All about: impaired cognitive [2]

Diseases and conditions

  • What is prenatal stimulation
  • Meningitis: Infection of the Central nervous system
  • Gifted children: how to identify them
  • Cerebral palsy: motor development disorder
  • Parkinson's disease: disease of the central nervous system
  • What is cranial trauma
  • What are brain tumors?
  • What is Vertigo: causes and treatment
  • How to strengthen memory
  • Alzheimer's disease: Pathology Neuro degenerative brain

What is prenatal stimulation

Did you know that talking to your baby when you are in your gut, tell him that you want to see the face, caress you belly and listening to music are very simple but effective ways to stimulate sensory and emotional capacity?
Prenatal stimulation consists of various techniques and exercises that you can work the development of the brain of the fetus, since it has been observed that it increases neural connections. This is their main objective, but these actions also gets the baby's physical, emotional and social development, as well as the emotional bonding with parents.
Prenatal stimulation to ensure maximum benefits, in addition to influencing the senses and emotions of the baby, the well-being of the mother-to-be, must work because his affective state will directly influence the development of the fetus. It is also important that the father is involved in this work, by which, from the outset, the woman should do it part of pregnancy and of the evolution of the baby.
According to Rosa Granero, psychologist expert in early and collaborative care of Center Monica Carreño matrons, "first-time parents are showing more interest in prenatal stimulation and spend much more time to do it right."

Does prenatal stimulation have scientific basis?

Prenatal stimulation is included in what is known as prenatal and perinatal psychology, branch of psychology of work this period of human development. It is very developed in European countries like Germany and the United Kingdom, and also in the United States, and is gradually beginning to take off in Spain in the hands of the Spanish Association of Perinatal Psychology (AOS).
This specialization helps women in preconception, gestational and postnatal stage to achieve greater physical and mental well-being that will affect the baby's health. And, it is shown that the fetus begins to develop their sensory and emotional capacities in the womb, and therefore is should seek to make this environment in a suitable place.
There are many studies that support that prenatal work has broad benefits to the fetus, and that can be worked the different senses (sight, hearing, taste and touch) and emotions, on all links with parents and with the outside world, with simple exercises.

Benefits of prenatal stimulation

The prenatal stimulation offers benefits both baby and mother. Rosa Granero, explains psychologist expert in early and collaborative care of Center Monica Carreño matrons, "prenatal stimulation is the possibility of creating a physical and emotional environment that promotes the health and well-being of the fetus", which is crucial for their physical and psychological development. But this benefit is achieved by working with the mother from the beginning of pregnancy, whereupon she will also be able to take advantage of these exercises.

Benefits for the mother

Some women tend to live the first trimester of pregnancy with some stress because of all the changes that are taking place in your body and in your personal situation, and even professional. It is the time of assimilation and is not always easy. As a result of this stress, the body secretes certain hormones (adrenaline and cortisol) that can adversely affect the development of the fetus (preterm, irritable children weighing less than normal, hyperactivity, increased susceptibility to colic). "Prenatal stimulation helps reduce the levels of these hormones that cause stress and alertness, and replaced by endorphins (hormone of happiness), which predisposes to having babies more awake, curious, relaxed, less weeping, easier for concentrate, or more flexible to interact with environment-minded", says Rosa Granero.
Although at this stage when the pregnant woman is often tense, prenatal stimulation is advisable in any period of pregnancy in which they have to deal with concerns, for example in the second trimester women tend to be worried about the State of health of the baby, and in Q3 they are usually nervous because approaching the moment of childbirth therefore "with very simple exercises, women can mitigate this uneasiness and get relax, which will favour the development of the future baby," says the psychologist.

Benefits to the fetus

On the other hand, are activities directed exclusively to the fetus. In this regard, there are indications that babies that have been stimulated prenatally, have a score of ten points higher IQ with regard to babies who have had similar social conditions but have not been stimulated.
According to this expert, the senses of the baby should begin to work from the fourth month to be optimal. Thus, in general, favors brain development and encouraged the sensory receptors, but there are many other specific benefits:
  • It increases the safety of the babies.
  • It reinforces the emotional bond with parents.
  • It facilitates the adaptation to the outside world, reducing the anxiety of the baby when it is born.
  • It improves the balance.
  • It predisposes to have children more peaceful, curious, awake...
To achieve these benefits, it is important that stimulation exercises are carried out in due course because "the areas of the brain have their level of maturity and if we stimulate until they are ready we run the risk that, while there is the learning and achievement of that function, will never be as optimal as make it when the timing of maturation" , indicates Rosa Granero.
This expert also argues that excessive stimulation of the baby is counterproductive, and that to prevent this from happening the parents should try not to become obsessed with this topic and alternating moments of tranquility and activity. "You must be aware of what is important, pay a little attention to the environment, remember to baby, and connect to it."

Techniques of prenatal stimulation for the well-being of the mother

Although the final beneficiary of prenatal stimulation is the fetus, there are techniques aimed at the welfare of the mother, reporting indisputable advantages to the baby.
The activities aimed at the well-being of pregnant women are especially in the first trimester of pregnancy. Among them are:
  • Gymnastics for pregnant women (walking, swimming, stretching...). These exercises may not pose an effort too much even for the pregnant woman or to the fetus; they must promote respiration and flexibility, and work the appropriate muscles to support weight gain is going to produce. With them you get improve mood, maintain agility, and sleep and rest better.
  • Yoga. This activity allows the woman connected with his own body and help take confidence despite the changes.
  • Pamper yourself. Pregnant women have to do activities that will please you and make you feel good. It should work with exercises that are easy to take in their everyday lives: massages, relaxing bath, listening to music, etc. In this way increases the feeling of wellbeing and pleasure, to be transmitted to the baby through the endorphins or hormones of happiness.
Stimulation through daily routines. Exercise at certain times of the day, for example listen to music at bedtime, favors the person gets used to having a routine at a certain time of the day, getting the baby to learn to associate stimuli (are you is indicating with this exercise, when the mother listening to music it will always spend the same) assimilate changes (we are in a State of more stress, but I listen to music and relax the body of my mother), and prepare for the birth, for the changes that will occur when it is born. Techniques of prenatal stimulation for the senses of the baby
In the second and third trimester of pregnancy prenatal stimulation techniques are made directly to work the emotional and sensory capabilities of the fetus, and the stimulation of the senses of the babywill work. At 16 weeks of gestation, the fetus can already perceive bright lights, with which visual stimulation can start. A fourth month the senses of touch and taste of the baby are already well developed. And from the fifth month, will begin with the auditory techniques.
It is recommended alternate exercises. Work a day a touch exercise and massage, and other days employ techniques auditory or Visual; so you should go combining according to consider, without losing sight that "the most important stimulus is communicate with baby, talk and send positive messages about the wait. It is also crucial to create a proper, peaceful, happy and pleasant climate in the family", emphasizes the psychologist expert in early and collaborative care of Center Monica Carreño matrons, Rosa Granero.
Visual techniques
  • Games with a flashlight. With the flashlight on, bring it closer and away from the gut. You can also make smooth movements so the baby can follow the light.
  • Uncover the tummy seconds to soak up the Sun.
With these exercises cognitive stimulation works, stimulates the eye retina in order that go adapting to light, and prepares you for the birth because it works so you distinguish between clarity out of the gut and the darkness that exists in the womb). Also stimulates their curiosity and attention.
Auditory techniques
From the fifth month ear reacts to the voice of the mother. In this sense, there are studies of the 1980s, as the of the psychologist Anthony De Casper, who corroborated before birth the child has the ability to perceive and remember speech sounds and recognize a narrative that has heard repeatedly from the uterus. Therefore, to stimulate the hearing you can perform different activities:
  • Listen to music at a suitable volume helps the fetus to connect with the outside world, and to encourage learning and the development of the intellect. Depending on the type of music the baby will lead in one way or another. "Listen to soft music's reassuring him, the instrumentation is the most advisable; Baroque music increases the concentration and music more intense, for example rock, excites you,"says the psychologist Rosa Granero.
  • Talk to the baby several times a day, for example, in the morning and at night, and a more dilated after lunch time. This would stimulate the senses, as well as develop their intelligence and work the emotional link. "Talk to the baby wanted and expected which is and convey expected him lovingly and which is a desired arrival, it will impact positively on the development, on the understanding, especially emotionally;" also is having a calmer baby", says the expert.
  • Listening to nature sounds. Most of the time the routine of every day we deprived of sounds from our environment. Be aware of sounds and silences helps the fetus to connect with the outside world, in such a way that when born the adaptation will be more simple. It is a preparation for the birth.
Techniques to stimulate touch
  • Pat the belly with the palms of the hands.
  • Touch the belly with fingers in different positions.
  • Massage the belly with the knuckles using circular movements.
  • Play with the baby. When baby gives a kick is available to answer by pressing gently on the area where it has been hit. This creates an interaction, and in addition the link works.
  • Using different textures, pass a bristle brush or a soft brush.
Techniques to stimulate the taste
We noted that the fetus is able to distinguish different flavors. In fact, there are studies showing that the baby reacts to the taste of amniotic fluid substances.
Motor techniques
With these techniques work especially the balance through the different body positions of the mother, and perception and discrimination of the movement, to be able to differentiate when the mother is in motion and when the baby stopped.
  • Swing on a swing.
  • Practice swimming.
  • Performs dancing slow and gentle.

Meningitis: Infection of the Central nervous system

What is meningitis?

Meningitis is an infection of the central nervous system. Neurological infections are one of the most serious medical problems, because the survival of the patient depends on fundamentally that it detected early way to proceed immediately to specific treatment.
The significance of different infections of the nervous system is highly variable. While it is true that there are some that only require bed rest, the most important are those in which the patient's life is in real danger, or may leave important sequelae which renders the patient forever.

Central nervous system

The central nervous system consists of the brain, the cerebellum, brain stem and spinal cord. The first three structures form the brain. All of this is protected by bone, in particular by the skull and spine. In addition, the nervous system is covered by three membranes called meninges, which are located directly over it and provide additional protection to the bone. On the inside of these membranes is the cerebrospinal fluid, which works as a cushion from injury.
Meningitis is defined as inflammation of the meninges, with consequent alteration of the cerebrospinal fluid. This liquid is very important for the diagnosis of meningitis, because its appearance will change, or not, depending on the type of microorganism that produces the box.
Meningitis is accompanied, at times, a process of inflammation of the brain that can lead to a decrease in the level of consciousness and other symptoms that suggest a more severe. When it happens this is known as meningoencephalitis.

