Neuro Shelf - Clinicals + Epileptic Seizures

Front 1

Patient with decreased sensation of pain and temp on lateral side of both arms --->

Back 1

Syringomyelia

Front 2

Pen light in patient's right eye --> bilateral pupillary constriction. When the light is moved to the left eye, there is a dialation. Which eye is the problem in? What is the defect?

either optic nerve or occulomotor nerve

Back 2

Atrophy of the left optic nerve.

OPTIC NERVE DAMAGE:
ipsilateral reflex is lost, and contralateral consenual is preseved.
OCCULOMOTOR NERVE DAMAGE:
ipsilateral reflex is in tact
contralateral reflex is lost

Front 3

Wild flinging arm --> hemiballismus- but is this contralateral or ipsilateral? what is the nucleus?

Back 3

subthalamic contralateral nucleus

Front 4

right drooped shoulder and cannot turn head to left...

which cranial nerve.... and right or left?

Back 4

right cranial accessory nerve #11.

Front 5

Patient with a lesion in his brain (cortex) and is unaware he has a lesion.... which lobe is affected?

Back 5

right parietal lobe

Front 6

Patient who's tongue protrudes to the right and he has right sided spastic paralysis.

Back 6

right medulla cn 12-hypoglossal

Front 7

Patient cannot blink his right eye or seal his lips- this is bell's palsy- LMN- is it ipsilateral/contra? and remember supranuclear is upper motor neuron and includes only the lower part of the face- ipsi/contra?

Back 7

bells palsy- cn7 = ipsilateral
supranuclear - superior to cn 7 - contralateral

Front 8

Women with headache + galactohoreha, amenohrea and visual problems--> dx =?

And what is the underlying cause of this?

Back 8

Prolactinoma- caused by a pituitary tumor- which increases the amount of prolactin in the blood.

Front 9

Man experiences dizziness + tinnitus- CT shows an enlarged internal acustic meatus. dx?

Back 9

shwannoma

Front 10

one eyed vision loss and slurred speach, Her history of weakness and Paresthesias have been resolved. dx?

Back 10

multiple sclerosis

Front 11

10 yr old child zones out in school--> dx?

Back 11

absence seizures

Front 12

motorcycle accident- the lady feels fine then she goes unconcsious within minutes- Ct shows an intracranial hemorrhage that does not cross suture lines.

Name the bone/vessel that were injured in the crash and what type of hematoma?

Back 12

Temporal bone- middle meningial artery--> Epidural hematoma

Front 13

Man with a history of Marfan's syndrome (connective tissue-fibrin genetic disorder FBN-1 gene) and hypertension presents with a severe headache- Spinal tap = BLOOD in CSF- what is the cause of the head pain?

Back 13

Subarachnoid henirrhage- resulting from a ruptured berry aneurysm.

Front 14

78 yr old man with Alzheimer's disease falls and presents 3 days later with a severe headache and vomiting... what struture ruptured in the fall...dx?

Back 14

bridging veins--> subdural hematoma

Front 15

Generalized seizures = whole cortex/diffused.
Simple/Complex Parital (focal) seizures = ONLY IN 1 AREA OF CORTEX-

Q: Partial Seizures can be divided into 2 groups: SIMPLE PARTIAL & COMPLEX PARTIAL- what is the difference???

And... When Simple Partial OR Complex Partial SPREAD to the rest of the cortex or other HEMISPHERE.... then it called???

Back 15

simple partial - still concious
complex partial- loss of conciousness


Partial Seizures (simple or complex) can spread and become SECONDARILY GENERALIZED-

Front 16

There are three type of seizures:
Focal Seizures, Secondarily Generalized Seizures, & Generalized Seizures.

describe differences- and excitation of neuron groups

Back 16

Focal - small group of neurons get excited and is limited to only 1 cortical region.

Secondary Generalized - group of neurons get excited and speads to WHOLE CORTEX via SUBCORTICAL structures.

Gerneralized Seizure- SEVERAL groups of neurons excited SIMUTANEOUSLY and spread to ENTIRE CORTEX.

Front 17

Seizures are caused by over excitation of which neurotransmitter- or too much inhibition of which neurotransmitter?

Back 17

too much Glutamate,
and too little GABA - insufficent hyperpolarization of GABA

Front 18

Name the glutamate ionotropic receptors linked to epileptic seizures (2 main ones)

NMDA binds to Ca2+ but it is blocked by ____?

*Remember- INHIBITORY Nt- GABA a - post-synaptic - binds to Cl-
GABA b - pre synaptic binds to K+

Back 18

NMDA + AMPA + kainate

NMDA binds to Ca2+ but it is blocked by Mg

Front 19

GENERALIZED SEIZURES(diffuse) can be divided into 6 groups- assign a name to the following description:

1. NON CONVULSIVE = Blank Stare- affecting schoolwork =

CONVULSIVE:
2. Quick and repetitive muscle jerks in arm (maybe starts with finger) -->
3. sudden brief muscle contraction -ARMS
4. Stiffening muscle tone
5. Stiffening then repetitive/rhythmical movements
6. Falls to the floor- like fainting- "drop seizure"

Back 19

Non-Convulsive:
1. Absence Seizure - school absent

Convulsive:
2. Myoclonic - sudden brief muscle contraction -ARMS
3. Clonic - rhythmic/repetitive mucle jerks contraction arm/neck/face-
4. Tonic - stiff mucle tone
5. Tonic-Clonic - stiff then rhythmic movement
6. Atonic Seizure - drop

Front 20

Seizures by age-
infection/trauma/metabolic is in both children and adults but...

genetic induced seizures-->
stroke induced seizures -->

Back 20

Children usually get epileptic seizures due to genetics

Adults usually due to strokes

Front 21

Patient who maintains conciousness, experiences myoclonic (sudden muscle contraction) and paresthesia (numbness/tingling) - dx?

Back 21

Simple Partial Seizure

Front 22

Patient LOSES conciousness and experiences Motor Automatisms (running, spinning, repetitive swallowing, kicking)- dx?

Back 22

Complex Partial Seizure

Front 23

Absence Seizure- patient loses conciousness- this is categoized as ....

If he loses conciousness and experiences- Myoclonic/Clonic/Tonic/Tonic-clonic/Atonic- then it categoized as a ...

Back 23

Generalized Seizure- Non-convulsive

Generalized Seizure- Convulsive

Front 24

Epilepsy is a disorder of the CNS or PNS?

Back 24

CNS

Front 25

Neurocutaneous disorders-
brown colored spots - in skin, Lisch Nodules(iris)

Back 25

Neurofibromatosis

Front 26

Neurocutaneous disorders-
Renal Cells carcinoma + hemangiomas (red) in skin and retina

Back 26

Von Hipple Lindau disease

Front 27

Neurocutaneous disorders-
tumors in CNS - benign tumors in various internal organs - heart- kidney- shagreen -
seizures

Back 27

Tuberous Sclerosis

Front 28

Neurocutaneous disorders-glycoma seizures- port-wine

Back 28

Sturge Weber Syndrome

Front 29

Communicating hydorcephalus - is casued by impaired absorption of CSF in the ____________ granulations

Back 29

arachnoid

Front 30

Non-communicating hydrocephalus is caused by a structural blockage in the Ventricular system- for example ___________...

Back 30

Sylvius aqueduct...