Assignment 2 Lasa 1 Case Studies Presentation By Wednesday A

Assignment 2 Lasa 1 Case Studies Presentationbywednesday August 12

Create a Microsoft PowerPoint presentation to educate a group of medical students participating in their grand rounds. There should be at least ten slides in your presentation, including a title slide and a slide listing all sources. Include speaker notes for each slide with the main talking points. Save the presentation as AU_PSY350_M3_A2_LastName_FirstInitial.ppt and submit it to the designated Dropbox.

Review the two case studies and answer the following questions:

Case Study 1: Isaac and Parkinson's Disease

  • Describe the symptoms of Parkinson's disease.
  • Discuss the possible hereditary and environmental causes of Parkinson's disease.
  • Identify the parts of the brain affected by Parkinson's disease.
  • Explain why the neurologist prescribed selegiline instead of L-dopa.

Case Study 2: Sabrina and Corpus Callosotomy

  • Identify the disorder most likely being treated by the surgery and describe how the procedure is performed.
  • Explain how the surgery is expected to help Sabrina.
  • Analyze the risks and benefits of the surgery and compare them to alternative treatments, providing a reasoned recommendation.
  • Describe the cause of Sabrina's apraxia and interpret what the reduction in symptoms reveals about hemispheric specialization.

Requirements:

  • Cite the online course materials, the textbook, and at least two credible sources from the Argosy University online library or reputable .gov/.edu websites.
  • Avoid using Wikipedia and .com sources.
  • Use at least ten slides total, including the title slide and references slide.

Grading Criteria:

  • Symptoms of Parkinson's and affected brain regions: 24 points
  • Hereditary and environmental causes of Parkinson's: 24 points
  • Reasons for prescribing selegiline instead of L-dopa: 28 points
  • Disorder treated by corpus callosotomy and surgical procedure: 20 points
  • How surgery benefits Sabrina, risks, benefits, and alternatives: 24 points
  • Cause of apraxia and insights into hemispheric specialization: 16 and 20 points respectively
  • Use of standard presentation components: 44 points

Paper For Above instruction

The following presentation aims to elucidate complex neurological disorders through two illustrative case studies—namely, Parkinson's disease in Isaac and the effects of corpus callosotomy in Sabrina. By integrating current neurobiological knowledge, this presentation offers a comprehensive overview suitable for medical students during grand rounds, emphasizing symptomatology, pathophysiology, treatment rationale, surgical procedures, and neuropsychological implications.

Introduction

Advancement in neuroscience has significantly enhanced our understanding of neurological disorders, enabling more precise diagnosis and tailored treatments. The case studies of Isaac and Sabrina exemplify distinct but interconnected domains—degenerative neurodegeneration and surgical neuropsychology—highlighting the importance of understanding underlying mechanisms to optimize patient care.

Parkinson’s Disease: Symptoms and Brain Regions

Parkinson’s disease (PD) is primarily characterized by motor deficits such as resting tremors, muscular rigidity, bradykinesia, and postural instability. Isaac’s initial tremor, which worsened over time along with stiffness and slowness, typifies the classical presentation of PD. These symptoms reflect dopamine deficiency in the basal ganglia, particularly the substantia nigra pars compacta, which plays a crucial role in movement regulation (Jankovic, 2008).

The loss of dopaminergic neurons in the substantia nigra impairs the direct and indirect pathways of the basal ganglia circuitry, disrupting thalamocortical communication and leading to the characteristic motor symptoms (Lees, Hardy, & Revesz, 2009). Additionally, non-motor symptoms such as cognitive impairment and mood disorders can arise due to widespread neurochemical changes.

Etiology: Hereditary and Environmental Factors

While most cases of PD are idiopathic, genetic factors contribute significantly. Variants in genes like SNCA, LRRK2, and PARK2 have been implicated, with familial cases often exhibiting autosomal dominant or recessive inheritance patterns (Klein & Westenberger, 2012). Environmental influences include exposure to pesticides, heavy metals, and rural living conditions, which increase PD risk through neurotoxic effects (Gorell et al., 1998). Conversely, protective factors—such as caffeine intake and smoking—have been associated with reduced risk, though these associations remain under investigation (Chen et al., 2007).

Rationale for Selecting Selegiline Over L-dopa

The neurologist’s choice of selegiline initially, rather than L-dopa, likely stems from considerations of disease progression and side effects. Selegiline is a monoamine oxidase B (MAO-B) inhibitor that slows dopamine breakdown in the brain, providing symptomatic relief with fewer motor fluctuations in early PD (Rao et al., 2003). L-dopa, while more potent, carries risks of dyskinesias and fluctuations over time (Olanow et al., 2004). Therefore, clinicians often prescribe MAO-B inhibitors initially to delay the need for L-dopa therapy.

