1. Boxers –also called Boxers Dementia or ‘Punch Drunk Syndrome’ (Gould & Pineda, 2010). It is a generative head disorder resulting from repetitive head trauma. Symptoms are described after cessation of exposure to chronic to brain injury. It commonly affects boxers. It is in other words a disease of boxers.
2. Reason to listen: many boxers have suffered the disease either during or after they have retired from their career. Terry Norris, who was a lightweight boxer with knock out power and fast hands, is a victim (Pitt, 2010).
3. Thesis: although it is not easily diagnosable, Dementia pugilistica exists and is a serious mental disorder.
4. Credibility statement: I have consulted widely from different sources in my endeavor to unravel the truth about Dementia Pugulistica.
5. Preview of main points:
6. First, I will discuss Dementia Pugulistica itself.
7. Second, I will discuss the neurophysiology related to sports injury
8. Thirdly, I will discuss the DSM-IV criteria.
9. Finally, I will discuss views about Dementia Pugulistica.

II. Even though it is not easily diagnosable, Dementia Pugulistica exists and is a serious mental

2. Dementia Pugulistica is the most prevalent mental disorder among boxers.
3. Dementia pugilistica also referred to as Boxers Dementia manifests in boxers after they have retired from their career. It is also referred to in the short form as DP. According to Gould and Pineda (2010), DP can be caused by other factors provided they produce stimuli that causes repetitive head trauma. Repetitive head trauma is described as, one occurring even before recovery from an existing head trauma.
4. DP is characterized with progressive neurological deterioration of the victim. Other symptoms of DP include:

a)      Gait ataxia-imbalanced gait

b)      Slurred speech

c)      Impaired hearing-difficulty hearing

d)     Tremors

e)      Disequilibrium of the whole body

f)       Neurobehavioral disturbances

g)      Progressive cognitive decline.

h)      According to David Cifu (2012) in his article ‘Repetitive Head Injury Syndrome’, repetitive damage to the brain can lead to neurogenerative disease and cognitive impairment in later life.

i)        Cifu (2012) also outlines the factors that lead to DP’s complications as: delayed diagnosis, subtlety of symptoms, overlapping of clinical signs, lack of knowledge on the specifics of diagnosis and paying attention only to the more concomitant injuries.

Transition: now that I have elaborated Dementia Pugulistica, I will discuss about its evidential

existence and its devastating, undesirable effects.

1. Dementia Pugulistica has been found to affect many renowned athletes and boxers: According to Pitt (2010), in his article ‘Fistic Medicine Dementia Pugulistica and MMA’, Terry Norris, a lightweight boxer is a victim of Dementia Pugulistica. Pitt (2010) further observes that not only boxers and athletes are victims to DP: Rugby players, football players, and wrestlers like Chris Benoit have been diagnosed with the condition. Due to this, Pitt (2010) refutes the name Boxer’s Dementia and prefers Chronic Traumatic Encephalopathy (CTE).
2. The DSM-IV criteria for Dementia. DSM-IV is a criterion for diagnosing mental illnesses. It was developed by the American psychological Association. Here I am going to discuss the DSM-IV criteria in relation to Dementia.
3. The development of many cognitive defects characterized by both:
4. Impaired ability to recall learned information or to learn new information.
5. One or more of these cognitive disturbances:
6. Language disturbances referred to as aphasia.
7. Struggling with carrying out motor activity despite intact motor functioning referred to as apraxia.
8. Inability to recognize and identify objects despite good sensory function referred to as agnosia.
9. Executive functioning disturbances, for example, in planning, being organized and in sequencing.
10. The cognitive defects in criteria 1a and 1b lead to impairment in occupational and social functioning and they represent a massive deterioration in from a pre-existing level of functioning.
11. Existence of focal neurological symptoms and signs, for example, extensor planter responses, exaggerated deep tendon reflexes, gait disturbances, pseudo bulbar palsy, and weaknesses in extremities plus others whose etiology can be judged to be related to the condition.
12. These defects noted not to occur exclusively in the course of delirium.
13. McKee, et. Al (2009). Outlines the specific signs of Dementia as behavioral and personality changes, memory disturbances, Parkinsonism, speech and gait abnormalities. It is observed that atrophy of components of the brain occurs inclusively of the thalami, temporal lobe, mamillary bodies and the brainstem.

