Neurofibromatosis

Neurofibromatosis

Neurosurgery

Neurosurgery

Spina bifida
Chiari malformation
Dandy-Walker malformation
Syringomyelia
Tethered spinal cord syndrome
Aqueductal stenosis
Septo-optic dysplasia
Cerebral palsy
Spinocerebellar ataxia (NORD)
Transient ischemic attack
Ischemic stroke
Intracerebral hemorrhage
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Saccular aneurysm
Arteriovenous malformation
Broca aphasia
Wernicke aphasia
Wernicke-Korsakoff syndrome
Kluver-Bucy syndrome
Concussion and traumatic brain injury
Shaken baby syndrome
Seizures and epilepsy
Febrile seizure
Early infantile epileptic encephalopathy (NORD)
Tension headache
Cluster headache
Migraine
Idiopathic intracranial hypertension
Trigeminal neuralgia
Cavernous sinus thrombosis
Alzheimer disease
Vascular dementia
Frontotemporal dementia
Dementia with Lewy bodies
Creutzfeldt-Jakob disease
Normal pressure hydrocephalus
Torticollis
Essential tremor
Restless legs syndrome
Parkinson disease
Huntington disease
Opsoclonus myoclonus syndrome (NORD)
Multiple sclerosis
Central pontine myelinolysis
Acute disseminated encephalomyelitis
Transverse myelitis
JC virus (Progressive multifocal leukoencephalopathy)
Adult brain tumors
Acoustic neuroma (schwannoma)
Pituitary adenoma
Pediatric brain tumors
Brain herniation
Brown-Sequard Syndrome
Cauda equina syndrome
Treponema pallidum (Syphilis)
Vitamin B12 deficiency
Friedreich ataxia
Neurogenic bladder
Meningitis
Neonatal meningitis
Encephalitis
Brain abscess
Epidural abscess
Sturge-Weber syndrome
Tuberous sclerosis
Neurofibromatosis
von Hippel-Lindau disease
Amyotrophic lateral sclerosis
Spinal muscular atrophy
Poliovirus
Guillain-Barre syndrome
Charcot-Marie-Tooth disease
Bell palsy
Winged scapula
Thoracic outlet syndrome
Carpal tunnel syndrome
Ulnar claw
Erb-Duchenne palsy
Klumpke paralysis
Sciatica
Myasthenia gravis
Lambert-Eaton myasthenic syndrome
Orthostatic hypotension
Horner syndrome
Congenital neurological disorders: Pathology review
Headaches: Pathology review
Seizures: Pathology review
Cerebral vascular disease: Pathology review
Traumatic brain injury: Pathology review
Spinal cord disorders: Pathology review
Dementia: Pathology review
Central nervous system infections: Pathology review
Movement disorders: Pathology review
Neuromuscular junction disorders: Pathology review
Demyelinating disorders: Pathology review
Adult brain tumors: Pathology review
Pediatric brain tumors: Pathology review
Neurocutaneous disorders: Pathology review
Lower back pain: Clinical
Traumatic brain injury: Clinical
Brain tumors: Clinical
Stroke: Clinical
Seizures: Clinical
Headaches: Clinical
Dizziness and vertigo: Clinical
Dementia and delirium: Clinical
Hyperkinetic movement disorders: Clinical
Hypokinetic movement disorders: Clinical
Muscle weakness: Clinical
Disorders of consciousness: Clinical
Meningitis, encephalitis and brain abscesses: Clinical
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Thrombolytics
Osmotic diuretics
Antiplatelet medications
Medications for neurodegenerative diseases
Anti-parkinson medications

Transcript

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With neurofibromatoses, neuro refers to the nerves, fibro- refers to fibrous tissue, and -oma means growth, or tumor.

So neurofibromatosis refers to fibrous tumors originating from the nervous system.

The body’s central nervous system is made up of the brain and the spinal cord, which are surrounded by three protective layers called the meninges.

Part of the central nervous system are the cranial nerves, which originate in the brainstem and innervate the head and neck, and the spinal nerves, which originate in the spinal cord, and supply the rest of the body.

Each nerve is surrounded by a nerve sheath, which is produced by cells called fibroblasts.

Inside, each nerve there are several fascicles, and each fascicle, in turn, is made up of several axons.

The axons are the long projections of neurons, that carry the information as electrical signals running up and down their length.

Along the axon there are cells called Schwann cells, which produce a myelin cover for the axon.

The myelin helps electrical signals travel along the axon faster.

Now, neurofibromatoses are genetic diseases which cause non-cancerous growths to form in the body’s nerve tissue, and there are two types - type I and type II.

They’re caused by inheriting faulty copies of either the NF1 or NF2 gene, which are found on chromosomes 17 and 22, respectively.

Just remember, NF1 goes with chromosome 17 and NF2 goes with chromosome 22.

Both of these have an autosomal dominant inheritance pattern, so a child only needs one faulty copy from either parent to get the disease.

Normally, these are tumor suppressor genes, which means they stop cells from dividing uncontrollably.

So when there’s a mutation in the gene, it leads to uncontrolled growth of fibromas which are growths that have multiple cell types including neurons, Schwann cells, and other supporting connective tissue.

Neurofibromatosis type I, is also called von Recklinghausen’s syndrome typically affects the nerves in the extremities and the skin.

It causes lots of neurofibromas, which are benign tumors that grow from the nerve sheath and are made of a mixture of Schwann cells, fibroblasts, and immune cells.Usually, they grow just beneath the skin surface, but they can also grow along peripheral and spinal nerves.

Cutaneous neurofibromas typically start forming in childhood and increase in number over time. They appear as a painless, mobile lumps under the skin.

On top of that, people with type I neurofibromatosis often have skin markings called café-au-lait spots, which are flat patches that are the color of milky coffee.

These spots typically appear on the back, the buttocks, and the thighs in the first year of life, and increase in number over time.

Also, on an eye exam, there are small tan colored bumps called Lisch nodules can be seen on the iris.

These nodules almost always appear by the age of 6, but don’t usually cause any sight problems.

Key Takeaways

Neurofibromatosis is a genetic disorder characterized by fibrous tumors that affect the development and function of the nervous system. There are three known types of neurofibromatosis: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis.

NF1 is due to a mutation in the NF1 gene on chromosome 17, and generally affects the skin and extremities. NF1 causes cutaneous neurofibromas (benign tumors that grow from the nerve sheath), caf-au-lait spots (flat patches with milky-coffee color), and Lisch nodules (small tan colored bumps). NF2 is caused by a mutation in the NF2 gene on chromosome 22, and is associated with bilateral acoustic neuromas that can cause tinnitus, and bilateral gradual loss of hearing. NF2 is also associated with multiple meningiomas in the brain and spinal cord.

Schwannomatosis is a rare form of neurofibromatosis, characterized by multiple schwannomas, pain, and numbness in the affected areas. Unlike NF2, schwannomatosis spare the vestibular nerve.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Neurofibromatosis" Orthopaedics and Trauma (2015)
  6. "Review Article : Molecular and Cellular Mechanisms Underlying the Cognitive Deficits Associated With Neurofibromatosis 1" Journal of Child Neurology (2002)
  7. "The Neurofibromatosis 2 Tumor Suppressor Gene Product, Merlin, Regulates Human Meningioma Cell Growth by Signaling through YAP" Neoplasia (2008)