Sabrina and Corpus Callosotomy

Sabrina’s case involves a corpus callosotomy, a surgical procedure used primarily in treating severe epileptic seizures unresponsive to medication. This surgery involves disconnecting the corpus callosum—the major commissural fiber tract connecting the two cerebral hemispheres—thereby preventing the spread of seizure activity (Sperling & Fisher, 2013).

By sectioning the corpus callosum, epileptiform discharges traveling across hemispheres are interrupted, significantly reducing seizure frequency and severity, particularly in cases of generalized or drop attacks (Krsek et al., 2012). The procedure is generally performed via a craniotomy, with precise severing of the anterior or complete corpus callosum, depending on the case.

Expected Outcomes, Risks, and Benefits

The primary benefit of corpus callosotomy is decreased seizure generalization, leading to improved safety and quality of life for patients like Sabrina. However, it may cause side effects such as disconnection syndromes, including transient or persistent apraxia, aphasia, or sensory deficits (Fisher et al., 2010). Risks include surgical complications like hemorrhage and infection.

Alternative treatments include medication management with anticonvulsants, but in cases involving catastrophic seizures, surgery offers a potentially definitive solution. The benefits of improved seizure control often outweigh the risks, especially when seizures are debilitating.

Choosing between surgery and medication depends on individual patient factors, including seizure type, frequency, and response to drugs. Given Sabrina’s condition and refractory seizures, corpus callosotomy appears justified, though ongoing evaluation of risks is essential.

The Cause of Sabrina’s Apraxia and Hemispheric Specialization

Sabrina’s initial apraxia of the left hand following callosotomy reflects the disconnection of interhemispheric pathways, particularly affecting motor planning and execution. Apraxia stems from impaired communication between frontal and parietal regions across hemispheres, especially when the dominant hemisphere (usually left) cannot coordinate with the contralateral side (Hickok & Poeppel, 2007).

The reduction of apraxia symptoms over time suggests neural plasticity and compensatory mechanisms, including reorganization within the remaining neural networks. This phenomenon underscores the brain’s capacity for adaptation following focal disconnection, providing insights into hemispheric specialization, where the left hemisphere predominantly governs language and praxis, and the right hemisphere contributes to visuospatial and some motor functions (Gazzaniga, 2000).

Conclusion

These case studies exemplify how neuroanatomy, neurophysiology, and clinical intervention intersect in managing complex neurological disorders. Understanding the symptomatology, underlying causes, and treatment rationales enhances diagnostic precision and therapeutic outcomes. The insights gained from Sabrina's recovery patterns also deepen our appreciation of hemispheric functions and brain plasticity, reinforcing the importance of individualized treatment planning in neurology and neuropsychology.

References

  • Chen, H., et al. (2007). Caffeine intake and the risk of Parkinson’s disease: A meta-analysis. Movement Disorders, 22(8), 1124–1130.
  • Fisher, R. S., et al. (2010). Overview of RNS System for the treatment of epilepsy: A review. The Lancet Neurology, 9(10), 998–1008.
  • Gazzaniga, M. S. (2000). Cerebral specialization and interhemispheric communication: Does the corpus callosum enable the human condition? Brain, 123(7), 1293–1326.
  • Gorell, J. M., et al. (1998). Pesticides and Parkinson's disease. Neurology, 50(2), 304–308.
  • Hickok, G., & Poeppel, D. (2007). The cortical organization of speech processing. Nature Reviews Neuroscience, 8(5), 393–402.
  • Jankovic, J. (2008). Parkinson’s disease: Clinical features and diagnosis. Journal of Neurology, Neurosurgery & Psychiatry, 79(4), 368–376.
  • Klein, C., & Westenberger, A. (2012). Genetics of Parkinson's disease. Cold Spring Harbor Perspectives in Medicine, 2(8), a009271.
  • Krsek, P., et al. (2012). Outcome of callosotomy in children with drug-resistant epilepsy. Child’s Nervous System, 28(4), 593–602.
  • Lees, A. J., Hardy, J., & Revesz, T. (2009). Parkinson's disease. The Lancet, 373(9680), 2055–2066.
  • Olanow, C. W., et al. (2004). The scientific and clinical basis for the treatment of Parkinson disease. Neurology, 62(7 Suppl 2), S1–S137.

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