The brain is the most important, and the most complicated, human organ. It plays the starring role in every aspect of life,from our simplest body movements to our most complex thoughts and feelings.

Dementia

The term Dementia refers to the significant loss of mental functions, including memory, thinking and reasoning, to the point where a person’s daily functioning becomes severely affected. Some types of dementia can be reversed, but most cannot.

Dementia can result from a number of nervous system or brain-related disorders that cause a degeneration or loss of nerve cells, with Alzheimer’s disease accounting for an estimated 50 to 70 percent3 of all dementia cases. Other dementia disorders include:

• Vascular dementia, caused by stroke and other blood-vessel disorders that interrupt blood flow to the brain;
• Dementia with Lewy bodies, which causes protein deposits in brain cells;
• Frontotemporal dementia diseases, which are marked by changes to a patient’s personality, behavior and language abilities;
• A combination of two or more disorders, most commonly when an Alzheimer’s patient suffers a stroke or other vascular blockage.

The vast majority of dementia-related diseases occur in elderly patients; as the diseases progress, patients suffer significant impairment in memory, thinking and speech functions; for example, they can’t finish a complete sentence, lose the ability to feed and dress themselves, and become unable to remember events that occurred just minutes earlier. Continued disease progression is marked by more aggressive behaviors, hallucinations and paranoia; brain damage eventually becomes so severe as to cause death.

Although there is currently no treatment to repair or restore lost and damaged nerve cells, a number of medications are available to help alleviate certain symptoms. Lifestyle changes and close supervision by trained caregivers can also help keep patients safe and restore some measure of quality of life.
   

Alzheimer’s Disease

Alzheimer’s disease is a pervasive and growing problem throughout the world. The most recent statistics available estimated more than 26 million cases worldwide in 20064 -- with one million Alzheimer’s patients in Thailand alone. Experts estimate that 10 to 15 percent5 of the population will eventually be diagnosed with Alzheimer’s. As we age, those odds increase substantially. And with research pointing to a genetic basis for Alzheimer’s, it’s essentially impossible to completely eliminate one’s own individual Alzheimer’s risk.

“Alzheimer’s is caused by damage to nerve cells,” says Dr. Sirichai Niramarnsakul, a board certified neurologist. “The damage prevents new cells from being regenerated. The result is a gradual yet continuous decline in a patient’s intellectual and decision-making abilities, memory and speech functions -- though the area of the brain that controls movement and motor functions may be unaffected.”

There are three stages in the progression of Alzheimer’s disease. During the first stage, patients encounter short-term memory difficulties; for example, they may be unable to recall what they did just a few minutes earlier or have trouble identifying objects placed in front of them.
   
During the second stage, patients experience hallucinations of sight and sound, and their behavior becomes more aggressive. By the third stage, the brain becomes severely damaged, and the body becomes unable to carry on with normal functions, which eventually proves fatal. It can take as little as three years, and as long as 20 years, for patients to progress from initial symptoms through the disease’s three stages.

Research has yet to find a cure for Alzheimer’s. Patient care usually focuses on treating specific Alzheimer’s symptoms and helping improve a patient's quality of life. Certain medications have had some measure of success in slowing the pace of neuron cell degeneration in some patients; doctors may also recommend the use of anti-depressants or other medications, along with exercise and nutrition regimens.

 
Parkinson’s Disease

Parkinson’s disease ranks second among the serious brain-related conditions, after Alzheimer’s. It’s estimated to affect about two in every 1,000 people (0.2 percent).6 Most cases of Parkinson’s are found in patients aged 50 and older, with men at greater risk than women. The largest number of cases are found in Europe and North America.

Parkinson’s disease results from the destruction of neurons responsible for producing dopamine, a chemical substance which helps control muscle movement. Declining dopamine levels result in uncontrollable shaking of muscles in the hands, arms, legs, and jaws, making normal body movements difficult.

Patients may also exhibit symptoms of depression, anxiety, memory loss, speech impairment, difficulty chewing or swallowing food, and digestive problems such as constipation and loss of bladder control. Some patients experience numbness, muscle pain and impotence.