Causes of meningitis

The best-known form of meningitis, its intense gravity, is the cause bacterial. But there is another type of infections that can also reach the nervous system and cause meningitis. In this way, other possible causes of meningitis are viral infections (caused by viruses), which are the most common and most benign; and fungal oirgen (caused by fungi such as candida or cryptococcus, and which are much more uncommon).
There are other types of meningitis which are non-infectious cause; i.e., are microorganisms that cause inflammation, but certain diseases, tumors, parasites, or reactions to drugs that do not usually found in the cerebrospinal fluid. This group of meningitis is very rare, and much less important than the infectious type.
The meningitis of viral origin, the most common, are due mostly to enterovirus (intestinal infections cause), although it can also occur by viruses herpes, HIV, mumps, or even West Nile virus. Many people have viral meningitis in the course of their lives and are not aware of it.

Types of meningitis

One of the most important points when it comes to diagnosing meningitis is to distinguish whether the cause is bacterial or viral, because the survival of the patient is not the same in both cases and, therefore, the therapeutic approach will be different depending on one way or another. Existing types of meningitis are:

Viral meningitis

This form of the disease usually involve much less risk to the patient's life. This type also is known as aseptic meningitis because studies responsible for demonstrating the presence of micro-organisms in samples generally tend to give negative.
There are several types of viruses that are capable of causing a meningitis box. The most common are the so-called enterovirus, but herpes simplex virus is also important.
The viral form of meningitis usually presents a more mild than the bacterial clinic. They usually present with fever, headache and, sometimes, present any symptom that is closer to the clinic of the bacterial form, but less intense. This box is usually disappear in a few days. In general, they are benign processes attending without complications, and treatment is limited to relieve the symptoms of the patient. However, be to highlight that meningitis caused by the herpes simplex virus should receive special attention, as it is more frequent that it complicated with encephalitis, where inflammation reaches the brain and causes major neurological alterations, which can incapacitate the patient's lifetime. That is why, at the slightest suspicion concerned of a herpes simplex virus he is added to the normal treatment specific for this virus, and submits the patient to a strict observation.

Bacterial meningitis

This is the best known form of the disease. Different microorganisms that can cause this type of infection depend on the age of the patient and other factors as, for example, the State of the immune system of the patient. This system is responsible for protecting the human body from external aggressions such as infections; malfunctioning implies a greater predisposition to allergies.
Among all the bacteria responsible for meningitis include:
  • The Streptococcus pneumoniae or Pneumococcus. It is the most common cause of meningitis. This bacteria often colonizes the pharynx of the people without giving any kind of disease. It can be found in 5-10% of healthy adults and a 20-40% of healthy children. However, sometimes, the immune system is not able to control its growth and reach the meninges through blood, or directly by contiguity when there is an infection of the sinuses for nose (sinusitis) or the middle ear (otitis media), or a skull fracture after trauma. The pneumococcus can also be the cause of pneumonia (pneumonias), which occasionally may be associated with meningitis. Pneumococcal meningitis can occur at any age. It is more frequent that occurs in people with some deficiencies of the immune system (e.g. treatment with immunosuppressant drugs,) or people with disorders of the spleen, in diabetics, alcoholics, people with kidney or liver failure, people malnourished, or after a trauma in which skull fractures occur. Its mortality rate is very high. There is a vaccine that covers some serotypes of pneumococcus, which has lowered the incidence of meningitis pneumococcal in children.
  • The Neisseria meningitidis or meningococcus, which is responsible for many of the epidemics of meningitis, especially in children and young people. The meningococcus can colonize the pharynx of many people without disease. Meningitis can occur in people with a disorder of the immune system, but frequently also occurs in healthy people. There is an effective vaccine against meningococcus, but unfortunately does not cover all the serotypes that are of this bacterium.
  • In the newborn and elderly bacteria causing this disease can be totally different from those of the rest of the population. For example, in newborn babies can be meningitis by a bacteria called Streptococcus agalactiae (also called Group B Streptococcus). This is a bacterium that colonizes the female genital tract and can infect to the newborn during childbirth. Fortunately, the study and eradication of this bacterium in pregnant women has decreased the incidence of this complication. In children under five years was common meningitis by a bacterium that is found in the respiratory tract call Haemophilus influenzae type b. Childhood vaccination has greatly diminished this disease. Children, the elderly, pregnant women, and some immunocompromised, may suffer a meningitis by a bacteria called Listeria monocytogenes. It is often associated with the consumption of dairy products and some raw vegetables and has a poor prognosis.
As we see, it is very important to take into account the age and State of health of the patient to begin managing the treatment for a suspected meningitis.
From this point, the information that follows will refer mainly to cause bacterial meningitis.

A meningitis diagnosis

Bacterial meningitis is a medical emergency. The more time has elapsed since the onset of the disease until the establishment of the treatment, the bigger the risk of permanent neurological damage. The seriousness of this infection is much higher in infants and the elderly. Suspected meningitis should the necessary antibiotics promptly and collect blood samples for crops. A crop is a diagnostic method that favours the growth of micro-organisms for the identification of the bacteria that cause the disease. In the diagnosis of meningitis more relevant data is going to get with the lumbar puncture. This will be as soon as possible, except that its realization is not indicated.
Physical examination
Before a clinical picture compatible with meningeal infection, is to perform a thorough scan of the patient looking for signs of infection, especially at the level of the head, neck, ears, and skin. A neurological examination that study the level of consciousness of the patient and the existence of intracranial hypertension (increased pressure inside the head) is conducted. The same appropriate maneuvers will be carried out to detect the presence of nuchal rigidity and meningeal signs.
Imaging tests
As diagnostic tests x-ray of the chest, sinuses, can be made to look for an infection to that level (sinusitis) that has spread to the nervous system, and a CT scan (computed axial tomography), which is not always indicated. However, definitive diagnosis will probably require an analysis of cerebrospinal fluid obtained by lumbar puncture.
Lumbar puncture
Examination of the cerebrospinal fluid is the pivotal study. In normal conditions it is a liquid clear and transparent. In the case of bacterial meningitis, its appearance is cloudy and their analysis shows a significant increase of leukocytes (white blood cells). It can be cultivated part of the liquid to determine the type of disease causing microorganism.
When there is suspicion of intracranial hypertension do a spinal tap, because it can lead to severe complications. In these cases, is previously a cranial CT scan to rule out hypertension and, if any, appropriate measures shall be taken.

Treatment of meningitis

Bacterial meningitis is a medical emergency. Given that the defenses of the patient are little or nothing effective to control the infection, the Elimination of microorganisms will exclusively depend on antibiotic treatment. For this reason, acute bacterial meningitis should institute immediate antibiotic treatment.
The type of antibiotic that is chosen to treat meningitis depends on the bacteria that causes the infection. As this disease is very serious, not to expect the results of the culture of the cerebrospinal fluid, which can take days. Why is usually to establish antibiotic treatment depending on the bacteria that most likely is causing the box, based on the age of the patient. The antibiotics most used in bacterial meningitis are third generation cephalosporins, since they cover the majority of microorganisms that cause this picture. Once the bacteria that caused the infection is known, is a more specific antibiotic administration.
In many cases, in addition to antibiotics, it is necessary to administer treatments for cerebral edema that occurs, to seizures or dehydration. Corticosteroids are useful to reduce brain swelling and it has been shown that, especially in children, they reduced the number of complications.
If it has accumulated fluid between the meninges, it may be necessary to drain it or remove it surgically.

Prognosis of meningitis

Mortality from bacterial meningitis, or the possibility of sequels, depends largely on the pathogen causing and the age of the patient. Mortality is very high in children under one year, decreases in adulthood, and again increase in elderly. The mortality estimated according to the pathogens are as follows:
• Pneumococcal meningitis: 20-30% in adults and 10% in children.
• Meningococcal meningitis: 3-13%.
• Meningitis by Haemophilus influenzae: 3-6%.
• Meningitis by Listeria monocytogenes: 15-29%.
In the forecast also influences the clinical condition of the patient before the meningitis, the severity of the clinical picture and the early establishment of an appropriate treatment. Bacterial meningitis that receives no treatment is lethal in nearly all cases. However, if it is early and properly, mortality is generally less than 10%.
After meningitis cure, between 5 and 20% of the patients presented some type of neurological sequel. Neurological sequelae are more common in young children, elderly, and pneumococcal meningitis. In childhood, the most frequent sequelae are deafness, mental retardation and epilepsy.
On the other hand, the meningitis caused by viruses, encephalitis, prognosis is very good. Usually heal without sequelae in the vast majority of cases. The outcome can be worse if occurs in people with any underlying disease or any immunodeficiency, or if it occurs in elderly or small children.

Preventing meningitis

Today many children are vaccinated against meningitis-producing bacteria most.
In this way, there are vaccines against pneumococcus, meningococcus and Haemophilus influenzae. However, the meningococcal vaccine is not fully effective, because it does not cover all strains of the bacteria that causes meningitis.
In the meningitis meningococcal should be given antibiotic treatment to persons who were in close contact with the patient: the family and workforce exposed, the closest companions of daycare or school (according to the age of the patient).
In case of an outbreak caused by a type of meningitis for which there is a vaccine, vaccination is also recommended to people who have had close contact with the sick and who are not properly vaccinated.
Also be treated with an antibiotic to the family and colleagues of care of patients affected by meningitis caused by Haemophilus influenzae.

Gifted children: how to identify them

Some parents realize that their children are certain attitudes or perform certain actions much older children. They are children before learning to talk and walk, that are very well expressed for his young age, showing a keen interest in the environment and curious about new things, that have a motor fine well developed and earlier than usual... But not all talented or precocious children are gifted, you will learn what are the characteristics that define a gifted child, and what to do if you discover that your little brainpower is above average.

When is a child gifted?

According to the World Health Organization (who) gifted is a person with an IQ above 130, although today Spanish legislation requires three conditions so that a child is qualified as such: an IQ equal to or greater than 130, high-performing and great creativity. If any of these factors does not appear, you can not speak of giftedness.
According to the Superior Council of experts on high capabilities of the Universidad Francisco de Vitoria, to achieve optimum productivity combining creativity with emotions such as empathy, affection, intelligence and motivation is essential.
IQ never decreases and increases medium or a point annually until reaching age 18 or 20 years of age. Ideally, according to all the experts, is that the gifted child grows in a proper family and school environment that allows you to develop that potential.
The great unknown is the role of the genetic factor in the intellectual giftedness. Ricardo Sanmartín, President of ASENID (Spanish Association of gifted children, and psychologist specialist, points out that "have been cases of several gifted brothers, the same way that in the same family have been found a gifted and a deficient. There are many theories about it trying to discern if the intelligence is acquired or is environmental. I think that intelligence was born and made."
In our country there are about 300,000 gifted students, although the majority (up to 98%) are not diagnosed, according to the report early, gifted and gifted students, conducted by the center of research and educational documentation of the Ministry of education and culture.
If you want to know if your child has this capability, you can make our test: could it be my gifted child?

