biology

New Brunswick neurological syndrome of unknown cause

New Brunswick neurological syndrome of unknown cause is a biology topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand New Brunswick neurological syndrome of unknown cause rather than just read about it. In short: A neurological syndrome of unknown cause was suggested as a potential novel degenerative disease in a cluster of individuals with similar clinical signs and symptoms in the Canadian province of New Brunswick beginning in 2019. The existence of this syndrome became the subject of several investigations including by federal and provincial governments, extensive media coverage, and scientific scrutiny.

Key takeaways

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Reference excerpt

A neurological syndrome of unknown cause was suggested as a potential novel degenerative disease in a cluster of individuals with similar clinical signs and symptoms in the Canadian province of New Brunswick beginning in 2019. The existence of this syndrome became the subject of several investigations including by federal and provincial governments, extensive media coverage, and scientific scrutiny. Symptoms listed on the New Brunswick Public Health (NBPH) website include memory problems, muscle spasms, balance problems, difficulty walking or falls, blurred vision or visual hallucinations, unexplained or significant weight loss, behaviour changes, and pain in the upper or lower limbs. The existence of the neurological syndrome was originally promoted by neurologist Alier Marrero, who diagnosed hundreds of patients with the condition. Subsequent investigations by other neurologists, neuropathologists, and the Province of New Brunswick suggest that the syndrome does not correspond to a single neurological disease, that all re-examined cases of the proposed neurological syndrome corresponded to well-known conditions such as Parkinson's disease and Alzheimer's disease, that some alleged symptoms could not be substantiated upon re-examination, that the rapidity of onset had been overestimated in some cases, and that a single underlying cause for the proposed syndrome cannot be identified.

Background The investigation into the cluster was instigated in 2019 at the federal level by the Ottawa-based Creutzfeldt-Jakob Disease Surveillance System (CJDSS) unit – which operates under Public Health Agency of Canada (PHAC). CJDSS director Michael Coulthart worked with Alier Marrero, a neurologist at Dr. Georges-L.-Dumont University Hospital Centre, in Moncton, New Brunswick who had referred cases to the CJDSS unit for testing and diagnosis. The disease cluster was first noted through the routine case management arrangement between New Brunswick and federal health authorities, when experts from the CJDSS unit – which provides surveillance for "all types of human prion disease in Canada" – noticed a significant number of NB referrals had "some common symptoms and similar potential diagnostic profiles". The CJDSS ruled out any prion disorder, including Creutzfeldt-Jakob Disease (CJD) – an incurable, fatal disease. Marrero and Coulthart and colleagues worked for months together investigating the cases. The federal-provincial team began to suspect that they were looking at a novel neurological degenerative disease potentially caused by a toxin or agent. By December 2020, 24 new cases in New Brunswick of something that "looked like CJD but was not" had been diagnosed. PHAC considered this to be an "unusually high number" and contacted New Brunswick's Chief Medical Officer of Health (CMOH) Jennifer Russell, about the disease cluster. In January 2021, the CJDSS and Marrero updated the case definition of the syndrome, which had been first drafted in December 2020. The definition was then accepted by Public Health New Brunswick. In March 2021, provincial health authorities shared information describing symptoms with New Brunswick physicians in a memorandum that was leaked to the media. On 27 April 2021, NBPH published a webpage which is updated to inform the public of the disease cluster, its symptoms, ongoing investigations and their findings.

Symptoms In a 25 March 2021 interview, Marrero said that initial symptoms are often nonspecific, making a diagnosis challenging. He listed symptoms such as "behavioral changes, sleep disturbances, unexplained pain, visual hallucinations, coordination problems, unexplained hair loss, involuntary muscle twitching, formication (a sensation that feels like small insects crawling under the skin), ataxia, and brain atrophy". In April the NBPH website listed symptoms such as memory problems, muscle spasms, balance issues, difficulty walking or falls, blurred vision or visual hallucinations, unexplained or significant weight loss, behaviour changes and pain in the upper or lower limbs. In interviews conducted by the media, patients and their families described symptoms such as rapidly progressing dementia, unexplained and significant weight loss, myoclonus, aphasia, changes in behaviour, sleep disturbances, unexplained pain, visual hallucinations, co-ordination problems and severe muscle and brain atrophy, progressing over a period of 18 to 36 months. The majority experience multi-day insomnia even with "sleep medication". Memory loss and aphasia are seen. In some cases, Capgras delusion and echolalia have been reported. Myoclonus persists "even in the late stages of the disease" and even "when patients are unconscious". Akinetic mutism were observed in late-stage patients, where they no longer have the ability to speak or move. The New York Times reported symptoms of "extreme fatigue, involuntary jerking movements, memory lapses and hallucinations" on 4 June 2021.

Demographics The cases suggest that the proposed syndrome affects men and women equally. Cases have been reported in all age groups from 18 to 86, with a median age of patients being 59 years old.

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Worked examples

Example 1 — a first encounter with New Brunswick neurological syndrome of unknown cause

Start with the simplest possible case. Write down what New Brunswick neurological syndrome of unknown cause claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In biology, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to New Brunswick neurological syndrome of unknown cause before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about New Brunswick neurological syndrome of unknown cause ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of New Brunswick neurological syndrome of unknown cause

In research: New Brunswick neurological syndrome of unknown cause appears in biology research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses New Brunswick neurological syndrome of unknown cause in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: New Brunswick neurological syndrome of unknown cause is common in secondary-school and first-year university syllabi. It links to neighbouring topics 2019 in New Brunswick, 2020s in New Brunswick, 2021 in biology, so understanding it makes those chapters shorter.
In everyday life: Look for New Brunswick neurological syndrome of unknown cause outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study New Brunswick neurological syndrome of unknown cause in 20 minutes

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Frequently asked questions

What is New Brunswick neurological syndrome of unknown cause in simple terms?

Why does New Brunswick neurological syndrome of unknown cause matter?

Because it connects several biology ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study New Brunswick neurological syndrome of unknown cause?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on New Brunswick neurological syndrome of unknown cause.