Stress and Neurological Disorders - M.A.Aleem in BMJ 2019;367:l6036

BMJ British Medical Journal 

Editorials

Stress related disorders and physical health

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6036 (Published 23 October 2019)

Cite this as: BMJ 2019;

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Re: Stress related disorders and physical health

Stress and Neurological Disorders

Stress may be a physiological or a pathological phenomenon. Acute or chronic stress can be a cause or the effect of certain neurological disorders in a person with or without any comorbid medical conditions.

Acute Stress
Acute stress can trigger seizure, headaches (primary and secondary), stroke, and increased intracranial pressure.

Chronic Stress
Chronic stress can wreak havoc on immune, metabolic and cerebrovascular systems of the brain.

Chronic stress can add fuel to the development of neurodegenerative disorders like dementia, Parkinson disease and motor neuron disease. It may also influence multiple sclerosis.

Stress In Pregnancy
Stress during pregnancy has been associated with an increased risk of a number of negative outcomes, which include emotional problems, attention deficit hyperactive disorder, contact disorder and impaired cognitive development in children.

Neurogenic Stress
Neurogenic stress may develop in response to brain damage, eg, traumatic injury, subarachnoid hemorrhage, epilepsy, and ischemic or hemorrhagic stroke. In neurogenic stress certain brain regions are implicated in the sympathetic cardiovascular response which increases in the hypothalamus, amygdala, and various cortical regions such as the insula and cingulate gyrus. Damage to these regions sets the neurogenic stress response in motion. The amygdala, which controls fear and conditioning, may produce a maladaptive psychological response when damaged, making managing stress response in these patients more difficult.

Stress and Functional Neurological Disorders
Stress can also produces functional neurological disorders like deafness or hearing difficulties, difficulty concentrating, difficulty swallowing, fatigue, impaired movement, lack of responsiveness, loss of balance, loss of the senses (such as smell or touch), memory problems, numbness, pain (in the muscles, skin, or joints), paralysis, seizures, speech problems, tingling sensations in the skin, tremors, twitches, vision problems and weakness.

So a stress free life is important to prevent the onset of and to prolong healthy life in certain neurological diseases.

Competing interests: No competing interests

25 October 2019

M.A. Aleem

Emeritus Professor of Neurology * Visiting Specialist in Neurology ** Consultant Neurologist ***

The Tamilnadu Dr.M.G.R. Medical University * Dhanalakshami Srinivasan Medical College ** ABC Hospital ***

Chennai 600032* Perambalure 621212** Trichy 620018*** Tamilnadu India

@drmaaleem