Streams and Rivers

The central nervous system (CNS) consists of the brain and the spinal cord.  If the cardiac system is like a car, the central nervous system is like a mountain lake with lots of run-off rivers and streams.  The CNS runs the body, voluntarily like when we take in a deep breath and involuntarily, like how we breathe while we are sleeping, or how respiration continues during loss of consciousness.  There are 12 cranial nerves, designated as CN with a Roman numeral listed to depict the specific nerve.  They are the rivers that extend from the base of the brain (midbrain, pons, medulla).  These nerves connect the brain to the eyes, mouth, ears and other parts of the head, providing motor, as in movement of the eyes and tongue (CNIII, IV, VI), sensory as in smelling (CNI), or a combination of both motor: for chewing and sensory for the sensations in the face (CNV).  Trigeminal neuralgia is a chronic condition causing intense pain in the face often stimulated by chewing; it is a disorder of CNV.  Bell’s Palsy is a painless distortion of the face due to CNVII involvement.  ​

There are many more CNS disorders than the two mentioned above.  As the rivers and streams travel away from the brain and spinal cord, the flow of water (nerve conduction) may be obstructed.  The decrease in the flow may be progressive, caused by a loss of structure or function of nerve cells, and therefore, degenerative.  Motor neuron disease is one type of disruption, and as you may have guessed, it involves motor function.  The neurons (nerve cells) generate and die and slowly the muscles become weaker, eventually leading to paralysis.  These diseases are incurable and most often affect the older population.  Amyotrophic lateral sclerosis or Lou Gehrig’s disease (ALS, 2 in 100k) and Parkinson’s disease (1,900 in 100k (>80 yrs)) are in this category.  ALS is the most common lower motor neuron disease.  Progressive and degenerative, ALS will lead to respiratory failure (due to paralysis) and require ventilatory support.  The ALS Association lists average survival times at three years, with 5-year survival at 20%, 10-year at 10% and 5% will live 20 years or longer.  Longevity will depend on the speed of disease progression.  Atypical cases generally have slower disease progression and thus longer life expectancy.  Many of the cases I have seen through Life Settlements have a slower progression. 

Parkinson's disease often begins with a tremor, evidencing loss of motor control.  Characteristic progression includes lack of facial expression (flat affect), slowness, and balance problems with frequent falls.  Dementia may also occur.  Ultimately, the disease will leave a person confined to a wheelchair or bed bound.  Treatment consists of medications and at times brain stimulator implants.  Longevity depends on the rate of progression and treatment response.  Slow progression can occur over twenty plus years.