American Medical Association Family Medical Guide - American Medical Association [430]
If medication does not control your seizures, your doctor may recommend surgery to remove tissue in the area of the brain where your seizures originate. For some people, surgery can reduce or eliminate the seizures and improve their quality of life.
If your condition results from an underlying disorder, your doctor will treat that disorder. As the underlying disorder improves, you should have fewer seizures. Some people can control their seizures by following a special diet.
Degenerative Diseases of the Brain
Degenerative diseases of the brain are characterized by the progressive deterioration and death of brain cells. The exact cause of these disorders is not known, but some forms can be inherited. The diseases and their symptoms differ by the type of degenerative changes and by the areas of the brain that are affected. For example, Alzheimer’s disease affects the areas of the brain responsible for intellect and memory, Parkinson’s disease affects areas involved with movement, and amyotrophic lateral sclerosis (ALS) affects nerve cells that control muscles.
Alzheimer’s Disease
Alzheimer’s disease is the most common cause of dementia, a brain disorder that results in a progressive and irreversible decline in mental functioning that eventually makes a person unable to perform daily activities. Alzheimer’s disease causes severe memory loss, disorientation of space and time, and decline in the ability to think clearly and speak coherently.
The incidence of the disease escalates with age, affecting 1 in 10 people over 65 and 1 in 2 people over 85. An inherited form of Alzheimer’s disease can develop in people in their 30s, 40s, and 50s. An estimated 4 million Americans may have Alzheimer’s disease, which affects more women than men, perhaps because women tend to live longer than men. People can live with Alzheimer’s disease for years, gradually losing more and more function. The average time from diagnosis to death is 4 to 8 years, but some people live with the disease for up to 20 years.
The most characteristic features of Alzheimer’s disease are found in and around brain cells. Dense deposits of protein called neuritic plaques form around the brain cells at the same time that twisted strands of fiber called neurofibrillary tangles form inside the brain cells. These plaques and tangles are linked to the degeneration of brain cells and to their loss of connections with other brain cells. Some of the brain cells die. This process of brain cell degeneration and death begins in the regions of the brain responsible for memory and spreads to other areas that control language and thought. The process seems to be amplified by inflammation in the brain, which can be brought on by a combination of genetic and environmental factors.
Scientists have discovered genes that are linked to late-onset Alzheimer’s disease. Three variations of one of these genes are called apoE-2, apoE-3, and apoE-4. People can inherit these genes in six different combinations (one gene from each parent): two apoE-2s, two apoE-3s, two apoE-4s, apoE-2 and apoE-3, apoE-3 and apoE-4, and apoE-2 and apoE-4. ApoE-4 confers the greatest risk of Alzheimer’s; apoE-2 provides the most protection against the disease. Nearly two thirds of us inherit two copies of apoE-3, giving us an average chance of developing Alzheimer’s disease. A person who inherits two copies of the apoE-4 gene is eight times more likely to develop Alzheimer’s, while a person who inherits two apoE-2 genes has the lowest risk of all. As researchers learn more about how these genes are linked to Alzheimer’s disease, they will be able to develop more effective ways to prevent, diagnose, and treat the disorder.
Symptoms
Doctors believe that the early stages of Alzheimer’s disease probably begin decades before symptoms appear, as more and more plaques and tangles form in the brain. When symptoms become evident, they appear slowly. The first sign