There are a number of neurological diseases which have an effect on bowel function. This chapter provides an overview of gastrointestinal (GI) physiology, with reference to the hindgut and pelvic floor. It addresses the problems caused by common neurological diseases. The intra-abdominal GI tract is varied, and divided into the organs of stomach, small intestine and large intestine. Bowel dysfunction affects approximately 80% of those with spinal cord injury (SCI) and causes more of a problem than urinary and sexual dysfunction in a third of individuals with SCI. Neurological diseases such as SCI or MS frequently impair CNS control of the gut. The difference between the neural control systems for bowel and bladder is underlined by the differing effects of such diseases on the two systems. Supraconal SCI tends to cause difficulty with evacuation of feces in addition to fecal incontinence, but predominantly difficulty with urinary continence.

Spasticity is one of the commonest sequelae of neurological diseases. In most patients spasticity is useful in compensating for lost motor strength. Nevertheless, in a significant number of patients it may become excessive and harmful, leading to further functional losses. Stimulation of spinal cord was developed in the 1970s on the basis of the 'gate-control theory' of Melzach and Wall for the treatment of neurogenic pain. This method has been found to be partially effective in the treatment of spastic syndromes, such as those encountered in multiple sclerosis or spinal cord degenerative diseases, such as Strumpell-Lorrain syndrome. Orthopaedic procedures can reduce spasticity by means of muscle relaxation that results from tendon lengthening and may help in restoring articular function when deformities have become irreducible. Current techniques for correcting excessive shortness of the muscle tendon assembly are muscular desinsertion, myotomy, tenotomy and lengthening tenotomy.

This chapter provides an overview of survival analysis as it relates to the major disorders within neurology. Death is the predominant outcome measure in the discussion. Two commonly used methods are described in the chapter, to handle censoring and variable starting times include life table analysis and the Kaplan-Meier approach. There have been a number of studies to elucidate the survival characteristics of individuals with multiple sclerosis (MS). Other neurological diseases discussed in the chapter include stroke, HIV-related neurologic disease, dementia, primary CNS neoplasms, and status epilepticus. Cerebrovascular disease (CVD) or stroke is the third leading cause of death and a significant cause of long-term disability in most industrialized nations. Human immunodeficiency virus (HIV)-dementia is largely a subcortical disorder involving deficits in cognition, behavior, and the motor system. Within the past two decades, Alzheimer's disease (AD) has been confirmed to be responsible for the majority of primary degenerative dementias.