NeuroBites – August 9th, 2018

Every week, the BVNS neurologists, residents and interns convene to discuss a human or veterinary neurology/neurosurgery article.

NeuroBites is a digestible synopsis written by Dr. Bush of the article covered in journal club.

Welcome to NeuroBites.

Schwartz JR, Roth T. Neurophysiology of Sleep and Wakefulness: Basic Science and Clinical Implications.
Current Neuropharmacology. 2008;6(4):367-378.

Click HERE for the full article.

Locus coerulous – are you serious?

Follow the small line if you can to a small spot in the brainstem where all the norepinephrine is made in the brain.
The translation of locus coerulous means ‘blue spot’ because under a microscope the norepinephrine granules in this spot look blue. My favorite color is blue (for those that could not tell by the BVNS or BAVI logo) and I imagine blue to be the color of the ocean and the sky in the summer.

Dr. Young’s journal club brought to light many things:

  1. When we say there is a ‘switch’ in the brainstem that can be ‘on’ when we are awake and ‘off’ when we are asleep – the locus ceruleous (LC) or tiny blue spot has a huge amount of control over waking and sleeping. In waking, the LC is active and in REM sleep it is completely off.  Neurons from the LC project all over the cerebral cortex to arouse the brain – especially during stress.
  2. On an exam, a resident would be asked which of the following is at the same level as the LC – our residents therefore have to memorize all of the other structures on this slide to be able to answer that question – yikes!
  3. The LC also projects to the brainstem and spinal cord and influences posture and balance.

The overall point is that this morning, Dr. Young allowed us to think about how clinically we reduce the brainstem to just a handful of functions and seldom stop to consider the incredible complexity and beauty of this portion of the brain.

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