Brian's day

Brian lost his balance this morning and fell. He had a hard time getting to the bathroom and then came back to bed. Later, when we got up, he was ok. He had a mild earache the other day that aspirin cleared up easily, so I thought his loss of balance might be from an inner ear infection. But inner ear infections usually are accompanied by dizziness and Brian wasn’t dizzy. Loss of balance and muscle weakness is a problem with Alzheimer’s so I have to assume this is another symptom that Brian is experiencing. The past month or so, Brian has also been experiencing rapid jerking movements of different parts of his body as he is going to sleep. This lasts twenty minutes and longer. They are called myoclonic jerks and often develop in patients with multiple sclerosis, Parkinson's disease, Alzheimer's disease, or Creutzfeldt-Jakob disease. Myoclonic twitches or jerks usually are caused by sudden muscle contractions, called positive myoclonus, or by muscle relaxation, called negative myoclonus. It isn’t painful and doesn’t seem to bother him. It is interesting to watch as the jerks occur several times a minute in different places. There are many different types of nyoclonus and Brian seems to have the Sleep myoclonus that occurs during the initial phases of sleep, especially at the moment of dropping off to sleep. Some persons with sleep myoclonus are rarely troubled by, or need treatment for, the condition.
The specific mechanisms underlying myoclonus are not yet fully understood. Scientists believe that some types of stimulus-sensitive myoclonus may involve overexcitability of the parts of the brain that control movement. These parts are interconnected in a series of feedback loops called motor pathways. These pathways facilitate and modulate communication between the brain and muscles. Key elements of this communication are chemicals known as neurotransmitters, which carry messages from one nerve cell, or neuron, to another. Neurotransmitters are released by neurons and attach themselves to receptors on parts of neighboring cells. Some neurotransmitters may make the receiving cell more sensitive, while others tend to make the receiving cell less sensitive. Laboratory studies suggest that an imbalance between these chemicals may underlie myoclonus. This is understandable since Alzheimer’s is a disorder that attacks the brain's nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes. Brian is depressed tonight as he told me he wonders why this had to happen to him. When he gets this way, I remind him that a cure is just around the corner. I only hope it is a short block.