Peripheral Neuropathy Tingling Numb FeetLegs Symptoms Resolved DavisClinc
When you initially presented to the office,you presented with numbness, tingling, and irritation in the lower extremities and feet.We've managed this condition with our peripheral neuropathy program. How have you done withthe management and how are you doing today? Oh I'm feeling fine, I'm feeling great. WhenI came in here I thought I'd have to live with pain the rest of my life and it's great,really great. Well we're very very proud to have you here as a patient and congratulationson your results. Thank you , thank you a lot.
Hirschsprung disease congenital aganglionic megacolon
The name DiGeorge syndrome isn't the mostdescriptive name, which is why it's often also referred to as 22q11.2 deletion syndrome,which is actually pretty descriptive, and describes a condition in which a small portionof chromosome 22 is deleted, which causes a bunch of developmental abnormalities andcomplications. Alright so our chromosomes are composed ofgenes, right? Which are essentially instructions for everythingfrom development to daytoday survival, and these genes are spread out across 23 pairsof chromosomes. 22q11.2 is like an address, so 22 stands forchromosome 22, with q designating the long
arm of the chromosome, then it's on region1, band 1, and subband 2. This portion of dna, 22q11.2, spans about30 genes and 1.5 to 3 million base pairs, which classifies it as a microdeletion sinceit's less than 5 million base pairs. Even though this region is relatively small,it encodes for some really important genes, one of which is the TBX1 gene, which is thoughtto play a big role in the disease. The TBX1 gene is involved in normal developmentof the pharyngeal pouches, specifically pouch 3 and 4, which are fetal structures that developinto parts of the head and neck. The third pharyngeal pouch goes on to developinto the thymus and the inferior parathyroid
gland, the fourth pouch goes on to developinto the superior parathyroid gland. So with a 22q11.2 deletion and therefore noTBX1 gene, the thymus and parathyroid gland both end up underdeveloped, called hypoplasia. T lymphocytes or T cells are immune cellsthat're super important for the adaptive immune response, and are produced in the bonemarrow but mature in the thymus. If someone has thymic hypoplasia and thymicdysfunction, the T cells don't mature, and so these people often have a deficiency inmature T cells. It turns out, though, that most people withDiGeorge syndrome have mild to moderate thymic
dysfunction, called partial DiGeorge syndrome,which means that the immunodeficiency isn't lifethreatening. Complete DiGeorge syndrome, though, wherethymic dysfunction is severe, can be fatal within the first year of life, due to a severelycompromised immune system. Now, let's talk about the parathyroid glands the other major organ that's affected in DiGeorge syndrome. The parathyroid glands secrete parathyroidhormone, which helps increase the level of calcium ions in the blood.
Parathyroid hypoplasia leads to low levelsof parathyroid hormone, which causes low levels of calcium ions in the blood, called hypocalcemia. In addition to affecting the thymus and parathyroidglands and causing hypoplasia, the 22q11.2 region encodes genes that can also affectother organs and tissues. Individuals with 22q11.2 deletion syndromecommonly have congenital heart defects, in particular truncus arteriosus and tetralogyof Fallot, as well as facial abnormalities such as cleft palate and a characteristicâ€œfaciesâ€� which means that they might have features that might be normal individuallylike a long face, small teeth, or broad nose,
but taken together these and many other featuresbecome the characteristic facies of DiGeorge syndrome. Patients might have many other characteristicphysical findings as well as higher rates of behavioral and mental health conditionslike schizophrenia. Diagnosis can be difficult, but genetic testingcan be done if DiGeorge syndrome is suspected, and certain blood tests looking at T cellnumbers and function, calcium, and parathyroid hormone can also be helpful. Because the syndrome is due to a genetic deletion,there's no known cure, though many of the
What Is Vertigo Why Do We Get It
You might think vertigo is a problem thatpeople have when they're afraid of heights.or are Jimmy Stewart. Nope! Vertigo is all inyour head.specifically, your ears. Hey guys, Lissette here for Dnews. Vertigois one of the four main categories of dizziness it's a subjective experience that makesyou feel like you've lost a sense of your surroundings. But there are some very realcauses behind it in some cases, vertigo can even lead to nausea, vomiting and youreyes to twitch from side to side. There are two types of vertigo: peripheralvertigo and central vertigo. Central vertigo is a neurological problem usually in thebrain stem or cerebellum which can be caused
things like multiple sclerosis, stroke, andtumors. But the most common by far, and what we'll be focusing on here, is peripheralvertigo. Because, as a 2002 study in The British Journal of General Practice reports, at least93% of patients with vertigo, are those with peripheral vertigo.which has a lot to dowith problems in your ears. Your ears are super important for keepingyour balance and navigating the world. They help you orient yourself in it. In your innerear, there are these tiny hairs called stereocilia, that line a pouchlike structure called thesaccule. And interspersed between these hairs, is a sticky goop called glycoprotein thatholds tiny crystals in place. These guys are
made up of calcium carbonate, and move wheneverwe move, which causes them to bang up against the hairs in our ear. When the hairs sensethe crystals moving, they send signals through nerves in our ears to our brain that giveit information about our vertical and horizontal movement essentially, these crystals tellour brains where the heck we're going and help us keep our balance. On top of these nerves, crystals, and hairs,we also have fluid in our ears. Like the crystals, the fluid moves when we move and that'spicked up by our hairs which send information to our brain. Our brain uses the informationcoming from both ears to figure out whether
we're stationary or moving, and how we areoriented! Vertigo occurs when something in this systemgoes wrong. The spinning sensation or dizziness is your brain trying to figure out what theheck is going on. It's getting cues that don't make sense. And a number of differentconditions can cause this. In the cases of vestibular neuritis and labyrinthitis, partsof your ear become inflamed, usually because of a viral or bacterial infection. When oneof your two ears is inflamed particularly the ear's nerves it causes your brainto get imbalanced information so you can end up with vertigo. Meniere's disease, althoughit's not well understood, it's thought
to be caused by too much liquid in your ear,which causes the same dizzying symptoms. And researchers think migraines can cause vertigobecause they cause changes in our vascular and nervous systems, which affect parts ofour ears. Finally, one of the most common causes of vertigo benign paroxysmal positionalvertigo has to do with the crystals. Sometimes these crystals fall out of place possiblydue to a head injury or because the goop that holds them in place in the inner ear becomestoo weak. When they fall off, these crystals can end up in places where they don't belong,like the middle ear, and cause our brain to receive signals that don't make sense toit. They throw everything off!
Luckily, this one can often be fixed by simplyfollowing a set of head movements that move the crystals out of where they don't belong.Invented by John Epley in the 1980's, this noninvasive procedure can be effectivein up to 90% of these vertigo cases. Other causes of vertigo can be treated with medication,although in more extreme cases surgery may be necessary. As nasty as that sounds, some people do undergothese procedures, because vertigo can be horrible. It can last anywhere from hours to monthsat a time and can be debilitating. On top of that, just moments of Vertigo can causea lot of harm. If we lose our balance and