Characteristics of the gifted child

Although gifted children are early in one or several areas, should not think therefore that all precocious children are gifted. The precocious child is one who has a premature competition with respect to the average population of age, but does not have to be necessarily smarter than the rest.
To know if your child has a gifted, or only shows a precocious talent in an activity of interest to you, it is best that you observe your behavior to detect if you have some of the following characteristics of gifted children:
  • They often learn to read before their peers and greatly enjoy the pleasure of reading.
  • Feel a great curiosity to know, what leads them to consult dictionaries and encyclopedias.
  • They have a wide vocabulary.
  • Early psychomotor development is presented.
  • Great capacity for reasoning, abstraction and concentration.
  • They learn and understand quickly and easily.
  • They have bad handwriting, to boast of it.
  • They have good sense of humor.
  • Imagination and fantasy. Great creativity.
  • Extraordinary sensitivity.
  • Empathy.
  • Self-reliance, perfectionism.
  • Do not like teamwork, proving to be very individualistic.
  • They are effective in their results.
  • They are equipped with a flexible thinking.
  • They tend to be generous and show is very sensitive to injustices.
  • They have safety and persuasive.
  • They are popular with colleagues and friends.
  • They do not withstand impositions not reasoned.
  • They prefer to talk with adults and play with older children.
  • They tend to show a great need for recognition and success.
  • They do not withstand the lack of progress or routines.

Diagnosis of the gifted child

Although it seems a contradiction, if it does not receive adequate stimuli, greater intellectual capacity of the gifted child can become a disadvantage for him at school, because he is bored, gets frustrated, and can remain absent, and not attend the explanations of the teacher, or also rebelling and refusing to abide by the rules.
Ricardo Sanmartín, President of ASENID, advised to go to an association if there have been some of the symptoms that point to a possible intellectual giftedness, but clarifies that "the first thing we asked parents is if teachers have seen something, because the criterion of a professor is an objective criterion and we do trust us more than one comment from a teacher that the appreciation of parents".
Sanmartin advises "do the psychopedagogical evaluation, consisting of nine tests. Ideally before age five". It delivers a report to parents with the results. "In the case that demonstrated the giftedness of the student, is informed parents of steps for official accreditation by the corresponding educational administration", added the Chairman of ASENID.
All the experts agree on the need for a diagnosis, for what is required the collaboration of the family and the school (teachers and guidance team), as well as power go to other specialists, or the various associations that exist in Spain.
Although they are children who learn easily, if the teaching plan is not appropriate there is a high probability of school failure or, at least, of a low academic performance. Half of the gifted suffer school failure. In addition, they also tend to appear problems of sociability, the absence of social models that identify themselves. Hence the need for a diagnosis, to determine how much before if a child is gifted and establish a plan of action.

How to help and educate a gifted child

According to the Superior Council of experts on gifted, gifted children, besides being faster to others, to act otherwise, since they think, feel, learn, and see situations and conflict from a different perspective, which leads them to deal with them and resolve them in a different way. It is necessary, therefore, to enjoy services and educational programs, in order that its high capacity is effectively and efficiently for themselves and for the rest of society.
Thus, if the child reaches gifted rating (although the organic law of education of 2006 uses the term of "gifted student"), may play host to the program that collects the current law, which consists of:
  • Acceleration: i.e., skip a course.
  • Curriculum adaptation: which is based on maintaining the child in his group, but providing more complex contents, always within your level and never advancing knowledge to be addressed in higher grades.
Currently, granted few accelerations and tends to curriculum adaptation.

Tips for parents of gifted children

Once the academic subject, parents should not forget that, despite their superior intelligence, your child is still a child, and in the family have to provide everything you need so that you can develop to its full capabilities, while continuing to enjoy their childhood. Experts recommend that:
  • Be allowed to grow and develop emotionally and socially as any other child of his age.
  • It is preferable to not label him as genius or different, to avoid that sits as a rare species.
  • Comparisons should not be with other siblings or friends of different intellectual condition.
  • It is convenient that it related to children of the same age.
  • Parents should work with tasks assigned especially for him by the school.
  • It is advisable to provide resources and materials to meet your talents and concerns, but without subjecting him to any kind of burden.
  • It is very positive to encourage their participation in the areas of interest that demonstration, stimulating him to satisfy his curiosity.
  • Enjoy cultural activities family, talk about current events, or share moments of reading, helps to satisfy your craving to learn of a way to emotionally very enriching.
As says the psychologist Ricardo Sanmartín, "the ideal is sure a gifted child in a family and school environment that enhances, not to mention give you many kisses and treat him as a child".

Cerebral palsy: motor development disorder

What is cerebral palsy?

Cerebral palsy (CP) is a disorder in the motor development of chronic and non-progressive, secondary to brain injury, usually produced during intrauterine growth, but that may also occur at the time of delivery (by lack of oxygen during the period of expulsion, for example), or during the first two years of the baby's life, while your brain is still developing (trauma infections...).
It is not a specific disease, but a Group of disorders of varying causes, which may be very mild or very severe symptoms. Lesions of cerebral palsy are translated in a difficulty to control the functions of the motor system, and the affected can present spasms or muscle rigidity, involuntary movements, lack of coordination, or disorders in posture or mobility of the body. Depending on the extent and location of the lesion, there may be other problems such as mental retardation, difficulty speaking or learning, or Visual or hearing impairments.
It is estimated that two of every thousand people suffering from cerebral palsy, a percentage that rises to 10 of every 1,000 when it comes to premature or low birth weight. This prevalence is stable in developed countries, but thanks to advances in treatment and care, the life expectancy of those affected has increased in recent years, so the number of patients has increased.
Causes of cerebral palsy
In the majority of cases the injury occurs during pregnancy because of intrauterine infections, vascular processes, brain malformations, genetic causes, etc.
It has been shown that more than a third of affected children weighing less than 2.5 kg at birth, cerebral anoxia (lack of oxygen), making it the likely cause in these cases is usually complicated by internal bleeding associated with prematurity and low weight. Trauma in childbirth is also a possible cause.
Less than 10% of cases are due to problems arising after the birth of the baby to term, and possible causes include: meningitis, encephalitis, severe infections, trauma, vascular accidents...
In some cases it is not possible to determine the cause of cerebral palsy.

Symptoms of cerebral palsy

The symptoms of cerebral palsy - that vary significantly from one patient to another, so there are not two equal cases-, are usually seen before two years of age. Affected children show delays in their ability to sit, turn, reach an object, crawl, stand... The clinical classification of patients with cerebral palsy is based on observed characteristics in affected children, which are related to the type of motor disorder predominantly and the extent and severity of the same, the presence of other associated disorders (frequently be observed also behavioral, cognitive, sensory disorders, mental retardation, epilepsy...), the causes of injury, etc. Among the most common presentations:
Spastic cerebral palsy
As quadriplegia, diplegia, paraplegia, hemiplegia or Monoplegia, it is the form of more frequent paralysis, and common clinical manifestations include hyperexcitability and the abnormal persistence of neonatal reflexes. These demonstrations make fists remain firmly closed, that there are reflexes tonics of the neck, often maintained constantly, and positions of extension when it is held vertically to the child (back arched, and rigid extension and internal rotation of the legs). Spasticity and stiffness is van showing to grow the patient, and frequently give rise to abnormal postures of limbs and contractures.
  • In the spastic quadriplegia, the most severe form, the four members are affected. The child has mental retardation associated with (more than 90% of cases) and frequent seizures.
  • In spastic diplegia are affected four members, although it is much more intense in the lower extremities. Intelligence is usually normal, but the apraxias (inability to carry out movements of purpose, learned and family) that hinder learning are frequent.
  • Only the lower extremities are affected in spastic paraplegia .
  • Spastic hemiplegia manifests itself in the third part of the diagnosed children and affects one side of the body. Frequently there is a homonymous hemianopsia (vision loss partial or complete of one half of the visual field in both eyes), and hemisensory deficit (lack sensitivity in the affected half of the body). It is limp and posture which adopts arm flexion maintained when is prone forearm (showing the back of the hand) and the wrist is flexed.
  • Monoplegia is limited to limb weakness. It is very rare.
Cerebral palsy/dyskenetic
It is less frequent than the spastic PC, and is characterized by involuntary movements, persistence of archaic reflexes and abnormal postures, movements and hypotonia (decreased muscle tone) in childhood coreoatetosicos and dystonias (movement disorders).
These patients tend to have affected the buco-laryngeal muscles, causing them to speech disorders. Also they can suffer from deafness, which might imply, wrongly, in the existence of profound mental retardation; only intellectual capacity after multiple scans can be assessed.
Ataxic cerebral palsy
Infrequent a form of cerebral palsy (5-10% of cases), which is characterized by hypotonia, lack of coordination of movement and balance deficit. In congenital cerebellar ataxia appear hypotonia and tendon reflexes during lactation. The tremor and ataxic gait are developed from the second year of life. There may be an associated mental deficit, but mild.

Diagnosis of cerebral palsy

There is a specific test to detect if a child suffers from cerebral palsy. To diagnose the disorder, doctors generally observe the development of the child and the clinical manifestations.
The definitive diagnosis, which includes all the factors involved: degree of affectation, causes, type of motor disorder and other associated disorders presenting the patient, requires specific evidence such as brain magnetic resonance imaging, and it takes time.
Severely affected infants may have generalized cerebral atrophy (brain size diminishes because cells are missing).
Diagnostic diferencialde cerebral palsy
It is necessary to differentiate the cerebral palsy from other diseases that present with similar symptoms such as the leukodystrophies. In borderline cases, lumbar puncture is used. Check that the cause of the spasm is not Hydrocephalus or a tumor in a cerebral hemisphere.
When the spasms and weakness affect lower neck muscle groups should take account of spinal cord injuries. The spastic diplegia is confounded with muscular dystrophy. The atonic diplegia should differ from neuromuscular diseases of childhood, as Werdnig-Hoffman disease and benign congenital hypotonia. Congenital cerebellar ataxia should be distinguished from a series of progressive cerebellar degenerations.
If there is more than one individual in the family with motor deficit we must think in a disease other than cerebral palsy, there is no family "cerebral palsy".
To determine the diagnosis of cerebral palsy will have to meet three requirements:
  • That disorder is permanent.
  • Be of cerebral origin.
  • It's not progressive.

