Principles of Treatment of diseases of Nervous system

Principles of Treatment of diseases of Nervous system : General care : 1. Good nursing. 2. Avoid bed sore by providing good bedding. 3. Frequent turning of animal. 4. Massage of affected parts with liniment in paralysis. 5. Infrared therapy in paralysis 6. Nervine tonics (B1 + B6 + B12) in paralysis. 7. Antiseptic inhalation – to avoid the respiratory tract infection. 8. Fluid and electrolyte therapy to reduce intra-cranial pressure. Limitations in treatment of Nervous disorders : 1. The failure of nervous tissue in brain and spinal cord to regenerate. 2. Impermiability of blood, brain barrier to many antibiotics. Specific Treatment : 1. Elimination and control of infection :  Treatment of infection of CNS is limited because of blood brain barrier.  Very limited information is available on the penetration of parenterally administered antibiotics into CNS of either normal farm animals or inflammation of the nervous system.  The most useful antimicrobial for nervous system meningitis in farm animals are third generation cephalosporines, sulphatrimethoprim and gentamicin.  In encephalitis / meningitis blood brain barrier is not likely to be intact or damaged and that parenterally administered drug will diffuse into the nervous tissue of CSF.  The level of chloramphenicol required in CSF for bacterial activity of most gram negative enteric bacteria causing meningitis in farm animals are not attainable and therefore it is not considered to be drug of choice.  Intrathecal injection of antimicrobials have been when parenteral therapy is unsuccessful. However intrathecal injections can cause rapid death and therefore not recommended. Relative diffusion of antimicrobials in human : 1. Excellent with or without inflammation – sulphonamides 3rd generation – cephalosporin viz. cefotaxime. 2. Good only with injection – Ampicillin, penicillin. 3. Minimal or not good with infection – Tetracyclin, streptomykin, kanamycin, Gentamicin. 4. No passage with injection : Polymixin-B, colistin. 2. Decompression :  Intracranial pressure is usually increased in most cases of encephalitis, but it is severe in acute cerebral oedema, space occupying lesions and hypovitaminosis.  The combination of mannitol and corticosteroides is used for reducing intracranial pressure.  Mannitol is given as a 20% solution @ 2gm/kg body weight I/V over 30-60 min period is a successful.  Intracranial decompresant with an effect lasting for 4 hours.  The effect of mannitol could be prolonged by I/V administration of dexamethasone 3 hrs after mannitol. The danger with mannitol could be prevented by following mentioned tips :  It should be repeated often.  It must be given animal in shock. It should be given I/V slowly.  Dexamethasone is to be given @ 1mg/kg body weight I/V. It is safe and has a good effect but does not decompress sufficiently.  Hypertonic glucose given I/V is dangerous because initial temporary decompression is followed by and increase in CSF pressure after 4-6 hrs interval. CNS Depressent :  Use of sedatives, general anaesthetics agents, tranquilizers to check convulsions and spasms during acute phase.  There drugs will control convulsion and therapy prevent the animal from injury itself, allow sometimes to examine properly. Assess the diagnosis and initiate treatment.  Diazepam @ 0.25 – 1 mg /Kg I/V or I/M 6 hrs interval.  Chloropromazine HCl @ 1mg/kg I/V or I/m at 8-12 hrs interval.  Triflupromazine @ 0.1mg/kg I/V or I/m at 8-12 hrs interval.  Phenobarbitone @ 4-6 mg/kg po for dog and cat. CNS stimulant :  They are useful during the period of depression.  They are indicated only in nervous shock.  After anaesthesia or other short term reversible anoxia such as cyanide or nitrate poisoning.  They exert only a transient improvement.

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