Neurological diseases, epidemiology, and public health

This chapter presents information for selected neurological conditions by referring to current or classic research papers. Conditions such as headache especially migraines have substantial public health impact because of the high prevalence, age groups affected, the associated lost economic productivity and the increase in disability-adjusted life years. Multiple sclerosis, a relatively common neurological disease, can affect individuals in young adulthood, decrease their productivity, and ultimately make them dependent on others. Traumatic brain injury occurring in youth or young adulthood can cause years of extra medical care in addition to lost productivity among those who survive the immediate event; in addition, repetitive trauma may cause chronic traumatic encephalopathy leading to dementia in later life. Epilepsy may have onset throughout one’s life course. While most causes are unknown, some may result from trauma or may be caused by specific genes, among other causes. While there are intractable forms of epilepsy, great strides have been made in preventing and managing seizures enabling patients to lead relatively full and normal lives. Neurodegenerative diseases, such as Parkinson’s disease and Alzheimer’s disease, are now acknowledged to begin 10–30 years prior to symptom onset. This will influence how risk factor studies are conducted and interpreted, which may offer earlier diagnostic potential. Effective treatments for the resulting clinical dementias that reduce productivity, functional ability, and independence from older individuals have not yet been realized. Without question, neurological diseases have substantial public health as well as grave personal impact.