Treatment and prevention of cerebral palsy

Cerebral palsy has no cure; the treatment is multidisciplinary, and its objective is to achieve the greatest possible degree of physical development and social integration of those affected. It should be focused to three lines of action:
  • The motor disorder treatment: to improve the mobility of the patient and prevent and treat associated deformation and/or the sore. To achieve this techniques of physiotherapy and occupational therapy, orthotic devices, surgery, and drugs are used to reduce seizures or relax the muscles.
  • Prevention or diminution of the effects that has the motor disorder on the overall development of the child: during the first years of life, learning and the relationship of the child with its surroundings are directly related to your ability to move. Their displacement and the manipulation of the objects help you know your environment, and motor limitation deprives you of this knowledge, hence the importance of an early therapeutic care that improves the autonomy of the patient and their possibilities of communication.
  • Treatment of associated disorders: whether sensory deficits (hearing loss, impaired vision...), epilepsy (very frequent in these patients), eating disorders, breathing, sleep, delayed growth, mental retardation, learning disabilities, etc.
In the majority of cases it is not possible to prevent brain injury which causes disorders grouped under the denomination of cerebral palsy, although appropriate prenatal controls partners, can be prevented to some extent risk factors as prematurity. Also improvements in therapeutic control of the newly born premature and multidisciplinary care are very effective to detect and treat early disorder and the problems associated with it.
The life expectancy of a child with cerebral palsy largely depends on the intensity and severity of brain injury presented associated disorders, and age to begin therapeutic intervention. Family response to the situation and the availability of adequate educational and therapeutic services are of vital importance in the evolution of the patient.

Parkinson's disease: disease of the central nervous system

What is Parkinson's disease?

Parkinson's disease or Parkinson's (PRK) is a chronic and degenerative disease of the central nervous system that affects an area of the brain called the basal ganglia, whose function is to act as a support system in the production and control of movements, both voluntary and involuntary.
Parkinson's develops a so insidious, slow, generally between 55 and 60, although the lower age limit for the disease is 35 years. Evolution is progressive, although variable. It is not a deadly disease, but it is still incurable.
Causes of the Parkinson's disease
In an area of the brain called the substantia nigra, there are a number of neurons (nerve cells) in a darker color than the rest, whose function is to produce and secrete a very important substance for the control of movements: dopamine.
In the "gateway" to these basal ganglia, which is called core striated (EST), receptors that dopamine acts are. When the dopamine receptors have been activated, produce a series of biochemical changes that allow the proper connection with the rest of the components of the basal ganglia, regulating the activity of the same. This complex function only takes out correctly when there is a perfect balance between all the components involved.
When this process occurs properly, the individual is able to keep under control voluntary movements that is say, those who "want to do"-, but also allows you to maintain inhibited involuntary movements--those who "don't want to" carry out-, and thus prevent their emergence.
When develops parkinson, black neurons responsible for the release of dopamine degenerate and, consequently, stop producing the neurotransmitter, or make it less. When this occurs, the regulation of basal ganglia is not adequate, and other components and substances of the nodes do not work in the required manner, resulting in a lack of control of movements: voluntary movements do not carry out in the desired shape, resulting in the appearance of one of the most striking signs of Parkinson's : hypokinesia (decrease of voluntary movements).
Some of the symptoms that occur in this disease are intensified by the presence of acetylcholine, a neurotransmitter antagonist to dopamine which intensifies their effects by reducing the level of this.

Symptoms of Parkinson's disease

The symptoms of Parkinson's, they include:
  • Hypokinesia: due to the decrease in dopamine. Slowness of voluntary and automatic movements. Lack of facial expression. Slow writing and small (micrograph). Clumsiness in handling objects.
  • Tremors: slow and rhythmic. Predominate in resting State and decrease when performing a voluntary movement. It is a symptom not necessarily all parkinson's patients, experiencing them although his presence is very important, since the diagnosis of Parkinson's disease is very difficult when there is trembling.
  • Muscle stiffness: resistance to move extremities, muscle hypertonia. Referred to as 'cogwheel' stiff because, although the Member presents resistance to be moved from one point resistance disappears and the movement is easy. Is it due to the lack of dopamine to allow exaggerated action of another substance contrary to this, acetylcholine, which stimulates the muscles and difficulty in movement.
  • Posture abnormalities: inclination of the trunk and the head forward. Elbows and knees are as cramped.
  • Walking abnormalities: gait is slow, with a tendency to drag your feet, and alternating with short (accelerating) with difficulty and quick steps to stop. Parkinson's patient suffers episodes of lock in which feet appear to be stuck to the ground, as if they were frozen or magnetized.
  • Disorder of balance: altered reflexes, easy to fall.

Other symptoms of Parkinson's disease that does not affect the movement

While it is true that the symptoms and signs related to the movement, posture, and balance are the most frequent and easy to identify, they aren't the only ones who a person diagnosed Parkinson's disease can develop:
  • Depression and anxiety: many diagnosed parkinson's patients may develop depression or anxiety, as well as sudden mood changes.
  • Cognitive disorders: loss of memory, confusion, difficulty concentrating.
  • Decrease in some senses, such as smell.
  • Dull pain and discomfort in the extremities.
  • Sleep disorders: daytime sleepiness and frequent NAPs. The hypokinesia and rigidity can make it difficult on the nocturnal sleep, especially when getting up from the bed, turn on or change their stance.
  • Fatigue.
  • Gastrointestinal problems.
Many of these disorders are due to degeneration of the basal ganglia function can end up affecting structures located near the brain.
One of these structures is the brain stem, where the thalamus, which regulates important functions as some of the senses and the nerve sensations that reach the brain (thalamus is known as the door of consciousness). Other structures that regulate the smell, breathing movements, the functions of the heart or blood vessels can also be affected: the bulb and extrusion.

Risk factors for Parkinson's disease

The cause which causes Parkinson's is not known, but it is accepted that there is a confluence of factors (multifactorial) that can help to trigger the disease.
Some of these risk factors for Parkinson's disease are:
  • Positive family history (genetic component).
  • Male: women are less likely to develop the disease.
  • Head injury: trauma, shock in head (boxers Parkinsonism).
  • Exposure to pesticides.
  • Consumption of drinking water and rural residence.
Other risk factors linked to Parkinson's disease less frequently are the consumption of coffee, smoking, use of nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen, indomethacin...) and hormone replacement therapy in postmenopausal women.

Types of Parkinson's

There are several types of Parkinson's. The main difference is the cause of the outbreak of the disease, since the most important characteristics are common to all types, regardless of the cause.
The most common forms of the disease can be classified into:

Primary Parkinson

Primary Parkinson's disease is one that is purchased outright. It is not caused by a chemical or other pathology. Various types of primary Parkinson's can be distinguished:
  • Family or genetic. Quite rare.
  • Idiopathic or sporadically. It has genetic basis. It is the most frequent.
  • Associated with other neurodegenerative process: Alzheimer's disease with Parkinsonism; atrophy or degeneration of other basal ganglia-related structures...
  • Genetic disorders that can cause manifestations of Parkinson's time: Wilson disease (a disease of the metabolism of copper of genetic origin, which makes this accumulate in the Central nervous system, liver and other organs); Huntington's disease...
  • Other disorders: of vascular origin (in the blood vessels that feed the basal ganglia, the substantia nigra, striatum core); Hydrocephalus; cerebral palsy.

Secondary Parkinson

Secondary Parkinson's is the one who is motivated by another disease, drugs or toxic:
  • Repeated head trauma: as you develop some boxers, because the blows received repeatedly.
  • Diseases infectious or post-infectious: as neurosyphilis (is the moment in which syphilis affect the brain); or Parkinson's that can develop in the period of time after an encephalitis (infection of the brain).
  • Metabolic diseases.
  • Drug-induced Parkinsonism: it is very important, since possibly the most frequent reason for development of symptoms of secondary Parkinsonism is the consumption of certain drugs, whether they are by prescription as for self-medication. There are several medications that can cause the appearance of these signs and symptoms. But, usually, the symptoms go away when you stop taking the medication that is producing them. Among the drugs that can cause parkinson: some antipsychotics and Neuroleptics (medications used for certain mental illnesses); some antiemetics (for vomiting), such as metoclopramide; Alpha-methyldopa (for hypertension); (for bipolar disorder) Lithium Carbonate; valproic acid (an antiepileptic)... It is necessary to always consult your doctor or pharmacist if you suspect that any medication is causing symptoms or signs of parkinsonism.
  • Toxin-induced Parkinsonism: cyanide, methanol and carbon monoxide.

Diagnosis of Parkinson's disease

In the absence of any type of marker that is say, something that can be seen in an analysis - to serve for the diagnosis, Parkinson's disease is diagnosed through clinical manifestations. In general, can be a pretty successful diagnosis when a patient presents, at least two of the three core symptoms of Parkinson's disease: hypokinesia, resting tremor and rigidity. It is very important that the tremor is at rest and that disappears when making a move, as there are other pathologies of the nervous system that do not have tremor at rest, but this appears to try to carry out the movement.
Family medical history and physical examination should be thorough, because, although it is not the most frequent form, Parkinson's may have a genetic inheritance (familial Parkinsonism). Approximately 5% of diagnosed cases of Parkinson's are due to genetic form. Elsewhere, although the causes may be different, it seems clear that there are certain genetic factors (genetic vulnerability), to interact with the environment, predisposes the individual to develop some type of Parkinson's (see causes).
The doctor may carry out exploratory testing of the head, such as a magnetic resonance image, to rule out other possible causes for the symptoms, such as Hydrocephalus (or accumulation of fluid in the brain, which increases its pressure and decreases the operation), cerebral vascular diseases or injuries caused by mass, as tumors. Also other tests may be performed to confirm the degeneration of nigral - especially in less frequent forms of Parkinson's - and thus, the diagnosis of the disease.

Treatment of Parkinson's disease

Treatment for Parkinson's is intended to address one or more therapeutic fronts, aiming to raise levels of dopamine in striatum core nodes, either providing dopamine missing, through the administration of substances that activate dopamine receptors (but non-dopamine), or delaying possible degradation of low dopamine that remains in the area.
Therapy for Parkinson's disease does not cure the disease (remember that it is degenerative), but it is proven that the quality of life of the patients improved significantly when they adhere to treatment and followed it regularly. However, approximately 5-10% of patients will not respond effectively to the treatment. In addition, not all treatments are suitable for all types of Parkinson's. The doctor will decide the most effective treatment depending on the shape of Parkinson's who has been diagnosed.

