Concept and Etiology
Parkinson's disease is a degenerative nervous system condition that impairs mobility (Ball et al.,
2019). Initial symptoms gradually appear and may begin with a barely detectable tremor in only one
hand. Although there is no cure for Parkinson's disease, drugs can help with symptoms.
Classification
Types of Parkinson's include:
Idiopathic Parkinson's disease, Juvenile Parkinson's, Drug-induced parkinsonism, Multiple system
atrophy, Progressive supranuclear palsy, Corticobasal syndrome, Dementia with Lewy bodies,
Vascular Parkinsonism, and normal pressure hydrocephalus (Jellinger, 2019).
Clinical manifestations
Its clinical manifestations include; Akinesia which is abnormal movement. Those who are suffering
can only move slowly. They may move shakily, taking brief, progressively little steps. Muscle
stiffness or rigidity is another common symptom that involves the limbs, legs, and neck, in particular,
that become stiff and strained over time (Santos‐García et al., 2020). If someone else attempts to move
the patient's limbs, it is difficult, if not impossible, and the individual stiffens up even more. Most
persons with Parkinson's disease experience tremors at rest, i.e., involuntary shaking. It becomes
worse as they move, but it is especially bad in the hands.
Diagnostic tests
The existence of motor symptoms is used to diagnose PD. The neurosurgeon employs a visual check
of fine motor and semi-quantitative rating measures, like the Hoehn–Yahr (HY) Scale and the
Movement Disorder Society-Unified Parkinson's Disease Rating Scale, to examine movement
problems (MDS-UPDRS) (Postuma et al., 2016). Because of neurologist bias, this subjective
evaluation leads to inter-and intra-rater variability; consequently, objective motor assessment methods
are critical in the future of PD diagnosis processes.
Multiple Sclerosis
Concept and Etiology: Multiple Sclerosis is a complex multifactorial disease involving genetic and
environmental factors affecting the autoreactive immune response that led to damage of myelin
(Deckx, 2013). The endocrine disturbances influence the course of the disease, since both
glucocorticoids and sex hormones have profound effects on the immune response also, endocrine
function in MS include hyperactivity of corticotrophin-releasing hormone (CRH) endocrine function
in MS include hyperactivity of corticotrophin-releasing hormone (CRH)- producing neurons,
dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis and altered basal or stimulated
cortisol concentrations (Huitinga,2001).
How does it deviate from the definition of health? MS is a very serious health problem it deviates from
having a normal healthy lifestyle. Though the functions within the body are still creating signals as a
normal healthy person its targeting areas of the body that are causing pain and unbalance sex life as
well.
Classification: Currently, multiple sclerosis phenotypic classifications include relapsing-remitting
multiple sclerosis a clinically isolated syndrome (Sand, 2015). MS lesions were also classified as (p)
reactive (absence of demyelination, activated microglial cells and perivascular leukocyte
accumulation, hypertrophic astrocytes or chronic inactive demyelinated (Huitinga, 2001).
Clinical Manifestations: (Symptoms and Signs)
The symptoms are slurred speech, fatigue, dizziness, problems with sexual, bowel and bladder
function. The signs are numbness or weakness in one or more limbs, electric shock sensations that
occur with certain neck movements, Tremor, unsteady gait and partial or complete loss of vision
(Mayoclinic,n.d).
Diagnostic Test:
The preformed test that are done to determine MS are blood test to help rule put other diseases with
symptoms similar to MS, and to check for specific biomarkers associated with MS. Spinal tap (lumbar
puncture) un which a small sample of cerebrospinal fluid is removed from your spinal canal. MRI
which reveals areas of MS (lesions) on the brain and spinal cord. Also, evoked potential tests which
record the electrical signals produced by your nervous system in response to stimuli (Mayoclinic,n.d).
Hypothyroidism
Concept and Etiology: How does the disease affect the endocrine and neural body systems in
particular? How does it deviate from the definition of health discussed in Module One?
