Infections Of Cns

Front 1

What symptoms are associated wtih aseptic meningitis?

Back 1

fever, HA, photophobia and pain on movement of eyes

Front 2

What CSF findings are common with meningitis and encephalitis?

Back 2

pleocytosis (primarily lymphocytes of 100-300 per mm3), increase in protein, normal glucose

Front 3

What are the symptoms associated with acute viral encephalitis?

Back 3

meningitis, impairment of consciousness, seizures, mutism or aphasia, hemiparesis, asymmetry of reflexes and Babinski signs, involuntary movements, cerebellar ataxia, polymyoclonus, CN palsies

Front 4

What are common causes of viral encephalitis?

Back 4

Herpes, Mumps, Arboviruses, rabies and others

Front 5

What are the presenting symptoms of Herpes encephalitis?

Back 5

fever, HA, confusion. Evolves over several days. May have gustatory/olfactory hallucinations, temporal lobe/motor sz, changes in personality, apathy/Kluver-Blucy syndrome

Front 6

What are the neuropsychological effects of Herpes encephalitis?

Back 6

deficits in attention, concentration, organization. Profound memory problems (anterograde, retrograde), patient may perseverate on old memories, social deterioration, changes in personality
Children have difficulites learning to read and with math

Front 7

What are the motor sx associated with Herpes encephalopathy?

Back 7

tremor, paresis, poor balance and coordination, motor seizures

Front 8

What EEG pattern is suggestive of Herpes Encephalitis?

Back 8

High-voltage sharp waves and slow wave complexes alternating at 2-3 sec. intervals

Front 9

What is the recommended treatment for Herpes encephalitis, what is the prevalence and prognosis of the disease

Back 9

treat with acyclover antiviral for 14 days. Goal to treat before stupor b/c if advances to altered consciousness there is only 50% chance of survival and most who survive will have memory deficits and seizures. Disease is rare and comes from Herpes 2. 3-30% return to normal function

Front 10

Describe Kluver-Blucy syndrome

Back 10

hyperoral, uncontrolled eating, affective blunting, loss of fear, hypersexuality. comes from bilateral temporal lobe ablation and can be seen with herpes encephalitis.

Front 11

What is progressive multifocal leukoencephalopathy (PML)?

Back 11

Disease associated with AIDS, Hodkin's disease, lymphoma or chronic leukemia. Develops over 3-6 months with focal cerebral, brainstem and cerebellar signs.
Leisons are demyelinated and appear on MRI.
Inclusion bodies are seen in oligodendrocytes, and astrocytes are large and show tumor-like mitosis.
Remission can be seen in AIDS patients with aggressive retroviral treatment.

Front 12

Describe 5 symptoms of Creutzfeldt-Jakob disease (subacute spongiform encephalopathy).

Back 12

Characterized by rapidly progressive dementia along with cerebellar ataxia, heightened startle response, diffuse myoclonic jerks and cortical blindness.
Death in less than one year. No treatment.

Front 13

Where is tissue damage associated with Creutzfeldt-Jakob disease?

Back 13

Diffuse loss of neurons, gliosis and vacuolation of cerebellar and cerebral cortices. No inflammatory changes or inclusion bodies.

Front 14

What imaging/testing is diagnostic of Creutzfeldt-Jakob disease?

Back 14

EEG after 1-2 months of the disease. high-voltage slow and sharp waves occurring periodically at 1-3 Hz intervals on an increasingly flat background ("burst suppression")

Front 15

What agent causes Creutzfeldt-Jakob disease?

Back 15

Prion (proteinaceous infectious particle). Lacks the structure of a virus. Can have an incubation period of a year or longer. Antibodies to the prion protein can be found in CSF

Front 16

What is the classic triad of symptoms are associated with Lyme's disease? What is the prevalence of the disease?

Back 16

Classic triad of symptoms: lymphocitic meningitis, painful radiculoneuritis, cranial neuritis. Bacteria (Borrelia burgdorferi) comes from tick and is most prevelant in north east (Connecticut). Starts with bullseye rash and flu-like symptoms about 1-2 weeks after infection.
15,000/year infected.

Front 17

Describe neurologic symptoms associated with Lyme's disease.

Back 17

15-20% of those infected will develop neurologic symptoms including facial nerve palsy, motor and sensory nerve inflammation, encephalitis

Front 18

What neuropsychological symptoms are associated with Lyme's disease encephalopathy?

Back 18

Cognitive impairment (memory and word generation), sleep disturbances, fatigue, personality changes, arthritis, musculoskeletal changes. Can be chronic.

Front 19

What is the treatment for Lyme's disease?

Back 19

Antibiotic treatment for 3-4 weeks

Front 20

What symptoms are associated with AIDS Dementia Complex/HIV Encephalopathy?

Back 20

Insidious onset that affects concentration, memory, processing speed. Motor symptoms include weakness, tremor, incoordination and gait problems. Can have personality changes including irritability, depression, or psychosis (hallucinations). As the disease advances mutism, incontinence and coma occur.
75-90% of AIDS patients have CNS involvement before they die.

Front 21

Is AIDS Dementia Complex similar to a cortical or subcortical dementia?

Back 21

Subcortical. Motor changes are similar to parkinsonian symptoms with myoclonis.

Front 22

What neuropsychological symptoms are associated with AIDS Dementia Complex?

Back 22

Symptoms consistent with diffuse brain damage including: decreased attention, memory, slowed responses. May also demonstrate deficits in naming fluency, problem-solving/self-monitoring.

Front 23

Describe neuroimaging findings associated with AIDS Dementia Complex.

Back 23

Bilateral subcortical brain atrophy (sparing the cortex), white matter lesions, EEG abnormalities