Medication to treat Parkinson's disease

Almost all drugs used in the treatment of Parkinson's disease experience side effects. In general, establishing a specialist treatment and usually does not start until the symptoms affect significantly the work of everyday life. The following are the main drugs used to counter the effects of Parkinson's disease.
Therapy with levodopa and enzyme inhibitors of DOPA-decarboxylase
Levodopa is a dopamine precursor amino acid. When administered, brain metabolizes it, turning it into dopamine, which is the diminished neurotransmitter. But outside the brain, the body also has enzymes that are responsible for turning this levodopa into dopamine. Enzymes are small molecules of the family of proteins that catalyze reactions. These enzymes to metabolize the levodopa to dopamine, do not allow that it reaches the brain and the lymph nodes. Therefore levodopa is given together with inhibitors of enzymes, thus allowing the levodopa to reach the brain and, once there, transform into dopamine.
The main adverse effects come from the conversion of levodopa to dopamine in the body, but outside of the brain. These adverse effects are nausea, vomiting, cardiovascular effects, and abnormal movements, especially in the area of the face and mouth. But as a result of the introduction of the inhibitors of the enzymes in the treatment, reduced the intensity of these adverse effects, which can also be avoided with other medications.
Other complications that may appear are psychiatric disorders, largely due to the accumulation of dopamine in the brain, since not only dopamine will act at the level of the nodes, but in many other areas, making these symptoms. Where this happens, the doctor can consider decreasing the dose or stop the therapy with levodopa; or add other medications that control symptoms (antipsychotics).
Eventually, therapy with levodopa may lose some of its effectiveness, appearing a phenomenon by which the doses given increasingly last less time you enable and, therefore, reappear (phenomenon of end-of-dose) and phenomenon on/off symptoms. The effective duration of levodopa-therapy is 5 to 7 years. After this period of time, they can begin to appear the phenomena described.
Therapy with dopamine agonists
The objective of this group of drugs is to act as if they are dopamine, i.e. activating receptors where dopamine binds. But they are not dopamine, which effects occur to a lesser extent adverse associated with abnormal movements. However, these agonists seem to be more related to adverse psychiatric or, at least, are more frequent.
Some of these drugs are: bromocriptine, pergolide, lisuride, amantadine (which is also used to treat severe cases of flu), apomorphine (also used in erectile dysfunction cases and in cases of poisoning, since it induces vomiting), pramipexole and ropinirole.
A new drug, with the peculiarity that is administered in the form of patch is available. He is rotigotine, and it works by the same mechanism, but it is much more easy to use.
Inhibitors of other enzymes (Mao-B inhibitors and ICOMT)
Fairly used, especially when the levodopa begins to show signs of exhaustion, allowing you to raise levels of dopamine by inhibiting the enzymes that degrade it (unlike inhibitors used with levodopa, who were responsible for inhibiting the enzymes that turn outside the brain, levodopa into dopamine).
Some examples: entocapona (ICOMT) and selegiline (Mao-B).
Central anticholinergic
By decreasing dopamine, acetylcholine (a neurotransmitter contrary to it) produces more intense effects, interact with their receptors more easily (among them, enhances rigidity and it can be related with the tremor at rest). There is a real increase of acetylcholine, but the lack of dopamine causes seem to increase the level of the transmitter.
These drugs (biperiden, trihexyphenidyl, procyclidine) decrease the action of acetylcholine receptors and, thus, help control the dopamine, especially rigidity anti-competitive effects.
On the other hand, they present many unwanted and annoying effects such as dryness of mouth, constipation, blurred vision... and in some cases may appear mental confusion, since we are preventing acetylcholine to act on their receivers.

Power for parkinson's patients

Patients with Parkinson's, in principle, do not have nutritional needs different from healthy people, except those who have both diabetes, cholesterol or high triglycerides, some kind of gastrointestinal pathology such as celiac disease or intolerance to lactose, among others. But present certain difficulties arising from its pathology (whether by make it difficult for chewing, swallowing, producing saliva, loss of appetite, constipation or any other), they do need to pay special attention when it comes to feed them.
The main objective is to get that these limitations are not reflected in their nutritional status, trying to find a varied and balanced diet that provides them the nutrients they need. An inadequate diet can encourage the emergence of other conditions such as: infections (and delayed healing), muscle weakness (worsened by the hypokinesia of Parkinson's), ulcers on the skin of the patient if it stays too long in bed...
Parkinson's, is also a condition that presents a high energy requirement, since the resting tremor that you consume large amounts of energy. A good intake will prevent unwanted weight losses. In addition, a proper diet may soften somewhat adverse effects of therapy (constipation and nausea), since the drug absorption in the intestine when food contains is slower.
However, it should be recalled that levodopa, by its nature, is a drug that when administered with protein-rich foods, may be less effective. In the event that the patient or caregiver noticed a worsening of symptoms, will have to readjust the amount of ingested protein.
We must not forget that if the disease is advanced, it will be advisable to manage the food into small pieces; and that it is preferable to take small portions of food, spread throughout the day and were composed of various nutrients, which will facilitate the intake without affecting the nutritional balance.
Of course, any undue weight loss must always be commented with the doctor.

What is cranial trauma

Brain is an essential body which controls all the body in multiple ways, the command center is located and any damage could have repercussions elsewhere in the body or in the conduct of the person. The term 'trauma' is used when there is an injury to the scalp, skull or, more profoundly, in the brain. Therefore, they fall into this category both small hits that cause bulging in the area, and serious brain injuries.
Although the human skull is tougher than it looks, not is should downplay a blow to the head. The attentive observation may indicate the severity of the blow and if necessary specialized care to prevent sequelae, especially in young children and elderly people, as they are the most vulnerable to such injuries.

Causes of head injury

One of the major causes of head injury are traffic accidents, especially those where motorists without helmet or people who do not have safety belts positions are involved.
They also tend to be cause of head injury accidents due to falls or shocks, and occur most often in the average domestic; Although they can also occur as a result of sports-related accidents.
Also, falls within the head injuries a problem called 'shaken baby syndrome', which is becoming more common. In children under three-year-old brain still does not occupy all the cranial space and to shake abruptly forward backward, the brain hits the interior walls of the skull causing serious injury. It is also a form of physical child abuse and one of the most common causes of death in abused infants.

The head injury prevention

The best way to avoid this type of situation is prevention, and so there are some good habits that are advisable to implement in daily life:
  • To the extent possible, avoid children to perform dangerous activities such as uploading to unprotected high places.
  • Always wear seat belt put on the vehicle, as well as the helmet if we are on motorbikes or bicycles.
  • Never drive any type of vehicle under the influence of alcohol or drugs, and prevent other people from doing it.
  • Always apply the necessary safety measures in case of any type of hazardous activity, whether gainful or labor.

Types of head injury

To assess the severity of trauma to the head, they will attend two types of classifications. The first relates to the type of injury, and the second has to do with the level of consciousness that the accident shows.

Depending on the type of lesion

  • Closed head injury: occurs when the head has been hit by an object that has not come to break the skull. They are the most common and, although it does not appear serious early attention is required.
  • Open head injury: is caused by striking the head with a hard object that has managed to break the skull and reaches the brain. This type of lesion presents more complications and should be treated quickly to avoid major sequels.

According to the level of awareness of the victim

  • Mild head injury: the loss of consciousness of the rugged is reduced to 30 minutes and the awakening shown reactive to stimuli, answer questions and moves. It is possible to have small episodes of memory loss that eventually will be sending. The recovery is almost complete.
  • Moderate head injury: the victim, although he is aware, does not respond correctly to stimuli. You have difficulty speaking and stay tuned, it seems sleepy and estuporoso. In some cases you may need hospitalization and even surgery. You can leave sequelae such as occasional memory loss, concentration difficulties and headaches.
  • Severe cranial trauma: the injured person is in a State of coma, does not respond to any stimulus and will not wake up. Urgent medical care is absolutely necessary. The recovery is long and hard, and never complete.

Symptoms of trauma and concussion

When trauma causes changes in the functioning of the brain, thus appearing different signs and symptoms according to the severity of the injury, one speaks then of concussion.
The signs and symptoms of head injury can appear immediately after the impact, gradually or they may take hours or days to manifest itself. Even when there is an injury, it is possible that even if the skull is intact the brain has been affected, so there is a concussion.
A concussion is a series of symptoms that can vary depending on the severity, and can last from a few hours to weeks. Depending on the severity are observed:
  • Mental confusion, difficulty thinking clearly.
  • Loss of memory of events surrounding the time of the accident.
  • Drowsiness, sleep more than normal and have trouble waking up.
  • Pupils unequal, observing eye is one of them more extensive than other.
  • Hallucinations, seeing flashing lights.
  • Difficulty to keep the balance, even preventing wandering.

Signs of alarm in cerebral trauma

If you observe any symptoms of concussion must be very attentive, because there are signs that must be taken into account, since they announced a case of emergency in which you have to act with extreme rapidity. The following signs are cause for alarm:
  • Consciousness changes abruptly, being alert in a moment and unconscious in another.
  • The affected behaves in unusual way.
  • The confusion is on the rise and does not go away.
  • It is unable to move an arm or a leg.
  • Seizures with possible loss of knowledge.
  • Prolonged unconsciousness (coma).
  • Pupils of the eyes of different size.
  • You vomit more frequently and twice
  • Problems with balance and even walk.

Diagnosis of a concussion

A concussion frequently does not reveal symptoms until after hours, even days. At the Medical Center, the professional will do a physical examination, and also perform simple questions such as "what day is your birthday?" to assess the State of consciousness and memory and confirm the diagnosis of concussion or brain trauma. It is also possible to use more advanced methods, they are called image tests that provide a view of the brain and the skull, making that the lesions become visible and therefore, until symptoms appear may be:
  • Computed tomography: is an imaging test that uses x-rays to observe both the skull and the bones of the face and jaw, and the brain. It is totally painless and usually lasts about 5 minutes. It allows to observe possible bone fractures, internal bleeding and aneurysm.
  • Electroencephalogram (EEG): this test focuses on the electrical activity of the brain cells. It is represented by a series of waves, and when there is an injury these waves are different from normal. It serves to verify the existence of seizures, and also to confirm brain activity in an area of the brain affected by the coup.
  • Magnetic resonance: If tomography is used to see the bones, the MRI shows brain and soft tissues that surround it, making easy the search for any injury. It is painless and radiation are not used.

What to do before a head injury?

Mild head injury in principle do not require immediate medical help or no special treatment. However, should keep in mind that the symptoms may appear later, so certain precautions should be taken:
  • Always watch the victim from a head injury and not lose sight of it.
  • That the affected do not perform actions that may cause other additional injury.
  • That it does not carry out activities requiring much concentration, such as reading, math, or another type of brain stimulation.
  • Avoid flashing and intense lights and loud noises.
If it has established that the trauma is moderate or severe and cerebral involvement, other more precise steps should be followed:
  • Call the number of emergencies in your area explaining precisely the situation that caused the trauma.
  • If the victim is unconscious, check breathing and, if necessary, apply cardiopulmonary resuscitation maneuvers.
  • If you are unconscious, but found that it breathes, must be treated with special care, therefore is not known if the column has been affected. This is placed the victim mouth up with your hands at the sides of his head to prevent it from moving.
  • If the victim is unconscious and vomits, turn the head to one side to prevent choking.
  • If there is bleeding trying to stop it by applying firm pressure to the wound, carefully not to move the head and applying precise care for bleeding.
  • If suspected that there might be a skull fracture, the wound is pressed directly or waste that may have formed, are removed but that is covered with a sterile dressing, gauze or clean cloths.
  • Put compresses of ice on the inflamed areas, with care not to leave them more than five minutes at a time.

