Table of Contents
Part one deals with neurological disorders related to improper functioning of the brain. According to Sacks, the medical community refers to such neurological disorders as brain deficits. In the same part, Sacks discusses about Dr. P., who is unable to differentiate between his hat and his wife’s face as a result of face blindness. Again, Jimmie G. is the next patient who forgets about things very fast because he suffers from Korsakov’s syndrome. Christina is another patient who cannot feel her own body leading to her loss of senses related to proprioception. Another victim of neurological disorders is Madeline J., who cannot control other parts of her body, specifically by her own hands. Nonetheless, the author further presents the case of McGregor, who cannot actually integrate information along his vestibular system due to Parkinson that blocks his mind. Finally, he presents us with the case of Mrs. S., who suffers from stroke.
However much such deficiencies may be worse to an individual, they always find alternatives to either consciously or unconsciously compensate for such disorders. Therefore, the neurological victims develop adaptive practices to enable them live a reasonably ordinary life.
However, there are types of neurological illnesses. Hence, this work will discuss how neurological conditions modify a patient’s perception of the real world in a euphoric manner. In addition, this work will discuss some of the recent research findings related to neurological concepts, the treatment options available for such disorders as well as the necessary future research that needs to be accomplished. Specifically, it looks into the recent facts about Parkinson’s disease, its treatment options and what the future research should concentrate on.
Neurological disorders/concepts Sacks examined in his chapter
According to Sacks, neurological patients can compensate their deficits. He claims that neurological deficiencies can be far much more than just impairments but encompass various excesses. Hence, the affected individual develops means of restoring, compensating for or replacing and preserving one’s identity. Ideally, the central nervous system plays a crucial role in maintaining such traits. Sacks presents adaptive traits that ensure better means of coping with the environment under harsh circumstances (Sacks, 1995). The focal point in this concept relies on vision, balance organs and proprioception that aid in substituting the missing roles of some parts of the brain. For example, McGregor, who could not employ balance organs managed to compensate the situation through his eyes. Even neurosyphilis patients with the same neurological symptoms as McGregor managed to compensate their respective situations through their eyes (Sacks, 1995). Hence, there is a center in the brain that is responsible for integrating information. Therefore, the controller will transmit impulses to the central nervous system to inform it about the instability within a certain part of the body. Hence, the brain will react to the default by controlling the tilting reactions related to posture to rationalize balance in an individual as in the case of Parkinsonism. Therefore, a stable body posture can be maintained provided the vestibular and the proprioceptive systems remain undamaged.
Additionally, the neurological conditions usually change how a patient perceives the real world. Extreme exposure to loud music can lead to periodic seizures within the temporal lobes of the brain. This further relates to agnosia that leads to disappearance in an individual’s expressive abilities of the voice; including, tone, timbre and how they understand words. Others may experience aphasia (Sacks, 1995). The bone of contention in this concept relates to the two temporal lobes of the brain; the left temporal lobe and the right one. Precisely, disorders regarding the right temporal lobe causes agnosias while those relating to the left temporal lobe causes aphasia. Typically, Sacks talks about Mrs. O’M, who was suffering from inner-ear deafness that made it difficult for her to perceive discrimination of tones. Hence, this resulted due to some kind of functional impairment of the auditory nerves of the brain. As a result, this could not allow her to distinguish between the different tones of her hymns. Similarly, Sacks examined the 19 year old Indian girl who developed a malignant brain tumor (Sacks, 1995). The malignancy showed a full resection during her earlier stages of life. However, the tumor reoccurred later during her late teens with more invasive characteristics that were hardly removable. The patient actually became nostalgic and euphoric with a fallacy of some kind of seizure.
Furthermore, Sacks presents the case of Donald who killed his own child while experiencing PCP influence. Scientifically, neither his hypnosis nor sodium amytal did not provide him of any memory concerning the deed. This proves that he had some kind of organic amnesia (Sacks, 1995). Actually, Donald seemed to have developed some strange behaviors as a result of austere equilibrium that compelled both his humane relations and passions to manifest themselves insanely. It is difficult to easily understand this condition since some people considered him sane, while others considered him schizoid. Later, upon withstanding the head trauma, he testified on his experience concerning the killing. However, he finally learnt how to cope with the situation to live with his new condition.
