1

Anatomy Review

Central Nervous System

Peripheral Nervous System

Meninges

Blood Brain Barrier

2

Bacterial Meningitis 1. Neisseria meningitidis

– 15% mortality due to Rx delays– Infants, young adults– Fatigue, overcrowding– Death due to ___________ shock– Treatment:– Vaccine does not cover all strains

2. Hemophilus influenzae – Commonest cause of meningitis prior to vaccine development– H. influenzae type B (Hib)– 30-50% carrier rate in children– Fatal without treatment

• Seizures, mental retardation common in survivors• Largest cause of mental retardation in U.S.A. and world-wide

3

Meningitis (cont.)

3. Streptococcus pneumoniae – Commonest adult cause of bacterial meningitis– Spreads from other sites

– 40% mortality rate

Viral Meningitis– Self limiting, non-fatal– Enterovirus and mumps virus most common

4

Rabies

_______________ inclusions seen in brain Re-emerging in U.S.A. with ______ as carriers Fatal encephalitis 20-60 day incubation Virus travels to CNS slowly and replicates slowly Agitation, confusion, hallucinations Death within days of ______ symptoms _______________ seen as throat muscles are

infected and spasm Vaccination can be used to “cure”

5

Bacterial Nerve Diseases

Tetanus ____________________ Anaerobic, endospore

former Found in soil, manure Vaccine is available (10 yr) ___________ wounds _____________ paralysis,

respiratory failure Antitoxin and antibiotics

for treatment

Botulism _______________ ___________ paralysis,

respiratory failure Botulotoxin in

contaminated canned goods (honey fed to infants)

Wounds may rarely be infected

Antitoxin (Ab) will neutralize preformed toxin

6

Viral Nerve Diseases — Poliomyelitis

Poliovirus (____________)– Affinity for CNS motor neurons– Fever, back pain, muscle spasms– Young/old may suffer permanent

paralysis– Virus is excreted in human feces,

problem in developing nations– Vaccines are available– Eradication target year – soon!