What not to do in the event of trauma

It is important to also know those who must avoid or actions that must not be performed if we have a case of head injury:
  • Not abandon the victim at any time.
  • If the rugged town and suspected of serious trauma, we should not remove it.
  • The victim can not drink alcohol for 48 hours after having suffered a head injury.
  • They should not remove debris or objects which protrude from a wound in the head, because it could trigger a hemorrhage.
  • Do not move the victim only has to be done in cases in which it is found in additional danger.
  • If a child falls and suspected head injury, do not lift it up or move it.
  • Do not wash the wounds on the head if you notice bleeding, since there may be fractures.

What are brain tumors?

A tumor is a set of cells that grow and multiply abnormally. Brain tumors can be primary, when they are formed from the own cells that make up the brain tissue, and metastatic, when its origin is in a tumor located in another area of the body that has spread to the brain.
Metastatic tumors are much more frequent than the primary, since between 20 and 40% of cancer patients may develop brain metastases. The incidence of tumors intracranial primary is 1-8 cases per 100,000 inhabitants per year. This incidence shows a peak in childhood, where brain tumors are the second most frequent cause of cancer after leukemia, and increases the age of 40.
The different types of tumors play a role different depending on the age of the patient. Thus, in childhood are frequent infratentorial tumors (located in the lower part of the brain) as medulloblastoma and cerebellar Astrocytoma, while adults predominate glioblastoma multiforme and anaplastic Astrocytoma (both malignant and with poor prognosis due to its high rate of recurrence after surgery). Meningioma is the most common benign primary brain tumor, and originates in the meninges, which are the layers of tissue covering the brain.

Causes of brain tumors

The causes of intracranial tumours are unknown. We know that in some types of brain tumors are important inheritance and genetic factors, but in the majority of patients there is no evidence of a family history

Symptoms of brain tumors

Brain tumors produce symptoms and neurological signs that are divided into General and focal. These symptoms vary according to the location of the tumor. Thus, the fast-growing tumors present clinical manifestations much before the slow-growing.
(Local) focal symptoms include seizures, paresis (paralysis), aphasia (difficulty to understand and produce language), apraxias (inability to perform movements), agnosias (alteration of the memory), cranial (cerebral nerves) condition, etc. These focal symptoms are caused by the tumor mass and peritumoral edema (fluid that surrounds the tumor).
General symptoms are attributed to an increased intracranial pressure. Intracranial hypertension may be produced by own tumor mass, by peritumoral edema, by obstruction of the flow of CSF (cerebrospinal fluid, in which the central nervous system is immersed), by obstruction of the cerebral venous system, or by a blockage of CSF absorption. These general symptoms include mental disorders, headaches, nausea and vomiting, dizziness, generalized convulsions and papilledema (fluid in the eye). It is also common to see alterations of the personality, headaches (sometimes night or morning dominance), dizziness and nausea, in initial stages.
In patients with intracranial hypertension are frequently symptoms and known as focal signs of false location, due to the displacement of the brain tissue of an intracranial compartment to another. The most common symptoms are: apathy (emotional indifference), urinary incontinence, and imbalance of the March, unilateral or bilateral paralysis of cranial VI, ptosis (fall of the upper eyelid of the eye), Mydriasis (dilation of the pupil), hemiparesis (paralysis of half the body) ipsilateral and bilateral Babinski (infant, abnormal reflex in adults, which consists of open fan the toes after rubbed firmly of the same plant) , focal or generalized seizures, and signs of corticospinal involvement.
Other symptoms that may cause to suspect the presence of a tumor are:
  • Changes in alertness and drowsiness.
  • Difficulty swallowing.
  • Tremor of the hands.
  • Weakness, numbness or tingling on one side of the body.
  • Lack of balance and coordination in the movements.
  • Vertigo.
  • Alterations of the senses and the ability to perceive certain stimuli (temperature changes, pain...).
  • Loss of bladder or bowel control.
  • Changes in mood, personality, and behavior.
  • Problems to read or write.

Diagnosis of brain tumors

The diagnosis of an intracranial tumor is established by clinical and complementary examinations which confirm the presence of the tumor, its location, and even, at times, provide specific information about its characteristics. The most useful test is magnetic resonance imaging (MRI), which defines, as computed axial tomography (CT), the tumor itself and differentiates it from circulating edema. Other tests are angiography (test diagnostic imaging which scans blood vessels), evoked potentials (test which consists of recording and processing brain responses to different sensory stimuli), and CSF studies.
The definitive diagnosis is established with a biopsy (taking a sample of tissue for study) of the tumor, which should be (except medical indication against), even if the tumor is not susceptible of surgery.

Differential diagnosis

Intracranial tumors must be differentiated from other processes capable of producing focal neurological symptoms. Therefore, other non-tumor expansive intracranial disorders such as bleeding, should be excluded cysts, vascular malformations, etc.

Complications of brain tumors

Any other location (not brain) cancer patients often have neurological complications of the disease, which sometimes can be serious and irreversible consequences, therefore they need early diagnosis that allows them to maintain the quality of life.

Brain metastases

It consists of the extension of a cancer within the brain. It is the most common complication. Tumors that more often produce brain metastases include lung, breast and melanoma skin cancer. Often patients with lung cancer and melanoma perform an MRI before starting treatment, in order to rule out the presence of metastases to the brain.
The clinic consists of the emergence, in days or weeks, a neurological defect (which depends on the location of the metastasis), seizures or headaches. The diagnostic method of choice is the MRI.
Brain metastases have a poor prognosis, since they indicate the presence of disseminated cancer. Depending on whether or not the primary tumor (tumor that has spread) is controlled, and the number of intracranial metastasis (single or multiple) applies a treatment or another (radiation or surgery).

Neoplastic meningitis

It consists of the involvement of the meninges (brain covers) by a systemic cancer. The most frequent causes are lymphomas and leukemias, as well as lung and breast cancer.
The clinic consists of the appearance of various symptoms, as intracranial hypertension or paralysis of cranial nerves, especially the oculomotor (responsible for the movement of the eyes), facial and the auditory.
The diagnosis is made by a CSF examination, where you will discover malignant cells.
Neoplastic meningitis does depends on the type of tumor arising from the condition, and from the moment of appearance in relation to cancer. In general, it is bad. Treatment can consist of chemotherapy and/or radiation therapy.

Cerebrovascular complications

The incidence, type, and the mechanism of cerebral vascular injury vary depending on the tumor. In general, bruising and cerebral infarcts occur. The main cause of the bruising is bleeding from the tumor metastasis, while attacks are produced by a coagulation or a thrombus.

Treatment of brain tumors

The treatment of brain cancer depends on the type, degree, the extension and the location of the tumor. The therapeutic possibilities include surgery to remove the tumor, chemotherapy and radiotherapy. It is common to use several of these techniques, combining them to obtain greater benefit against cancer. The treatment guidelines should be monitored by a medical expert.
In high-grade gliomas treatment has achieved better results and a higher rate of survival of patients, has been the combination of surgery (when possible), radiation therapy, and chemotherapy. He is recommended in these cases radiotherapy after the operation with techniques allowing to delimit the zone as much as possible to radiate to avoid damaging healthy brain tissue.
Some drugs that have demonstrated efficacy in postoperative treatment of these tumours are temozolomide, taxanes, and irinotecan.
You must be regular monitoring of patients, performing a brain resonance, every six months when it's low grade gliomas, and every three months in the high-grade. In cases in which the resonance offers questions, another test called emission tomography (PET) Positron, which consists of evaluating the behavior more or less aggressive tumor, according to the incorporation of glucose or other labelled molecules can be.

What is Vertigo: causes and treatment

What is vertigo?

Vertigo is a fictional sense, generally Rotary type, displacement of the body or objects to your around.
It must be distinguished from seasickness, which consists of a feeling of insecurity and instability, something like the drunk, while vertigo causes an impression of movement or rotation, which can be fleeting, lasting hours or even days in the patient.
In many cases, vertigo is accompanied by nystagmus, which consists of a spasmodic involuntary movement of the eyes, which can be horizontal, vertical or rotary, and can affect one eye or both.
Vertigo is associated with an alteration, either permanently or temporarily, of the balance. It can occur at any age, although it is between 40 and 60 and is more common in women.

The balancing mechanism

The balance system is a complicated reflex. The information is transmitted from the visual system and vestibular (that is housed in the inner ear). Through this gateway information amounts to the brain, where it is processed. Vertigo is caused by erroneous message receipt or the misreading of signals at the level of the brain.
In many cases the vestibulo-ocular reflex is also damaged. This reflex is responsible for stabilizing the image on the retina to turning your head, to maintain a clear image. To better understand this: when you turn your head to the right, our eyes automatically move to the left to keep the same image that we had before the giro. Deficiency or alteration of this reflex, the patient makes rapid eye movements called sacadas, if these sacadas occur when you rotate your head to the right, will be the right lobby which is affected.

Causes of vertigo

There are many reasons which produces the vertigo; currently have been described up to 305 causes, among which are:
  • A head injury.
  • Abnormalities, and ear infections.
  • Heart disease.
  • Abnormal blood pressure.
  • Brain tumors.
  • Multiple sclerosis.
  • Clinical manifestation of cerebral ischemia.
  • As a result of previous treatments with salicylates, aminoglycosides and anticonvulsants.

Symptoms of vertigo

Vertigo may be peripheral or central.
  • Peripheral: in this case is that damaged vestibular system. Vertigo is very intense and often pursue episodic way, i.e., that there are moments in which the patient is well and others which do not. It is accompanied by hearing loss. Nystagmus has a horizontal direction and is increased by removing the fixation of the gaze.
  • Central: is associated injuries in different brain levels. In this case, the vertigo is much less intense, although continuous. It is not accompanied by hearing loss. In this type of vertigo, nystagmus can have any direction.

Most important forms

  • Meniere's disease: It affects the vestibular system. It is of unknown origin. It starts between 40 and 50 years and affects both men and women. It is mainly characterized by episodes of vertigo, hearing loss and sound hallucinations (known as tinnitus). Vertigo usually lasts minutes or a few hours and is accompanied by vomiting. Hearing loss worsens progressively. At the beginning, the disease manifests itself in a single hearing, although after a few years will affect both.
  • (VPPB) benign paroxysmal positional vertigo: It is one of the main causes of dizziness in patients attending consultation, and predominates in adult women. It is characterized by the presence of brief episodes of vertigo accompanied by nystagmus. Occurs when the person changes position, therefore usually occurs at night (to turn the head on the pillow) causing them to wake up the patient. In almost half of cases, forwards spontaneously about three months after its inception; only a small group of people suffer from it permanently.