Transition: now that we have discussed the DSM-IV classification of dementia, it is important we look at the views of various people about dementia pugilistica.

1. Those people who agree that Dementia Pugulistica exists and is a serious mental disorder, and it requires serious attention. Also in focus, the people who agree that dementia is not a disease of boxers and athletes alone.
2. According to Pitt (2010), Dementia Pugulistca has been diagnosed in other categories of patients apart from boxers. Pitt laments that Dementia Pugulistica, should no longer be referred to as the disease of boxers. According to his observation, Dementia Pugulistica has been diagnosed and confirmed in footballers, rugby players as well as athletes. He gives an example of Chris Benoit as a footballer who has been diagnosed with DP to emphasize his point. Pitt further claims that Dementia is irreversible and that neuromotor dysfunction will most likely result to psychological decline.
3. McKee et al. (2009), observes that Dementia Pugulistica is distinguished from other mental disorders in that superficial mental cortices are the most affected by the condition. They further connote that progressive brain degeneration is prevalent during the prognosis of the condition. They agree that Dementia Pugulistica most often occurs due to repetitive brain injury. The authors conclude that the deposition of diffuse plaques is noticeable in the presence of Dementia Pugulistica.
4. Barnes et al. (1999) relates Dementia Pugulistica with brain concussion, Second Impact Syndrome and Post-Concussion Syndrome. Of all the researchers, this article the decision of victims of Dementia Pugulistica to return to play. They argue that Dementia pugulistica exists as a continuum, and thus, the victim is highly likely to go back to play. The authors emphasize the need for a comprehensive neurophysiologic assessment in the diagnosis and management of Dementia Pugulistica. Importance of treating minor head injuries is also emphasized.

III. Conclusion.

1. Review of main points
2. Today, I first discussed Dementia Pugulistica itself.
3. Second, I discussed the neurophysiology related to sport injury.
4. Third, I discussed the DSM-IV criteria for vascular dementia.
5. Finally, I discussed the views of some researchers on Dementia Pugulistica.
6. Restate Thesis: Even though it is not easily diagnosable, Dementia pugulistica exists and is a serious mental disorder.
7. Closure: Dementia Pugilistica is a serious mental disorder that mostly affects boxers. It results from repetitive brain injury. Treatment of minor brain injuries and continuous reassessments are essential in prevention and management.

References

American Psychological Association. (2000). Diagnostic and statistical manual for mental disorders, (4^th ed). Washington DC: American Psychological Association.

Cifu, D. (2012). Repetitive head injury syndrome. Medspace. Retrieved from http://emedicine.medscape.com/article/92189

Barnes, R., Erlanger, D.M., Kutner, K.C., & Barth, J.T. (1999).Neuropsychology of sports-related head injury: Dementia pugilistica to post -concussion syndrome.The Clinical Neurophysiologist, 13(2), 193-209.

Gould, J.D. & Pineda, P. (2010). The neuroanatomical relationship of dementia pugulistica and Alzheimer’s disease. Retrieved from http://www.neuroanatomy.org/2010/005_007.pdf

McKee, A.C., Cantu, R.C., Nowinski, C.J., Hedley, Whyte, E.T., Gavett, B.E…….Stern, R.A. (2009). Chronic traumatic encephalopathy in athletes: Progressive tauopathy after repetitive head injury.Journal of Neuropathology and Experimental Neurology, 68(7), 709-35.

Pitt, M. (2013). Fistic medicine dementia pugulistica and MMA. Crave Online Media. Retrieved from http://www.sherdog.com

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