Nervous Case Study 2*

 

A 30-year-old female has had several neurological episodes, each separated by several months, in which she experiences brief periods of physical weakness, clumsiness of the legs and hands, visual disturbances, and mood swings.  She described her mood or emotional state to the doctor, stating she was experiencing depression, irritability, apathy, or anger more often. She felt her mental ability was declining.  She also described uncontrolled movements of her hands, feet, face, and trunk. Recently she had begun to experience short periods of akinesia, or loss of movement.  Her motor weakness is most prominent in her lower extremities. CT scans show evidence of multiple lesions in the white matter of the brain and spinal cord. During her last episode, there were increasing neurological deficits due to an increasing number of disseminated lesions. Prednisone (60 mg/day for five to seven days) was prescribed and helped her return to as normal and active a life as possible.

 

Questions:

 

1. Why is there electrical activity in the brain? Describe how nerve impulses are transmitted from neuron to neuron.

 

2. What is myelin? What is its function?  Explain.

 

3. Compare and contrast the structure and functions of the Central Nervous System and the Peripheral Nervous System. How are nerve cells ensheathed with myelin in the CNS? In the PNS?

 

4. What is the demyelinating disease affecting this individual? What makes this disease special?

 

5. Describe how the demyelinating disease causes the symptoms described.

 

6. How does the Prednisone help this individual?

 

7. What other treatments are available to this patient?

 

*adapted from Case Histories in Human Physiology, 3rd Ed. , Van Wynsberghe and Cooley