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Spinal

A SCI is damage or trauma caused to the Spinal Cord leading to a loss or impairment in sensation or function. Common causes of this damage are road traffic accidents, sports injuries and falls. There are also specific diseases that may lead to SCI such as transverse Myelitis, Polio, Spina Bifida and Friedreich’s Ataxia for example.

SCI can be divided into two types of injury: Complete and incomplete.

A complete injury means no sensation or function below the level of the injury due to the full severage of the Spinal Cord. Incomplete injury means there may be some sensation or function below the level of the injury due to a part of the Spinal Cord remaining intact.

Injuries of the cervical spine usually result in the person being tetraplegic or quadriplegic. People with an injury of C4 or above will require support with their breathing via an invasive or non invasive ventilation system.

Injuries at the thoracic spine level or below will result in paraplegia.

As well as paralysis there are a number of significant neurological changes affecting a person with SCI including bladder and bowel dysfunction, sexual dysfunction, temperature control dysfunction (poikilothermia), autonomic dysreflexia, postural low blood pressure and chronic pain.

Acquired Brain Injuries

Traumatic Brain Injury (TBI) – this means any injury to the head and brain caused by trauma through road traffic accidents, physical attack, falls etc.

There are four main types of acquired brain injury – Stroke, Brain Tumour, meningitis and hypoxic / anoxic brain injury.

Effects of brain injury include behaviour and personality problems, cognitive problems, physical difficulties including paralysis and epilepsy.

There are two national charities for people affected by brain injury: Headway and the Child Brain Injury trust.

Motor Neurone Disease (MND)

MND is a neurological condition that causes a progressive weakness of many of the muscles of the body. Motor nerves become damaged and eventually stop working. There are four main types of MND:

  • Amyotrophic lateral sclerosis (ALS), the most common type of MND. Symptoms start in the hands and feet with excessive stiffness.
  • Progressive bulbar palsy (PBP), the muscles first affected are those used in talking, chewing and swallowing (the Bulbar muscles).
  • Progressive muscular atrophy (PMA), a rare type of MND affecting the small muscles of the hands and feet without associated stiffness.

Primary lateral sclerosis (PLS), a rare type of MND causing weakness in the leg muscles, clumsiness in the hands and speech problems.

Muscular Dystrophy

Muscular Dystrophy (MD) is a genetic / inherited condition that causes gradual weakness in the muscles. There are over 30 types of MD and they have various symptoms and levels of disability. Some of the more common types of MD are:

  • Duchenne MD, the most common and severest form; a child may become severely disabled in their early teens and may require assisted ventilation by their late teenage years.
  • Becker MD.
  • Myotonic MD.
  • Limb-girdle MD.
  • Facioscapulohumeral MD.
  • Oculopharyngeal MD.
Muscular Sclerosis (MS)

MS is a disease affecting the nerves in the brain and spinal cord causing problems with muscle movement, balance and vision. It’s an autoimmune condition and the immune system attacks the myelin sheath coating the nerves. There are three main types of MS: Relapsing remitting MS, secondary progressive MS and primary progressive MS.

Stroke

There are two main causes of stroke: ischaemia (blood supply is disrupted due to a clot) and haemorrhagic (a burst blood vessel causing brain damage). Treatment depends on the type of stroke and the cause of the damage. Usually strokes are treated with medication and / or surgical intervention to clear blood clots or fatty deposits. In some cases, surgery is required to repair blood vessels.

The damage caused by a stroke can be widespread and long lasting requiring considerable and ongoing therapy to maximise function and increase independence.

Individuals require access to a wide range of therapies and equipment to support their discharge back into the community.

Low Awareness State

A person diagnosed to be in a vegetative state appears to be wakeful with their eyes opening and closing resembling sleep and waking but there is no sign of awareness or functioning of their mind.

This state may be a transient one or may persist until the person dies.

Persistent Vegetative State (PVS) is the term given to a person in vegetative state for longer than 4 weeks.

Permanent Vegetative State is the term given to e person who is unlikely to recover from their condition.

Minimally conscious state / minimally responsive / low awareness state are the terms for individuals showing minimal but definite signs of awareness.

Locked in Syndrome is the term for a person following a brain stem stroke which means they cannot move but can communicate using eye or eyelid movement.

Coma is a state when the person does not exhibit any sleep / wake cycles and their eyes are closed.

Cerebral Palsy

Cerebral palsy is a term used for many neurological conditions that affect a child’s movement and coordination.

Symptoms vary greatly and depend on the type of Cerebral Palsy diagnosed. Some children can have difficulties walking whilst others have profound disabilities and require life long care.

Children often have other related condition such as Epilepsy, incontinence, Learning Difficulties, sensory impairments, speech and language difficulties, curvature of the spine and excessive drooling.

Cerebral palsy cannot get worse over time but has a profound effect on the child’s body which may lead to problems in later age.

Guillain Barre Syndrome (GBS)

GBS is an acute disease of the peripheral nervous system in which the nerves in the arms and legs become inflamed and stop working.

Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) – once known as chronic GBS is a similar but longer lasting illness.

Other related illnesses include: Miller Fisher, MADSAM, AMAN, Multifocal Motor Neuropathy, AIDP, CIAP and Lewis Sumner.

GBS is rare but can affect anyone of any age. The condition can affect individuals in a variety of ways form a temporary disability to a life long disability, including those who require full invasive ventilation for the rest of their lives.

GBS causes sudden weakness, loss in sensation and pain. It is usually triggered by an infection.

Other Neurological Conditions

There are many individuals who are given a diagnosis of a rarer neurological condition or indeed do not receive a firm diagnosis at all other than that they have a neurological condition. These diagnoses may include:

  • Huntington’s disease (HD)
  • Progressive Supra Nuclear palsy (PSP)
  • Post Polio Syndrome (PPS)
  • Multiple System Atrophy (MSA)
  • Prion Diseases
  • Myasthenia Gravis
  • Cerebella Ataxia
  • Arnold-Chiari Malformation
  • Ataxia – Friedreich’s ataxia
  • Charcot-Marie-Tooth Disease
  • Creutzfeldt-Jakob Disease
  • Inclusion Body Myositis
  • Lambert-Eaton Myasthenic Syndrome – (LEMS)

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