Diagnosis of vertigo

Firstly, it is necessary to make a good clinical history, in which the form of beginning of the picture, the existence of associated symptoms (nausea, vomiting, hypotension), factors that improve or worsen the dizziness as well as a family history of the patient should be included.
It is important to check the ocular motility, because when it is abnormal may indicate that there is a dysfunction of the inner ear or the nerve connections between this and the brain.
The examination of the ear with Otoscope can to reveal the presence of any exudate or otological discharge or pain, which indicates that it is more likely that this is an infection of any other anatomical problems.
In addition, it is necessary to assess the vestibulo-ocular reflex; Normally this is done by rotating the patient's head while this fixed gaze at a point (such as the nose of the doctor).
Evaluation of the hearing aims to help differentiate a peripheral vertigo of one central.
Perform Imaging tests such as x-rays, resonance and TAC serves to rule out some bigger problems as a tumor of the vestibular nerve, or trauma or major fracture.
If vertigo is accompanied by other symptoms such as headaches, lack of coordination in the movements, double vision, weakness in the limbs and unintelligible language, may be indicative of the existence of a neurological brain disorder.

Treatment of vertigo

To relieve the vertiginous symptoms are recommended, always under advice and control of the doctor, one of this series of drugs. That Yes, keep in mind that these drugs must be in low doses at the beginning of the treatment of vertigo to, subsequently, be gradually increasing the dose:
  • Promethazine and meclicina.
  • Diazepam and Clonazepam.
  • Tietilperacina and metoclopramide.
  • Ondansertron.
  • Sulprida.
Meniere's disease He is treated with a combination of a low-salt diet (low salt) together with the restriction of alcohol and nicotine, and the administration of diuretics, in order to reduce the crisis of vertigo and hearing loss limit. They should be followed also hygienic measures to avoid any activity that may trigger the crisis of vertigo and prevent sudden changes in posture. Critical periods of vertigo are treated with the drugs mentioned above. In the event of failure of these use intramuscular streptomycin or gentamicin transtimpanica (this usually control the vertigo in 90% of cases, but it poses a risk of damage to hearing).
When medical treatment for vertigo has failed it will resort to surgery.
The benign paroxysmal positional Vertigo (BPPV) you can send by itself alone, but its treatment is important to prevent physical and emotional inability that produces. Should be autoaplicados exercises, which consist of repeated provocation of the clinical manifestations through repeated changes of position; in this way is just getting remission of vertigo. But these exercises are not always well tolerated by the patient.
In cases that do not respond to treatment as usual, when symptoms are severe and the patient's daily life is limited, are used to surgical treatment.

How to strengthen memory

You don't know where you left the keys? When is the birthday of your wife? If your brain plays tricks to you, it is time to work your memory so that these continued forgetfulness become a thing of the past.
Memory is the mental ability that allows us, through unconscious associative processes, save and recall what we have been learning in every day, what we have lived, seen, said or heard.
As a computer, the memory of human beings goes through three processes to store that information that we will then use. Thus, you should encode such information, then you must save it to, finally, be able to recover it. Although there are different ways to classify the memory, one of the most typical divisions is establishing that there is a short-term memory (here the steps of saved and recovery disappear) and other long term.

Memory problems

Although there are many who think that memory problems are things of grandparents, the truth is that memory and other cognitive processes begin to deteriorate from age 45, according to a recent study published by the Centre for research in epidemiology and public health of France and the University College London of United Kingdom.
Early symptoms tend to be small mistakes, failures in the words or communication or disorientation, time which is convenient to go to medical specialist to determine if it is a normal cognitive impairment or the prelude to a degenerative disease such as Alzheimer's.
But the ideal to prevent all such problems is to work on it on a daily basis using a few simple tricks.

Tips to strengthen memory (1 to 10)

1 reads a book. Reading is a pleasure, a nice hobby, but also one of the best ways to boost our memory. And it is that reading helps to expand and handle correctly the vocabulary, improves your understanding of the language and encourages the imagination, all of them related with memory capacities. Occasionally, there are books that require that pay special attention to different names, data or relationships between characters that force to work, even more, the memory.
2 storytelling. There are many people who do not enjoy the books or who prefer group activities. No problem. I am sure that will be entertaining to read a story to children in the House or move to a Senior Center and make it for residents. If your imagination allows you, it's great that you can invent stories and, in addition to having a good time with them, you will work your memory to remember your cartoon credible.
3 resumes. do you think now join University distance or a University for the elderly and studying a career? As you want to get into an adventure for several years, but if you can't make a cursillo or, even, help your children, nephews or grandchildren with their homework. This will force you to remember concepts, words or formulas that you thought that you had already forgotten.
4 join self-study. Sure we all know some young that you spend many hours in front of the books, but then the notes in their exams do not correspond to so much effort. Now are also many adults who need to be studied (a few oppositions, refresher courses, a master's degree...), by which good study techniques have appreciated. Experts can indicate how to enhance memory in the study with tricks ranging from the Association of ideas, the technical mnemonics, or grouping of information.
5 listens to music. There are hundreds of studies that support that listening to music, preferably classic, improves and maintains the brain functions in all stages of life. And is that music stimulates the cells of the brain, which helps mental concentration, memory and visual and auditory development.
6 start playing. Kill boredom and spend a good afternoon with your family or friends with a deck of cards or a board game. Depending on the type of game, different skills, are strengthened, although, in General, working memory, logical reasoning, the handling of language or verbal fluency. You can always choose more educational games than others, but virtually all will help you to start your brain.
7 get hobbies. They not only serve to fill the leisure time, the hours dead on the subway or in a waiting room, since leisure activities also strengthen memory. In this sense, the crosswords and the letters enabled the handling of language, the popular Sudoku enhance math skills, hieroglyphics stimulate logical thinking and games find differences favor the visual attention.
8 get crafts. This activity can also help strengthen the memory because creativity, agility in the hands and the coordination with the visual capacity force the brain to put the batteries. If you consider yourself around a "broad", do not despair because we are not talking of doing elaborate things, small tasks such as sewing, pottery, the restoration or even the kitchen may be sufficient.
9 order your memories. There is much that is worth remembering in our lives and all they also help us to working memory. Ordering your old photo albums and those older images will do that you try to remember where that picture was made, how to call that old friend who many years ago that you don't see, when you went to this place last... It is also a good idea to sort papers or old charts, since, in addition to your shelves and drawers will look better, the effect is similar.
10 uses technology. They say that many of the technological advances have made increasingly have to think less, but fortunately there are many options that help us to improve our health. And it is that they have become fashionable computer programs and video games that help us to get physical, but also mental exercise. Activities of logic, couples games or visual dexterity exercises or needing to memorize data are some of the proposals of these healthy games.

Tips to strengthen memory (10 to 20)

11 eats well. Food also plays an important role in our work to strengthen the memory. It is key to choose foods rich in certain substances that help the brain to work well. So, should we include foods rich in phosphorus (cocoa powder, egg yolk, blue fish, almonds, products dairy...), potassium (avocado, banana, wheat germ, orange...) and magnesium (pipes of sunflower, peanuts, soy, whole grains...). Also we need to make its necessary contribution of glucose, best of slow assimilation to the brain.
12 bets for supplements. There are certain substances that help improve our memory because of their antioxidant compounds or improve blood circulation. Thus, for example, green tea is one of the best antioxidants, oregano improves the circulation of blood in the brain, as do also the ginseng or biloba gingko.
13 drink with moderation. Alcohol is not a good friend of our brain and is there more to see how tries to speak, think, or recite a person with a few drinks more. These devastating effects are not accompanied with the wine, always in moderation, since it contains resveratrol, a flavonoid that is beneficial to the arteries and, of course, also to get blood to the brain.
14 cultivates your interest. There is no doubt that much better remembered the things that we are interested in that which does not. For this reason, it is important that we volquemos in the Affairs, and if they seem boring, try to associate them with other more entertaining things for you. If you're able to recite by running the alignment of your favorite football team, you'll also be able to remember other things that you like less, only should strive a little more.
15 practice of meditation. According to a study from the Massachusetts Institute of technology, in collaboration with the universities of Harvard and Yale, meditation can help to strengthen areas of the cerebral cortex responsible for attention and processing external sensory stimuli. In addition to fighting the stress and anxiety, it seems that the practice of daily meditation has more benefits.
16 get physical exercise. Mental exercise is important to strengthen memory, but it is also physical. And it is that exercise helps to improve the oxygenation of the brain, which allows this to work best. You know, "mens sana in corpore sano".
17 use your other hand. If you are right-handed, as if you're left-handed, it is important that you don't forget you have another hand. Do small tasks with the hand that we're not used makes our brain to be forced to create new connections. From now on, opens the door with the other hand, draws, please watch the other arm or simply removes the food in the pot: your brain will thank you.
18 grab pencil and paper. It is proved that write help to remember things. It is not that we autocastiguemos copying 500 times something, but do it a few times or read it aloud while we are writing it. Also at this point, it is important to make us an agenda and sign all appointments, obligations and data that we do not want us to go there.
19 calm down. When you can not remember where you have left something, how is called someone or time is a certain quotation, it is more likely that you go getting increasingly nervous and that stress will definitely block memory. It's relax, close your eyes, take a deep breath and returns to think about it a couple of minutes later when you're not so burdened by that initial dismissal. Sure that you just remembering it.
20 rests well. When we are sleeping our brain rests and, for him, it's time to sort all the information that has been absorbing throughout the day. Therefore the pauses in the study are so important and so is sleeping sufficiently.

Alzheimer's disease: Pathology Neuro degenerative brain

Alzheimer's disease is a neurodegenerative brain, progressive and irreversible pathology. It affects of diffusely to the neurons of the cerebral cortex and other adjacent structures, and leads to a degeneration of cognitive and behavioral disorders.
It is characterized by a deterioration in the ability of the subject to control their emotions, develop in its surroundings according to normal behavior patterns, and properly coordinating their movements and memory, among other disorders.
It is the most common form of dementia (represents 60% of all cases of dementia), and affects nearly 36 million people around the world. Prevalence reaches at least 30% of the population that exceeds 85 years. Still women about 70 per cent of those affected between 65 and 90 years old.
In addition, due to the increase in life expectancy, estimated the number of people with Alzheimer's is expected to triple in the next 40 years, coming to get it some 113 million people.

