Nervous System

It has four main parts- cranial, central, peripheral, and autonomic. The central nervous system is
comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral
nerves. The nervous system along with the endocrine system correlates our adjustments and
reactions to internal and environmental conditions.

MALNUTRITION-INDUCED NEUROLOGIC DISORDERS

These disorders are usually seen because of chronic alcoholism, debilitating diseases that affect
the gastrointestinal tract, starvation resulting from unavailability of nutrients as in poverty, and
malnutrition caused by individual ignorance about diet and nutrition and conditions caused by
stress.

Nutritional Neuropathy

Nutritional neuropathy is the most common form of nutritional disorder of the peripheral nervous
system. In the early stage of the disease, there is a symmetric impairment of motor and sensory
function accompanied by reduced or absent reflex activity affecting the legs largely than the
arms. Sensory symptoms tend to be more prominent than the motor dysfunction. In the more
advanced stages of the disease motor impairment such as foot drop, wrist drop, or complete
paralysis of the legs may be elicited. The cause is mainly due to lack of thiamin, which is
important carbohydrate metabolism. This may be aggravated by a lack of protein or by the
presence of toxic substances in the diet from the bacterial or metabolic sources.

Treatment involves an improvement in the overall diet and not on thiamin alone. A preparation of
B-complex vitamins should be administered orally or parenterally, the latter resorted to when
absorption in the gut is a problem.

Vitamin Bu neuropathy is described as a progressive degeneration of the posterior and lateral

columns of the spinal cord due to a deficiency of vitamin B. The onset is gradual Peripheral
neuropathy, tingling, coldness and numbness in the extremities are ebserved. The physical signs
of motor weakness and ataxia may be more evident, depending upon the involvement of
peripheral nerves and the spinal cord. Loss of normal reflexes, weakness of extremities and
mental deterioration are observed. Decasional tonfusion and dementia are present.
Treatment is achieved mainly by administration of a diet used for the treatment of pernicious
anemia but with increased doses of cyanocobalamin

Pyridoxine (vitamin B, deficiency) neuropathy results from antituberculosis drug (soniazid) or

hydralazine treatment in adults or from dietary deficiency in infants Vitamin B is needed for the
synthesis of a number of brain transmitters Pyridoxine neuropathy can lead to brain damage and
mental retardation in infants while mood changes, excessive somnolence and even psychosis in
adults. Women using oral contraceptives may also experience the same symptoms because this
can lead to vitamin B, deficiency. Treatment is by using large amounts of pyridoxine

Vitamin E deficiency in severe case contributes to neurologic problems. Some of the features are
a motor-sensory polyneuropathy, truncal and limb ataxia, ophthalmoplegia, retinal degeneration,
and myopathy. In its severe stage, it may result neuroaxonał degeneration and destruction of
muscle fibers. The deficiency may arise asa result of abnormal lipid metabolism and consequent
malabsorption of the vitamin.

The neurologic symptoms can often be prevented by the early detection of the deficiency and by
administration of large doses of the vitamin. A beneficial effect may follow vitamin E therapy
and cystic fibrosis associated with spinocerebellar degeneration with replacement therapy. It may
also improve vitamin E deficiency states resulting from malnutrition and from chronic fat
malabsorption.

Pellagra (Niacin deficiency) is associated with neurologic symptoms that resemble those of
encephalopathy accompanied by signs of peripheral nerve and spinal cord volvement in the early
stages of the disease, the patient may be depressed, apathetic, fearful and apprehensive.
Insomnia, dizziness and headache are common. As The disease progresses, psychosis
characterized by confusion, delusion, disorientation, and hallucinations may develop. Later, the
patient may lapse into coma.

The peripheral neuropathy of pellagra does not respond to niacin supplements alone, both niacin
and pyridoxine must be added to the diet. Large amounts of niacin, about 10-20 mg per day in
the presence of adequate tryptophan is needed.