generate barcode c# .net DISEASES OF THE NERVOUS SYSTEM DUE TO NUTRITIONAL DEFICIENCY in Microsoft Office

Generator QR Code ISO/IEC18004 in Microsoft Office DISEASES OF THE NERVOUS SYSTEM DUE TO NUTRITIONAL DEFICIENCY

DISEASES OF THE NERVOUS SYSTEM DUE TO NUTRITIONAL DEFICIENCY
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Among nutritional disorders, those of the nervous system occupy a position of special interest and importance The early studies of beriberi, at the turn of the century, were largely responsible for the discovery of thiamine, and consequently for the modern concept of de ciency disease A series of notable achievements in the science of nutrition followed the discovery of vitamins Despite such progress, a number of diseases due to nutritional de ciency and particularly those of the nervous system continue to represent a worldwide health problem of serious proportions In Far Eastern communities, where the diet consists mainly of highly milled rice, there is still a signi cant incidence of beriberi In other underdeveloped countries, de ciency diseases are endemic, the result of chronic dietary deprivation And the ultimate effects on the nervous system of mass starvation, involving large portions of the African continent, is alarming to contemplate It comes as a surprise to many physicians that de ciency diseases still occur in the United States and other parts of the western world To a large extent this is attributable to the prevalence of alcoholism Relatively less common causes are dietary faddism and impaired absorption of dietary nutrients (which occurs in patients with celiac sprue, pernicious anemia, or surgical exclusion of portions of the gastrointestinal tract for treatment of obesity or for other reasons) Finally, there are the de ciencies induced by the use of vitamin antagonists or certain drugs, such as isonicotinic acid hydrazide (INH), which is used in the treatment of tuberculosis and interferes with the enzymatic function of pyridoxine
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The term de ciency is used throughout this chapter in its strictest sense to designate disorders that result from the lack of an essential nutrient or nutrients in the diet or from a conditioning factor that increases the need for these nutrients The most important of these nutrients are the vitamins, more speci cally, members of the B group thiamine, nicotinic acid, pyridoxine, pantothenic acid, ribo avin, folic acid, and cobalamin (vitamin B12) Most de ciency diseases cannot be related to the lack of a single vitamin (subacute combined degeneration of the cord, due to vitamin B12 de ciency, is a notable exception) Usually the effects of several vitamin de ciencies can be recognized This statement should not obscure the fact that particular manifestations of de ciency disease (eg, the ocular palsies of Wernicke disease) are indeed related to a de ciency of a speci c nutrient, nor should it diminish the need to identify such relationships Nutritional diseases of the nervous system are not simply a matter of vitamin deprivation Practically always, the general signs of undernutrition, such as circulatory abnormalities and loss of subcutaneous fat and muscle bulk, are associated Furthermore, a total lack of vitamins, as in starvation, is rarely associated with the classic de ciency syndromes of beriberi or pellagra; a certain amount of food is necessary to produce them An excessive intake of car983
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bohydrate relative to the supply of thiamine favors the development of a thiamine de ciency state All de ciency diseases, including those of the nervous system, are in uenced by factors such as exercise, growth, pregnancy, and infection, which increase the need for essential nutrients, and by disorders of the liver and the gastrointestinal tract, which may interfere with the synthesis and absorption of these nutrients As already mentioned, alcoholism is an important factor in the causation of nutritional diseases of the nervous system Alcohol acts mainly by displacing food in the diet but also by adding carbohydrate calories (alcohol is burned almost entirely as carbohydrate), thus increasing the need for thiamine There is some evidence as well that alcohol impairs the absorption of thiamine and other vitamins from the gastrointestinal tract In infants and young children, a reduction of protein and caloric intake (so-called protein-calorie malnutrition, or PCM) has a devastating effect on body growth Whether or not PCM also hinders the growth of the brain, with consequent effects on intellectual and behavioral development, cannot be answered as readily The data bearing on this matter are discussed in the last part of the chapter While conceding that de ciency diseases of the nervous system may occur in pure form, and are so described in the following pages, more often the symptoms of other de ciencies are added; ie, the de ciency diseases occur in various combinations Characteristic also of the nutritional diseases is the potential for involvement of both the central and peripheral nervous systems, an attribute shared only with certain metabolic disorders The following de ciency diseases are discussed in this chapter: 1 2 3 4 5 6 7 Wernicke disease and Korsakoff psychosis (thiamine de ciency) Nutritional polyneuropathy (neuropathic beriberi, probably associated with thaimine de ciency) De ciency amblyopia (nutritional optic neuropathy; tobacco-alcohol amblyopia) Pellagra with remarks on spinal spastic ataxia and encephalopathy [nicotinic acid (niacin) de ciency] The syndrome of amblyopia, painful neuropathy, and orogenital dermatitis (so-called Strachan syndrome) Subacute combined degeneration of the spinal cord (vitamin B12 de ciency) Neurologic disorders due to a de ciency of pyridoxine and possibly other B vitamins (pantothenic acid, ribo avin, folic acid) Inherited disorders of vitamin E metabolism
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In addition, attention is drawn to several distinctive neurologic disorders in which nutritional de ciency may play a role, although this has not been proved: (1) alcoholic cerebellar degeneration,
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