Course

Neurology

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12 Lessons

Exercise and physical activity appears to have profound effects on the brain. Neuroimaging techniques (like functional MRI) have shown that exercise leads to changes in brain structure and function. It has been shown that physical activity can be an effective treatment for depression, improve memory and be beneficial for both the treatment and prevention of a variety of neurological conditions. Exercise promotes the release of various neurotransmitters and has been found to promote the generation of new neurons in some situations.

Exercise exerts its effects on the brain through several mechanisms. The benefits of exercise come directly from its ability to reduce insulin resistance, reduce inflammation and stimulate the release of growth factors. Indirectly, exercise can improve an athlete’s mood and sleep as well as reduce stress and anxiety. Each of these factors is likely to enhance cognitive function.

Participation in football, and other forms of exercise, can provoke some underlying neurological conditions (like migraines) but can also be an effective method of controlling and managing other conditions (like epilepsy and other seizure disorders). As a result, it is important that doctors looking after football players be aware of these conditions.

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Learning outcomes

After studying this topic you should be able to:

  • have an understanding of the effects of exercise on the brain and neurological system;
  • be able to conduct a clinical assessment of players presenting with neurological symptoms;
  • be able to appropriately order and interpret common investigations related to the neurological system;
  • be able to diagnose and provide exercise advice for a patient with epilepsy and other seizure disorders and understand the effect of activity on drug metabolism;
  • be able to diagnose common exercise-associated headache syndromes and be able to create an appropriate management plan;
  • have an awareness of the other common conditions affecting the neurological system;
  • be able to implement preventative strategies to reduce the risk of developing neurological symptoms.

Tasks

  • Review the media content and read the provided text
  • Read the “required” articles
  • Complete the case-based assessment task

Suggested reading

Brukner and Khan’s
Clinical Sports Medicine 4th Edition
Chapter 54 (Pages 1082-1092)

Required reading

F-MARC Football Medicine Manual 2nd Edition

Chapter 3.6 (pages 193-201)

References

  1. Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: Updated recommendation for adults from the american college of sports medicine and the american heart association. Circulation. 2007;116(9):1081-1093.
  2. Junge A, Dvorak J. Injury surveillance in the world football tournaments 1998-2012. Br J Sports Med. 2013;47(12):782-788.
  3. Pimentel J, Tojal R, Morgado J. Epilepsy and physical exercise. Seizure. 2015;25:87-94.
  4. Verrotti A, Cicconetti A, Scorrano B, et al. Epilepsy and suicide: Pathogenesis, risk factors, and prevention. Neuropsychiatr Dis Treat. 2008;4(2):365-370.
  5. Nakken KO, Loyning A, Loyning T, Gloersen G, Larsson PG. Does physical exercise influence the occurrence of epileptiform EEG discharges in children? Epilepsia. 1997;38(3):279-284.
  6. Bell GS, Gaitatzis A, Bell CL, Johnson AL, Sander JW. Drowning in people with epilepsy: How great is the risk? Neurology. 2008;71(8):578-582.
  7. Dubow JS, Kelly JP. Epilepsy in sports and recreation. Sports Med. 2003;33(7):499-516.
  8. McCrory P. Headaches and exercise. Sports Med. 2000;30(3):221-229.
  9. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629-808.
  10. Hindiyeh NA, Krusz JC, Cowan RP. Does exercise make migraines worse and tension type headaches better? Curr Pain Headache Rep. 2013;17(12):380-013-0380-5.
  11. Seifert TD, Evans RW. Posttraumatic headache: A review. Curr Pain Headache Rep. 2010;14(4):292-298.
  12. Olesen J. Problem areas in the international classification of headache disorders, 3rd edition (beta). Cephalalgia. 2014;34(14):1193-1199.
  13. McCrory P, Bell S, Bradshaw C. Nerve entrapments of the lower leg, ankle and foot in sport. Sports Med. 2002;32(6):371-391.
  14. Robinson M, Fulcher M. Brachial neuritis following a corticosteroid injection. BMJ Case Rep. 2014;2014:10.1136/bcr-2013-203126.
  15. Chio A, Benzi G, Dossena M, Mutani R, Mora G. Severely increased risk of amyotrophic lateral sclerosis among italian professional football players. Brain. 2005;128(Pt 3):472-476.
  16. Katz Sand I. Classification, diagnosis, and differential diagnosis of multiple sclerosis. Curr Opin Neurol. 2015;28(3):193-205.