Causes of Alzheimer's disease

Identified several biological factors which interact with different mechanisms of genetic or environmental type, and which result in lesions that cause progressive nerve cell degeneration and the onset of Alzheimer's disease.
We have identified two characteristic signs of the disease as a cause of Alzheimer's that are: the emergence of the so-called senile plaques, plaques amyloid, or neuritic plaques, and the presence of tangles of neurofibrils:
Senile plaques are extracellular deposits of the protein beta-amyloid in the brain's gray matter, and are associated with degeneration and neuronal death. This beta amyloid protein is derived from the degradation of a larger protein called amyloid precursor protein, which is found in the membrane of many cells and whose mission is not fully clarified. The accumulation of beta-amyloid is due to an increase in its production or to a reduction in their elimination.
On the other hand, the formation of tangles of neurofibrils is the result of abnormal protein polymerization tau (a protein that is in neurons), and starts in the region of the hippocampus, where memory management function. These two processes involved in Alzheimer's disease may be interrelated and, in any case, cause a degeneration and neuronal dysfunction.

Risk factors for developing Alzheimer's

The main factors related to the development of the disease are age and family history of Alzheimer's disease. Exposure to certain substances, such as tobacco, also seems to favor his appearance.
On the contrary, a moderate intake of alcohol, the Mediterranean diet, physical exercise in the middle ages and an active social life, been associated with a lower risk of developing the disease in different studies. Also they have related to the years of education a lower risk of the disease.

Types of Alzheimer's disease

It is a disorder that can come associated with different causes; Thus, we can differentiate three types of Alzheimer's:
  • Family Alzheimer: are known to persons in whose family cases of Alzheimer's disease have been more likely to suffer from the disease. There is also a type of Alzheimer's specifically called familial Alzheimer's disease, characterized by starting so early, i.e., before the age of 60. This type of Alzheimer's disease is given by mutations in genes such as the gene for the amyloid precursor protein, the gene of the presenilin I or II presenilin gene. Mutations in these genes lead to an abnormal accumulation of the protein beta amyloid, a main component of senile plaques. This type of familial Alzheimer's disease is rare.
  • Associated with Down syndrome Alzheimer: due to Trisomy in chromosome 21, people with this syndrome present excess of amyloid precursor protein, which favors that your metabolism will lead to an accumulation of senile plaque causing fragments. In individuals with Down syndrome, we found cases of Alzheimer's from the age of 12.
  • Age-associated Alzheimer: although this disease is not a consequence of ageing, affects 5-7% of people older than 65. There are more than 70 genes whose presence in the organism can favour the onset of Alzheimer's disease associated with age. These include ubiquitin gene, the gene for the protein tau, or the gene for apolipoprotein E.
In any case, the altered metabolism of amyloid precursor protein is involved in all types of Alzheimer's disease described.

Symptoms of Alzheimer's disease

The first symptoms of Alzheimer's include a wide range of cognitive and behavioural. Many of the signs that can be seen in the earlier stages of the disease can be easily confused with the typical signs of aging, so it is good to know them and know to differentiate them.
One of the lighter which usually associated to Alzheimer's but also with old age could be starting to forget things, activities that would make, or names of people. This can be normal at a certain age, for example forgetting the name of a co-worker, a neighbor or Baker, and yet remember that working with you or living in the fifth. While a person with symptoms of Alzheimer's disease also forget the context, i.e., probably you don't even remember its name, but that is not your neighbor or your grocer.
Early symptoms of Alzheimer's
Memory and concentration
  • Change of place or loss of important objects.
  • Confusion about how to carry out everyday tasks.
  • Difficulty to solve simple arithmetic problems.
  • Difficulty to make routine decisions.
  • Confusion about the month or the season of the year.
  • Difficulty to perform drawings (test clock), buildings in three dimensions, or to orient themselves in open spaces. The patient gradually loses the ability to recognize objects, persons, or places.
Mood and behavior
  • Unpredictable mood swings.
  • Progressive loss of interest by the environment, or in their tastes or hobbies.
  • Depression, anxiety, or confusion in response to changes.
  • Denial of the symptoms.
  • It may present irritability, aggressiveness, agitation and social disinhibition.
Late symptoms of Alzheimer's
Language and speech
  • Difficulty completing sentences or find the right words.
  • Inability to understand the meaning of the words.
  • Reduced or irrelevant conversation.
Movements and coordination
  • Markedly deteriorated, including slowed movements, ailing March and sense of balance decreased movement and coordination.
The duration of the disease ranges between 5 and 20 years, and once it is diagnosed, life expectancy is reduced by half.

Diagnosis of Alzheimer's disease

Currently there is no diagnostic test specific or reliable to diagnose Alzheimer's, so it is necessary to resort to an array of tests of different types that allow, firstly, rule out other types of dementia and, secondly, assess the degree of the same.
  • The first step that will give the physician that is evaluating the patient will be the study of family history, personal history and symptoms that the patient presents. It will also perform a general physical examination and neurologic examination.
  • Neuropsychological testwill be held. Some of the most commonly used are called mini-mental test and the test of the clock. The mini-mental test consists of questions that explore the orientation, the ability to repeat a few words, concentration, calculation, memory and the language of the patient. It can be in 5-10 minutes. The patient gets a score that should be low, suggests a diagnosis of dementia. Watch test consists of making the patient draw a clock with the hands pointing out eleven and ten. This way we will be able to assess activity in the temporal lobes of the brain where they reside, among others, the functions related to memory and the development of complex Visual activities. It will be evaluated if the patient manages to write all the numbers, doing so in the right place, and if it is capable of situating the hands marking time which instructed. Each of these steps is assigned a score; from 7, it is considered that the patient is not suffering from the disease.
  • Neuroimaging studies are techniques used to confirm a suspected diagnosis in patients who present other signs of the disease.
    • By CT (computed Axial Tomography) and MRI be ruled out structural injury as a cause of dementia. In addition, in the case of Alzheimer's disease, is usually appreciate atrophy of certain brain structures.
    • The computed tomography by emission of Simple photon (SPECT) and Positron Emission Tomography (PET) allow to perform a functional analysis, i.e., provide information about metabolic changes related to Alzheimer's disease. A decrease in metabolism in some brain regions is characteristic.
    • Recent studies of the University of Pennsylvania are running a new method which consists in analyzing images obtained by magnetic resonance imaging (MRI) employing an algorithm allows to detect Alzheimer's disease and its progression with a 75% effective.
  • It is possible to use the detection of biomarkers as an additional method to the above. Pay special attention if you notice a decrease in the cerebrospinal fluid of the protein beta-amyloid and tau protein increased.

Treatment of Alzheimer's disease

Alzheimer's is a disease for which currently cure is not known. It is not possible to halt its advance or restore the damaged functions. The drugs that are on the market today are intended to slow the progression of the disease, reduce symptoms (depression, psychotic symptoms, sleep disorders...), improve cognitive function and slow down certain metabolic processes, which is believed to accelerate the degenerative process.
  • Drugs that protect the cholinergic system: system, that modulates information processing in different parts of the brain, is affected so early in the disease. These drugs Act on the enzyme that degrades acetylcholine (a neurotransmitter), increasing their levels in the brain. Some of the most commonly prescribed are Donepezil, rivastigmine and galantamine. They produce a slight improvement in the cognitive abilities of the sick. They all have side effects on the digestive tract, such as nausea and vomiting. They can also cause dizziness and decreased heart rate. All these side effects decrease if the administration of the drug at low doses and climb the dose gradually.
  • The NMDA receptor antagonists (N-methil-D-aspartate): the main component of this group is a drug called memantine, which inhibits the toxic action on an amino acid called glutamate neurons. Used in moderate to severe Alzheimer's disease. It can be used in combination with drugs in the former group. Its most common side effects are dizziness, headache and confusion.
  • Nonsteroidal anti-inflammatory drugs: are indicated both in prevention and in the treatment of Alzheimer's disease. Among them are the type drugs aspirin and ibuprofen, which act by blocking prostaglandins, the inflammatory response factors that seem to play an important role in Alzheimer's. Not recommended for long-term use.
  • Antioxidants: several studies have shown that antioxidants may slightly delay the progression of the disease or its symptoms. High doses of vitamin E, or the consumption of Ginkgo biloba - a medicinal plant that has antioxidant properties - contribute to a slight improvement in comparable to that experienced memory after the consumption of certain drugs, but without its side effects. It is necessary to take care and manage Ginkgo always under medical supervision, as there exist contraindications in use with certain medications.

Recommendations for living with Alzheimer's

Once you have been diagnosed Alzheimer's disease will begin a very difficult process, both for the sick and for the people that surround him (more if fit for the latter). The entire environment of the patient, the House and the family, should be reorganized to avoid any type of injury, to facilitate the management of complicated situations, and to ensure a quality of life appropriate to the patient and their carers.
A: should be taken measures
  • Preventing falls: be sure to remove all that with whatever it is easy to slide, remove obstacles that hamper the displacement, prevent cables to drag along the ground, ensure a good birth of stays, etc. Where necessary, there are adapted walkers which are available at orthopedic centers.
  • Accidents: is important to withdraw from circulation all sharp, flammable and toxic materials. It is advisable to equip the tub with bars that facilitate the entry and exit of the same, and non-slip bands. Install insurance in windows and doors, and not only never let the patient in places such as terraces, stairs, and other places that might be dangerous for him. It is highly recommended to always have the phone number for the emergency department or nearest health center.
  • Organize the environment: in general you should try to simplify the layout of the House and objects, not to let anything fall easily or with what is tripping. In addition, it should not change site things to not mislead the sick. It is good to indicate the path from the bedroom to the bathroom and the kitchen, and posters with the name (and preferably a simple drawing) can be placed from these stays at the door.
  • Activities of daily living: since the early stages of the disease are must create a routine and follow it more faithfully possible; What will help the patient to orient themselves in space and in time. This can also be achieved facilitating patient access to a calendar where this can go by day, drawing up a list of activities, or placing a watch that the patient understand view (usually find it easier to interpret the digital watches).

Tips for families of patients with Alzheimer's disease

The family will live and suffer all the progress of his illness with the Alzheimer's patient. Changes that are going to happen from now on will be in many cases the appearance of certain negative feelings (depression, fear, anxiety, guilt...), and a level of stress and wear, both physical and psychological, that will result in what has been called "the caregiver syndrome".
To avoid that the person that takes the main role of caregiver suffer this disorder must, first, be informed and receive some type of training to orient it in the development of its function. Second, you should know that you have help whenever you need it, psychological, social and family support.
Last, but not least, the caregiver must have time to rest and carry out activities outside the environment of the patient. In short, don't forget that the maintenance of the quality of life of the people that surround you is as important as the well-being of the patient.

Support Alzheimer's associations

The effects of this neurodegenerative disease go far beyond the symptoms related to the progressive deterioration of cognitive development and loss of memory. Relatives of the patient with Alzheimer's disease and its nearest surroundings also become protagonists of the disease to be emotionally affected by the change of behavior of the patient. This is why the major associations related to Alzheimer's disease to focus efforts not only on the person who suffers it, but also and in particular in the family and its closest surroundings.

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