In this module, scholars will learn how to connect neurochemistry with clinical neurology and will cover the following topics:
- How to Use This Course
- The 4 Neurochemical Priorities (never get lost!)
- The Road map
- Logistics of lab assessment
- How to order labs
- Who pays for labs?
- Blood Tests and Codes for this Module
- CBC
- Phosphorus
- Comp Metabolic Panel
- Magnesium
- Hemoglobin A1c
- LDH
- GGT
- How to Work Up a Real Patient
- Every Case Study details the patient’s presentation, work up, treatment plan and follow up.
- Case Study – 17 year old female with headaches, fatigue, neck/back pain
- The 10 Core Principles
- What Does a Brain Do?
- Global view of Brain function and purpose
- A primer on the evolutionary development of brain structure and function
- Structural Components of the CNS – Brain macrostructure
- Concepts of Neuron Structure & Function
- How Neurons Work – Thresholds and Potentials
- Neurotransmission, Transmitters and Receptors
- Dopamine
- GABA
- Serotonin
- Acetylcholine
- NMDA Receptors, Glutamate and Long-Term Potentiation
- Transneuronal Degeneration and Diaschisis
- The DARK Side of NMDA Receptors (creepy!)
- Excitotoxicity – what promotes it and what inhibits it
- Synaptic Integration
- Case Study – 27 year old woman with agitation and delirium
- Clinical Point on Ions
- sodium, potassium, calcium
- Glial Cells
- Macroglia
- Focus on Astrocytes
- Clinical Point on Aquaporins
- Oligodendrocytes and Schwann Cells
- Microglia
- Normal role and pathophysiological role
- Blood-Brain Barrier
- Neurovascular unit aka Gliovascular Unit
- What crosses and what doesn’t
- Membranes and Lipids
- Clinical Point on CoQ10 and Statin Drugs
- Case Study – 65 year old male with high cholesterol
- A Statin Alternative that actually works
- Amyotrophic Lateral Sclerosis
- When is ALS not ALS?
- A reasonable evidence-based approach to ALS
- Energy Metabolism in the Brain -glycolysis and oxidative phosphorylation
- Stroke
- What happens to energy production during and after stroke?
- Stroke-induced inflammation
- The Stroke-Migraine Continuum
- Epilepsy
- Pathophysiology
- Nutritional and Metabolic Factors to consider in Epilepsy
- The Ketogenic Diet for Seizures
- How to work up, manage and treat a patient with Seizures.
- Case – 10 year old girl with irritability, ADHD and recent seizure
- Case – 16 year old girl with Hashimoto’s, Brain Fog and Vomiting
- Case – 39 year old man with Seizures, dizziness and depression
- Case – 64 year old woman with concerns about her Hemoglobin A1c and Lipids
- Understanding Blood Chemistry – For each test:
- What physiology is actually being tested?
- What makes it high?
- What makes it low?
- What are the lab reference ranges?
- What is the functional/optimal ranges?
- Comp. Metabolic 14 PLUS
- Glucose
- Calcium
- Protein
- Albumin
- Globulin
- Sodium
- Potassium
- Chloride
- Carbon Dioxide
- Anion Gap
- BUN
- Creatinine
- eGFR
- Phosphorus
- Alkaline Phosphatase
- ALT
- AST
- GGT
- Bilirubin
- Hemoglobin A1c
- Lactate Dehydrogenase
- Special Section on Magnesium
- Normal roles in physiology
- Testing
- What makes it high?
- What makes it low?
- Magnesium in Migraine
- Magnesium in Stroke
- Magnesium in Chronic Pain
- Pattern Analysis of Blood Test Results
- Case – 63 year old man with hypertension, diabetes, edema and fatigue
- Case 66 year old woman with Diabetes and phospholipid antibodies
- More Blood Test results scenarios