Finally, Sacks talks about Dr. P., who could never identify and fully describe the expressions of television actors. Recognizing photography by his fellow painter, Albert Einstein was never easy for him. Paradoxically, he was able to distinguish the different parts of the photographs and describe each one of them separately. Ideally, Dr. P. suffered from face blindness. Hence, there is actually a conception of mental illness within the patient. However, there is also a concept of equalization and adaptation. It is imperative to contemplate over how Dr. P. could actually see things but fails to understand them in case he sees a face (Sacks, 1995). Hence, he could not integrate his sensation and integration capabilities to relate faces, emotions and objects.
Recent research findings on Neurological Disorders
Current research points out those neurological disorders, with specific reference to Parkinson’s disease (PD) are associated with motor symptomatology. However, there are other non-motor symptoms like rapid eye movements, personality transition, hyposmia and disorders related to disruption in sleep behavior. Such symptoms can be accompanied by depression at the onset, and before the manifestation of the motor symptoms (WHO, 2015). Additionally, this research cites hallucinations and dementia as other related characteristics of the disease that one can observe after a long period of attack. However, the overt dementia mostly affects older patients with a considerably prolonged time-span of the ailment.
The etiology and risk factors of the disease is based on the interaction between some genetic factors and the environmental conditions. Therefore, the genetically related factors have led to 11 types of the PD with almost similar characteristics related to clinical manifestations as well as pathogenic mechanisms (WHO, 2015). Hence, the recent research on the PD typically emphasizes on age, sex, dietary habits and environmentally-related toxins as the major causes of traumas that ultimately lead to disease progression.
Its epidemiology has recently recorded a prevalence rate of 4.5-19 per 100,000 people annually (WHO, 2015). This means that the PD is a very chronic disorder with its prevalence far much exceeding its incidences. Statistics have proved that the prevalence rates usually increase with respect to age since a smaller percentage of patients had developed the disease at early ages. Hence, victims below 20 years are referred to as juvenile Parkinsonism, while those who have developed it between the age of 20 and 40 years are called onset Parkinsonism (WHO, 2015). The distribution of the disease on a global perspective is attributed to specific regional factors. For instance, lack of awareness of the disease is a health-care related issue.
Latest Treatment Approaches to PD Neuropsychological Disorder
COMT inhibitors: this means Catechol-O-methyltransferase (COMT) inhibitors that limit the metabolism of levodopa and its relationship with 3-O-methyldopa. Hence, this regulates the quantity that passes over the blood-brain barrier. However, this process does not alter the plasma concentration within the levodopa. However, there is insufficient data to prove the validity of this treatment option.
Levodopa: also called carbidopa, this option has outstanding feature. It actually stimulates the neurotransmission of dopamine within the brain. It usually changes to dopamine upon passing through the blood-brain barrier; and also thwarts peripheral changing of carbidopa to dopamine. This property is unique and has a crucial role in limiting the devastating effects of the drug such as vomiting and nausea.
What the future of neuropsychological treatment for the disorder you reviewed in the Sacks chapter looks like
Future research regarding the etiology of the PD should focus on finding a detailed relationship between the causative agents of the disease and the estimate of the population diagnosed with PD every year. This will give a clear view of how the treatment approaches will be applicable in given populations. However, a general view of the future research concerning the PD recommends application of cholinergic agents to improve the ones currently used (Barker & Williams-Gray, 2014). There is anticipation that the current ones are responsible of the posterior cortical dementing syndrome. Additionally, computer-related and virtual reality assessments are important in improving the traditional methods (Fernandez, 2012).
- Sacks O. (1995). The Man Who Mistook His Wife for a Hat and other clinical tales. John C. Marshall Publishers. New York Times.
- Fernandez H. (2012). Updates in the Medical Management of Parkinson Disease. Cleveland Clinic Journal of Medicine. Volume 79. Number 1, January 2012.
- Barker R. & Williams-Gray C. (2014). Mild Cognitive Impairment and Parkinson’s Disease – Something to Remember. Journal of Parkinson’s Disease 4 (2014) 651–656 DOI 10.3233/JPD-140427 IOS Press.
- WHO (2015). Neurological Disorders: Public Health Challenges.