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66 Cards in this Set
- Front
- Back
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Four Parkinson's Plus syndromes
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progressive supranuclear palsy
multiple system atrophy corticobasal ganglionic degeneration dementia with lewy bodies |
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symptoms of progressive supranuclear palsy
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gait instability
rigidity no voluntary vertical eye movements but preserved Doll's eyes |
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symptoms of multiple system atrophy
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shy drager syndrome:
orthostatic hypotension- syncope- autonomic dysfunction- ataxia motor manifestations become less responsive to levodopa |
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symptoms of corticobasal ganglionic degeneration
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alien hand syndrome
apraxia dysphasia cortical sensory loss |
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dementia with lewy bodies
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fluctuations in cognitive function- hallucinations- parkinsonism- falls-syncope-sensitivity to neuroleptics making parkinsomism worse
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axonal nerve damage presents with proximal/distal/both?
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proximal muscle weakness/sensory disruptions
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axonal nerve damage shows what on NCS and what else on EMG
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NCS- little change in velocity
EMG- deinnervation shown |
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axonal nerve damage CSF
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normal
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demyelinating nerve damage shows what on NCS/EMG
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NCS- slowing in velocity
EMG- no deinervation unless axon is involved and it is long-standing/severe damage |
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CSF shows what on demyelinating nerve damage
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elevated protein
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Three common demyelinating peripheral neuropathies
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AIDP- GBS
CIDP CMT- inherited |
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Nerve degenerations of motor nerves symptoms
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no sensory
proximal/distal muscle weakness fasiculation/muscle cramps |
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three common motor nerve degenerative diseases
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ALS
spinal muscular dystrophy PLS |
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three types of direct trauma nerve damage
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neurapraxia
axonotmesis neurotmesis |
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neurapraxia is defined as
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damage of nerve without severing the axon- can repair and recover
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axonotemesis is defined as
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damage to axon- severe compression that can slowly repair
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neurotmesis is defined as
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severing of the axon and supporting tissues- poor prognosis
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difference between myopathy and neuropathy- location of weakness
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myopathy- proximal
neuropathy- distal- also sensory loss and loss of reflexes |
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motor neuron diseases are typically diagnosed when the patient has
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lower/upper motor dysfunction without any sensory deficits and without any other cause- sroke, B12, DM
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how long after stroke do you start worrying about edema/herniation
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72 hrs.
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BP lower in limb- fatigue when using
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subclavian steal
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anterior spinal artery infarct
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weakness/decreased pain/temp but intact vib/prop.
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loss of pain/temp in arms and hands with spasticity in LE
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syringomyelia
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want to make sure ALS is not
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cervical myopathy
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S1 radiculopathy- the pt cannot
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stand on toes
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L5 radiculopathy the pt has
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foot drop
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radiation injury usually occurs how long after?
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2 years
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fever, muscle rigidity, increased CK, altered mental status
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neuroleptic malignant syndrome
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FEF lesions- eyes look
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at lesion
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Wallenberg Syndrome-
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ipsilateral ataxia/horner's/facial numbness/dysphagia- contralateral pain/temp loss
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infarct to cerebellar peduncle -
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hemiplegia
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infarct to pons causes
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ataxia- clumsy hand syndrome
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uncal herniation signs
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contralateral hemiparesis, loss of consciousness, CN III- dilated pupil
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cerebellar tonsillar herniation causes
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apnea/resp.changes
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central herniation-what happens
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decorticate then lose brainstem responses, then decerebrate- not good
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what do you use to treat central herniation
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mannitol- can cause rebound edema
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head injury- immediately causes
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edema
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scalp sensitivity and jaw claudication
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think giant cell arteritis
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GBS, sulfa drugs previosly, recurrent abdominal cramping -
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acute intermittent porphyria
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GBS, previous sulfa drugs, abdominal cramping, skin sensitivity
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porphyria verrigate
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GBS + upper respiratory symptoms
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diptheria
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absent ankle reflexes- upgoing toes- - rhomberg
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b12 deficiency
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sudden onset of pain/weakness in hip/thigh followed by atrophy
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diabetic amyotrophy
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trigeminal neuralgia is treated with
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carbamazepine
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restless leg syndrome is treated with
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pramipexole, seniment, benzos, opoids
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__ dementia- pt is socially inappropriate
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fronto-temporo
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opthalmoplegia- ataxia- acute confusion
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weirnicke's encephalopathy
give thiamine to prevent anterograde amnesia |
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Bells palsy + history of rash
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Lyme Disease
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how to test for lyme disease
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ELISA
western blot |
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tinnitis, hearing loss, ear pain-
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meinere's disease- endolymphatic hydrops
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sick/nausea/vomitting- seizure at end of week caused by
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hypernatremia
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transverse myelitis
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1 week proressive sensory loss to spinal level with band-like sensation
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shy-drager syndrome
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multiple system atrophy
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pt that is opisthotonos
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compazine/prochlorperazine can cause treat with benedryl
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treatment of tardive dyskinesia
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benzos/baclofen/vit E
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cushing response
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HTN, bradycardia, bradypnea
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cushing response is present during
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herniation
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if there is air in the EDH that might signify
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fracture of sinuses/mastoid air cells
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attention testing
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spelling a word backwards
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horner's + HA + neck injury
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carotid dissection
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temporal auras generally consist of
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abdominal sensation/fear/deja vu
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parietal auras
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electric- tingling/numbness
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occipital
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visual changes
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loss of executive function, hallucinations, REM/sleep disordered, neuroleptic sensitivity
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Diffuse Lewey Body Dementia
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areas disrupted in B12 deficiency
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peripheral n
dorsal columns LCST |
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optic neuritis treated with
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corticosteroids
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