Diseases of the

Nervous System
Part 1
 Meningitis
• An infection of the CSF surrounding the
brain & spinal cord
• It is caused by bacteria and viruses.
• Viral meningitis: generally less severe &
resolves without specific treatment.
• Bacterial meningitis: quite severe & may
result in brain damage, hearing loss, or
learning disability.
Bacterial Meningitis
• Causative agent: Before the 1990s, Haemophilus influenzae & is
seen in young children
• Today, Streptococcus pneumoniae & Neisseria meningitidis are
the
leading causes of
bacterial meningitis
& are seen in the
general public

Neisseria
meningitidis
phagocytized by
white blood cells
 Bacterial Meningitis

• Transmission: Neisseria meningitidis: person-

person (schools, military camps, prisons); H.
influenzae: respiratory droplets; S.
pneumoniae: respiratory droplets

• Signs/Symptoms: High fever, headache, and

stiff neck in anyone over the age of 2 years.
• Nausea, vomiting, discomfort looking into
bright lights, confusion, and sleepiness.
• As the disease progresses, patients of any
age may have seizures.
Bacterial Meningitis

• Diagnosis: culturing CSF

• Treatment: penicillin, cefotaxime, ceftriaxone

• Prevention: vaccines against H. influenzae &

some strains of N. meningitidis and many types
of Streptococcus pneumoniae.

• N. meningitidis vaccine is not routinely used in

the United States.
 Tetanus

An acute often fatal disease characterized by skeletal

muscles rigidity & convulsive spasms
• 37 reported cases in 2001

Causative agent: Clostridium tetani.

Describe it.

Where is it found?

Transmission: puncture wounds

handling bedpans, dirty diapers, or other objects
contaminated with feces
Tetanus
• Vegetative cells produce exotoxin
tetanospasmin into the bloodstream.

• Tetanospasmin blocks
acethylcholinesterase

• The toxin reaches the nervous system,

causing painful, violent muscle
contractions.
Tetanus-Signs/Symptoms

Early symptoms:
lockjaw,stiffness in the neck & abdomen,
& difficulty swallowing.
Later symptoms:
•fever
•elevated blood
pressure
•severe muscle
contractions
Tetanus
Complications: 11% of cases result in death,
especially people > 60

Treatment: IV penicillin, tetanus IgG, tetanus

antitoxin

Prevention: DTaP
1933: development of tetanus vaccine decreased
the incidence of tetanus in the U.S.
 Botulism

• In the US, an average of 110 cases of botulism

each year.

Causative agent: Clostridium botulinum

Describe it.

• The disease occurs in three forms:

• foodborne
• infant
• wound
Foodborne Botulism

 ingestion of pre-formed toxin usually from

improperly home-canned nonacid foods

 leads to illness within 12-36 hours of

eating contaminated food

 Foodborne botulism is a public health

emergency because the contaminated food
may still be available to other persons
besides the patient.
Infant &Wound Botulism

Infant botulism: caused by ingesting

spores of C. botulinum, which then
grow in the intestines & release
toxin.

Wound Botulism: wounds become

infected with C. botulinum that
secretes toxin.
Botulism- Signs/Symptoms

 double vision, blurred vision, drooping eyelids,

slurred speech, difficulty swallowing, dry mouth,
muscle weakness that always descends through the
body
 Paralysis of breathing muscles can cause a person to
stop breathing and die.

Diagnosis:
 patient history & physical examination.
 botulinum toxin in the patient's serum or stool
 presence of C. botulinium in stool
 Botulism- Treatment

• For respiratory failure & paralysis, use

of a ventilator
 Removal of contaminated food by
inducing vomiting or using enemas.
 antitoxin against botulism
 Currently, antitoxin is not routinely given
for treatment of infant botulism.
 Wounds are treated surgically, to
remove the toxin-producing bacteria.
Botulism
Complications: death due to respiratory failure

Prevention: Persons who do home canning should follow

strict hygienic procedures (boiling food for at least
10 minutes).

 Children less than 12 months old should not be fed

honey. Honey is safe for persons 1 year of age and
older. Why?

 Wound botulism can be prevented by prompt medical

care for infected wounds & not using injectable
street drugs.