“Although Parkinson’s disease is a chronic, incurable condition,” Dr. Sirichai says, “a number of medications are available to help increase dopamine levels, and some anti-depressant medications can help alleviate other symptoms. A healthy regimen of exercise and proper nutrition can help strengthen muscles and improve a patient’s ability to control body movements.”

Some patients may benefit from advanced treatments such as Deep Brain Stimulation (DBS), depending on their individual situation and whether they meet specific treatment criteria.
 

Seizures

Seizures are another prevalent brain-related disorder. An estimated 50 million7 people around the world -- and one percent of the Thai population8 -- suffer seizures. Seizures affect people of all ages.

Seizures usually result from a malfunction of neuro-electric charges in the brain. There are many risk factors for seizures, including family history and genetic pre-disposition, abnormalities in blood vessels in the brain, congenital defects, bacterial infections, accidents or injuries to the head, the presence of a brain tumor, and lead and other toxic substances. Identifying a seizure’s precise cause remains very difficult; only about 30 percent of seizure cases can be traced to a specific cause.

“The onset of a neuro-electric malfunction disrupts one or more areas of the brain, causing a brain seizure,” Dr. Sirichai explains. “It’s not uncommon for a healthy person to have a single seizure occurrence and then never have another seizure. So the accepted definition of seizure as a disease encompasses patients who have experienced more than one seizure. Obviously it’s very important to seek medical attention after the first seizure, and advanced brain imaging technology can help identify or rule out a serious problem around the time of the first seizure episode.”

Seizures can vary greatly in severity and symptoms. Major seizures can affect all areas of the brain and disrupt normal functioning throughout a patient’s body. Just prior to the onset of a major seizure, a patient will typically lose consciousness and collapse, his eyes will quickly roll upwards, he may groan loudly and clench his teeth, and breathing may stop temporarily. Then the actual seizure begins, with the patient’s body usually moving and shaking for a period of a few minutes. When the seizure ends, the patient is likely to experience fatigue and weakness along with headache and muscle pain.

Milder seizures that affect an isolated area of the brain typically produce milder symptoms such as tingling or numbness of the face, arms or legs. The patient may appear catatonic and temporarily lose consciousness. After regaining consciousness, the patient usually has no memory of the seizure.
 

Helping a Seizure Victim

When someone suffers a seizure, hard objects should not be put into the patient’s mouth (a soft cloth is considered safer). Most seizures last only a few minutes, but in a small percentage of cases, they may continue for as long as 20 minutes, putting the victim’s life in serious danger due to the extended period of unconsciousness. Be sure to summon medical help immediately.

While seizures usually don’t cause damage to the brain, they can result in emotional and behavioral changes. Medication is usually effective for about 80 percent of seizure patients, while other treatment options including surgery may be recommended for those who don’t respond to medication.
 

Keep Your Brain Healthy

• Keep your brain stimulated; explore new hobbies, read, do crossword puzzles and play intellectual games, and alter your normal daily routines;•Lower your risk of stroke and blood clots by exercising regularly and reducing stress;
• Eat a low-fat diet rich in fruits and vegetables, and ask your doctor about vitamin and nutritional supplements (vitamins A, C, E and B12, selenium, ginkgo biloba extract, etc.) that may enhance brain function;
• Avoid smoking and excessive alcohol consumption;
• Follow your doctor’s recommended schedule for regular check-ups and screenings, including blood pressure, blood sugar, cholesterol and heart rate monitoring;
• Get seven to eight hours of sleep every day;
• Wear protective head gear during activities such as bicycle riding, motorcycle riding, etc.;
• Seek immediate medical attention if you suffer any head injury.

Sources

1.    www.ninds.nih.gov/disorders/brain_basics/know_your_brain.htm
2.    pni.go.th/pnigoth/?page_id=5273   www.alz.org/alzheimers_disease_what_is_alzheimers.asp#
3.    en.wikipedia.org/wiki/Alzheimer's_disease#cite_note-Brookmeyer2007-2
4.    www.intelihealth.com/IH/ihtIH/WS/32193/35421.html   and                                                                  https://www.connecttoresearch.orgpublications/4
5.    www.connecttoresearch.org/publications/10
6.    en.wikipedia.org/wiki/Epilepsy#Seizure_types
7.    www.thaiepilepsy.org/