Junior Seau’s Death: Another Case of Chronic Traumatic Encephalopathy?

Is Junior Seau’s death attributable to Chronic Traumatic Encephalopathy (CTE)?

The former NFL linebacker who played for the San Diego Chargers, Miami Dolphins and New England Patriots, was found dead yesterday of a possibly self-inflicted gun shot wound to the chest.

The 43-year-old was a ten-time All-Pro and 12-time Pro Bowl selection, Seau was a member of the NFL 1990s All-Decade Team.

Family and friends are shocked at the death, saying they had no indication that Seau was suicidal.

In 2010, CNN reported that Seau was arrested on a domestic violence charge in Oceanside, California.  Just hours later, he drove his car off a cliff in nearby Carlsbad. An investigation did not reveal any alcohol or drug use in the incident, and charges were later dropped.

Seau joins a growing list of former NFL and NHL and WWF players, such as Chris Henry, David Duerson, Rick Martin and Chris Benoit who have died young, often at their own hand. Special autopsy performed on each of these athletes later diagnosed that all suffered from CTE, caused by years of concussions.

What is CTE?

Chronic traumatic encephalopathy is a form of brain damage which is believed to be caused by repeated concussions. Originally described in boxers, and called dementia pugilistica (DP) (commonly called “punch drunk”), symptoms include memory impairment, speech and gait problems, Parkinsonism, tremors and lack of coordination.

Early on there may be emotional instability, erratic behavior, depression and problems with impulse control. Eventually it leads to full-blown dementia. Floyd Patterson, Sugar Ray Leonard, and Muhammad Ali are all suspected to be victims of DP.

In 2002, Dr. Bennet Omalu, a forensic pathologist and neuropathologist in Allegheny County, Pennsylvania examined the brains of four professional football players who had histories of repeated concussions. Microscopic findings where identical to those found in DP, and he renamed the condition chronic traumatic encephalopathy.

The disease is characterized by the build-up of a toxic protein called tau in the form of neurofibrillary tangles (NFTs) throughout the brain (brown areas in the picture at left). These tangled clumps of protein are abnormal and found within the nerve cells in the brain.

They were first described by Dr. Alois Alzheimer in one of his patients suffering from dementia. These tangles interfere with the normal functioning of the brain and eventually kill brain cells. Although the dementia of CTE is similiar to that seen in patients with Alzeheimers Disease, they are different conditions.

The distribution of the damage is widespread, including the cerebral cortex (which includes the frontal and temporal lobes), the thalamus, hypothalamus, brainstem and spinal cord.

How is CTE Diagnosed?

Unfortunately, CTE can only be diagnosed at autopsy using special tests that are not routinely performed.

Boston University, at its Center for the Study of Traumatic Encephalopathy(CSTE), has thus far studied the brains of 14 former NFL players,  and has found CTE in 13 of those players. They have even found evidence of CTE in younger football players- the youngest being 18 years old.

What Can Be Done to Prevent CTE?

Here is an excellent video by the CSTC that explains the problem and what needs to be done:

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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