Refusing treatment: diseases of the central nervous system

The central nervous system (CNS) is made up of the spinal cord and the brain. It is the system of nerves that controls most of the things that the body and mind do.

The brain interprets information from our eyes, ears, nose, mouth and skin, as well as from internal organs such as the stomach. It uses this information to help us think, react and move. The spinal cord sends this information to the brain for it to process, and then carries instructions from the brain to the rest of the body, telling it what to do.

Diseases of the CNS cause damage to the cells of the brain or spinal cord. This can have a large impact on the way we think, move or react to things. Most diseases of the CNS are progressive, which means that they get worse over time. There is currently no cure for these conditions.

There are many different diseases of the CNS and the symptoms depend on which part of the CNS is affected. Each person is different so this means that the symptoms people experience and how quickly their condition progresses will differ from one person to another. Here is a brief overview of some of the most common conditions:

Parkinson’s disease
Parkinson’s disease causes the amount of a chemical in your brain, called dopamine, to decline over time. Dopamine helps to control movement and coordination in your body. Your brain uses dopamine to send messages to your muscles to make them move.
This loss of dopamine causes different symptoms. Many symptoms cause problems with movement but people with Parkinson’s can experience other symptoms too. The main symptoms include shaking and tremors, muscle stiffness, slowness of movement, tiredness, pain, depression and constipation.
Motor Neurone Disease (MND)
MND affects nerve cells, called motor neurones, in the brain and spinal cord. Motor neurones carry important messages to the muscles in your body. When these messages stop reaching the muscles it leads to weakness and wasting. As the condition progresses, people with MND will find everyday tasks like gripping, walking, speaking, swallowing and breathing increasingly difficult. Eventually, they may become impossible.
Common symptoms of MND are pain and discomfort, stiff joints, muscle wasting, difficulty speaking and communicating, difficulty eating and drinking and respiratory muscle weakness (finding it hard to breathe).
Multiple Sclerosis (MS)
MS affects the nerve fibres of the central nervous system causing damage to the coating around them. This means that the nerves gradually become unable to send information between the brain and body. This causes a range of symptoms including tiredness, loss of vision, loss of balance, difficulty walking, pain and slurred speech.
Huntington’s disease
Huntington’s disease is caused by a faulty gene that damages certain nerve cells in the brain. It’s hereditary, which means the faulty gene is passed down from a parent. It can affect movement, thinking, judgement and behaviour.
Symptoms include uncontrollable movements of the face, and jerking or fidgety movements of the body, difficulties eating (due to the mouth and throat muscles not working properly), personality changes, mood swings, fidgety movements, irritability and changes in behaviour.
For more information on: