis of functional neurologic disorders. Handbook of
Clinical Neurology, 523–541. https://doi.org/10.1016/b978-0-12-801772-2.00043-6
• Leasure, A. C., Acosta, J., Sharma, R., Krumholz, H. M., de Havenon, A., Falcone, G. J., &
Sheth, K. N. (2022). Abstract 103: Burden of ischemic and hemorrhagic stroke across the
US from 1990-2019: A global burden of disease study. Stroke, 53(Suppl_1).
https://doi.org/10.1161/str.53.suppl_1.103
• Sharma , M. (2014). Treating, repairing the body's electrical system.