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Summary Hot topics in Neurology and Psychiatry (Part 1)
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Summary Hot Topics In Neurology andPsychiatry (HTNP)
1
,Introduction Crisis & Forensic child and adolescent psychiatry
Topics
- Complex psychiatric problems in crisis and forensic psychiatry
- Neurodevelopmental risk factors for psychiatric problems in crisis and forensic psychiatry
‘Most problems resulting in a psychiatric disorder start during childhood.’
→ Risk factors: environment, biology and psychology
Psychiatric disorder: a mental illness diagnosed by a mental health professional that greatly disturbs
your thinking, moods, and/or behavior and seriously increases your risk of disability, pain, death, or loss
of freedom.
Definition mental disorder;
- Dimensional
- Subject to societal changes/ to change through new knowledge
Types:
- Internalizing: those disorders are rooted in distress emotions (e.g., sadness and fear) and
include depressive tendencies, loneliness, anxiety symptoms, and somatic complaints (e.g.,
complaints about headaches and stomachaches).
• Inward/affective
- Externalizing: those disorders are mental disorders characterized by externalizing behaviors,
maladaptive behaviors directed toward an individual's environment, which cause impairment or
interference in life functioning.
• Outward/behavioral
NOTE: Autism spectrum disorders cannot be placed in 1 of the 2 types, as it can contain both symptoms.
Psychiatry - assessment:
1. Interview with subject and parents
2. Observation
3. Rating scales
4. Neuropsychological/ cognitive tests
5. Developmental history
6. Laboratory/ imaging
Crisis and forensic psychiatry – assessment (checklist)
- Underlying acute somatic problem
- Underlying trauma
- Danger to self?
- Danger to others?
4 main themes in this minor:
• Psychosomatic problems → relation between physical and psychiatric problems
• Suicidal and self-harming behavior → danger of hurting him/herself
• Trauma and related disorders → adverse environment, trauma
• Forensic psychiatry → danger of hurting somebody else
2
,General introduction: Pediatric and adult neurology
‘Clinial neuroscience’ is the aim to translate between basic preclinical neuroscience and the clinical
setting of neurology.
Learning objectives:
1. Describe the normal anatomy and physiology of pediatric and adult brain.
2. Investigate the main clinical and histopathological manifestations as well as therapeutic options
of the neurological conditions discussed in the course.
3. Investigate current and future diagnostic, prognostic and therapeutic options applying the
histopathological, clinical and imaging abnormalities for the neurological diseases discussed in
the course.
4. Describe the main research techniques used to study neurological disorders and apply these to
formulate new research questions.
Outline
➢ Pediatric neurology
- Normal development: Clay workshop!
- Common conditions & research
- Cerebral palsy
- Sleep disorders: narcolepsy
- Neuro-infection: common conditions, research and COVID-19
➢ Adult neurology
- Multiple sclerosis: symptoms, treatment, radiology, neuropsychology
- Neuro-oncology: symptoms, treatment, imaging and research
Preview: multiple sclerosis
Multiple sclerosis (MS) is a chronic disease affecting the central nervous system (the brain and spinal
cord). MS occurs when the immune system attacks nerve fibers and myelin sheathing (a fatty substance
which surrounds/insulates healthy nerve fibers) in the brain and spinal cord.
- Missing myelin in the brain (not in the rest of the nervous system as the producing cells are
different → oligodendrocyte in CNS and Swann cells in the PNS)
→ so, some axons are not containing myelin in the CNS
Clinic-radiological paradox
- Patients with many lesions do not have to be severely impaired
- However, patients with few lesions can be severely impaired
High potential imaging: Atrophy
Atrophy is the partial or complete wasting away of a part of the body.
- Know the gender facts
- What is considered abnormal?
3
, Development of the CNS
How does the body build the CNS?
• Requires precise orchestration and coordination
- Myriad molecular and cellular processes
- A wide range of cell types
- Over a long period of time
NOTE: dysregulation can lead to neurological and psychiatric
disorders.
NOTE: your CNS is still being finetuned until around the age of 20/30
years
From neural plate to neural tube
Neurulation = formation of the nervous system out of the ectoderm
→ week 3-4 of the embryonic development
1. Mesoderm cells produce the notochord.
2. The notochord induces the thickening of the ectodermal cells to
form the neural plate.
3. The central cells of the neural plate move outwards
- Forms the neural groove and neural folds
4. Neural folds fuse together: neural tube
5. Lips of the neural tube gives rise to neural crests cells.
NOTE: The neural tube forms the central nervous system.
NOTE: The neural crest cells form the peripheral nervous system
4
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