With hypothyroidism, the thyroid gland does not product adequate thyroid hormones. This is a
common disorder, usually managed with medications such as levothyroxine.
Classification: How is the disease classified?
Hypothyroidism has four classifications. Primary due to thyroid hormone deficiency, secondary due to
TSH deficiency, tertiary due to thyrotropin-releasing deficiency, and peripheral due to extra-thyroidal
conditions (Chaker et al., 2017).
Clinical Manifestations (Symptoms and Signs): What are the symptoms and signs of the disease or
disorder? Be sure you understand the difference between symptoms (subjective) and signs (objective).
Hypothyroidism is manifested with fatigue, sluggishness, increased sensitivity to cold, constipation,
pale and dry skin, edema in the face, hands, and feet, hoarseness, hypercholesterolemia, unexplained
weight gain, myalgia, arthralgia, muscle weakness, heavier than normal menstrual periods, infertility,
brittle fingernails, hair loss or thinning, bradycardia, hypotension, depression, and goiter (Story, 2018).
Diagnostic Tests: What are some additional diagnostic tests that can be done to illuminate the
diagnosis? For example, when you injure your ankle, they take an X-ray to determine if it is broken or
sprained.
Diagnostic testing for hypothyroidism includes patient history, physical examination, bloodwork that
includes serum thyroid hormone levels, serum TSH, liver function tests, complete blood count (CBC),
cholesterol panel, and electrocardiogram (EKG).
Encephalitis is inflammation of the brain parenchyma and occasionally spinal cord from infection,
autoimmune conditions, or (in rare cases) allergic reaction. Encephalitis is most commonly the result
of a viral infection, with the most common sporadic encephalitis cases in the US caused by HSV
(Greenlee, 2020). Direct viral invasion of the brain usually damages neurons, and severe infections
can cause bleeding from the cerebral vasculature and haemorrhagic necrosis (Greenlee, 2020). Given
that the definition of health in almost every case necessitates the relative absence of disease or
infirmity, acute infection or autoimmune response is directly contrary to the definition of health.
Infectious encephalitis is defined as either primary or secondary. Primary encephalitis results from
direct infection of the brain or spinal cord, where secondary infection begins elsewhere in the body
and then travels to the brain or spinal cord (Story, 2017). Autoimmune encephalitis is subclassified
either based on anatomic location or the causative antibody (Farkas, 2021).
Encephalitis, especially from an infectious source, often begins with generalized flu-like symptoms
and malaise. Diplopia, photophobia, and headache are often the first symptoms to appear, followed by
hallmark symptoms of encephalopathy: altered mental status optionally with ataxia, tremor or
myoclonus, and/or focal neurological deficits. Bulging fontanelle can sometimes be found in infants.
Diagnostic tests include CSF analysis including opening pressures, cell count, and culture; serum labs
including blood culture, HIV serology, and treponemal testing; imaging of the brain (MRI preferred to
CT) and chest (XR or CT); and EEG (Venkatesan & Geocadin, 2014). A requirement for ruling-in
encephalitis is altered mental status for 24 hours or greater. This must be accompanied by 2 or more of
the following that are not attributable to another cause or underlying condition: documented fever
within 72 hours, seizure, new focal neurological findings, abnormal imaging of brain parenchyma
consistent with encephalitis, abnormal EEG, or presence of leukocytes >= 5/mL in CSF (Venkatesan
& Geocadin, 2014).
Story, L. (2017). Pathophysiology: A Practical Approach (3rd Edition). Jones & Bartlett Learning.
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infections/encephalitis
Venkatesan, A., & Geocadin, R. G. (2014). Diagnosis and management of acute encephalitis: A
practical approach. Neurology: Clinical Practice, 4(3), 206–215.
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Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. The Lancet,
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Huitinga, I., & De Groot, C., Van der Valk, P., Kamphorst, W.,Tilders, F., Swaab, D. (2001).
Hypothalamic Lesions in Multiple Sclerosis. Journal of Neuropathology & Experimental Neurology,
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