🧠 Neurodegenerative Disease Management [Neurosurgery Wiki]

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====== 🧠 Neurodegenerative Disease Management ======

===== 🔍 Diagnosis =====
  * **History & Examination:** Progressive neurological deficits, cognitive decline, motor/sensory disturbances.
  * **Imaging:** MRI (e.g., hippocampal atrophy in Alzheimer’s, nigrostriatal degeneration in Parkinson’s).
  * **Laboratory tests:** Rule out reversible causes (e.g., vitamin B12, thyroid, infections).
  * **Biomarkers:**
    * CSF tau and Aβ42 (Alzheimer's)
    * DaTscan (Parkinson’s)
    * Genetic testing (e.g., Huntington’s, ALS-related mutations)

===== 🧬 Common Diseases and Their Management =====

==== 🟠 Alzheimer’s Disease ====
  * **Pharmacologic:**
    * Acetylcholinesterase inhibitors: ''donepezil'', ''rivastigmine''
    * NMDA receptor antagonist: ''memantine''
  * **Non-pharmacologic:** Cognitive stimulation, caregiver support
  * **Monitoring:** MMSE, ADAS-Cog

==== 🔵 Parkinson’s Disease ====
  * **Pharmacologic:**
    * Levodopa + carbidopa
    * Dopamine agonists: ''pramipexole'', ''ropinirole''
    * MAO-B inhibitors: ''rasagiline'', ''selegiline''
  * **Surgical:** Deep Brain Stimulation (DBS)
  * **Rehabilitation:** Physical, occupational, and speech therapy

==== 🔴 Amyotrophic Lateral Sclerosis (ALS) ====
  * **Pharmacologic:** ''riluzole'', ''edaravone''
  * **Supportive care:** Non-invasive ventilation, gastrostomy
  * **Multidisciplinary care:** Neurologist, pulmonologist, nutritionist

==== 🟣 Huntington’s Disease ====
  * **Symptomatic treatment:**
    * ''tetrabenazine'' for chorea
    * SSRIs or antipsychotics for behavioral symptoms
  * **Genetic counseling:** Essential for family planning

===== 📈 Disease Monitoring and Follow-Up =====
  * Regular neurological evaluations
  * Functional status: ADLs, gait, speech
  * Imaging or biomarkers when appropriate
  * Periodic cognitive testing

===== 🧩 Multidisciplinary Management =====
  * Neurology
  * Neuropsychology
  * Rehabilitation medicine
  * Palliative care (advanced stages)

===== 🛡️ Preventive Strategies & Risk Reduction =====
  * Control of vascular risk factors
  * Cognitive engagement and physical activity
  * Mediterranean diet, low in saturated fats

===== 🔚 End-of-Life Planning =====
  * Advance care directives
  * Palliative and hospice support
  * Family and caregiver guidance