1.0 PARKINSONISM

Movements of salat may be difficult in advanced Parkinson’s disease but are possible. In advanced cases hajj may be a physical challenge. Unintentional injury to self and others is likely because of uncontrollable movements; special precautions may have to be taken.

2.0 SENILE DEMENTIA

Demented patients cannot remember verses of the recitation properly and may confabulate. They should follow and not lead in salat.

Dementia that does not impair cognition does not exempt from puasa and hajj.

Court testimony of elderly demented patients should be evaluated in the light of their memory and cognition. In many cases dementia is incipient and may not be suspected; special tests of competence should be administered by the judge before proceeding.

Dementia may be a reason for exclusion from positions of leadership. However the leadership potential of the elderly should not be forgotten altogether. What they may lack in short term memory and cognition can be made up from the accumulated wisdom of experience.

3.0 HEAD INJURY

Head injury may be open or closed, focal or diffuse.

Focal head injury is usually due to a hematoma (epidural, subdural, intra-cerebral).

Post concussion syndrome is a form of diffuse head injury.

Head injury may be associated with paralysis, impaired consciousness, or loss of sensation. Salat and hajj obligations may be affected depending on the extent of injury.

4.0 BRAIN TUMORS

Brain tumors, both benign and malignant, have pressure effects. The symptoms of increased intra-cranial pressure are: headache, nausea, vomiting, personality changes, and loss of consciousness.

They affect salat, hajj, marriage contracts, and judicial proceedings depending on severity. Each case should be assessed on its own merits and how far it affects competence.

5.0 BRAIN INFECTIONS

Brain infections may manifest as viral or bacterial meningitis complicated by brain abscesses, cysticercosis, AIDS etc.

They have effects of consciousness, sensory, and motor function. The mental clouding that results affects salat, puasa, hajj, and witnessing in court.

6.0 SPINAL CORD INJURIES

Spinal cord injuries may lead to hemiplegia, quadriplegia and paraplegia.

Salat movements are restricted in paraplegia and quadriplegia. Hajj is possible if a vehicle is used to carry the pilgrim.

7.0 NEUROMUSCULAR CONDITIONS

NMJ disease such as myasthenia gravis limits salat movements and may make hajj difficult. The patient undertakes physical activities to the best of ability

8.0 NEUROPATHIES

Neuropathies may be mono-neuropathies or polyneuropathies caused by trauma, toxins, metabolic disorders or associated with various disease conditions. Pain from neuropathies may be increased during salat movements.