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29 Cards in this Set
- Front
- Back
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What characterizes MS |
Progressive demyelination or sclerosis of the white matter in the brain, spinal cord, and/or optic nerve Plaques seen throughout CNS |
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MS symptoms pattern |
Often follow an exacerbation and remission |
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MS risk factors |
Women Colder northern climates European descent Age 20-40 Affected first-degree relative |
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Cause of MS |
Unknown Genetic risk in individuals with certain MHC polymorphisms Supports autoimmune etiology, but an immune attack on virally infected oligodendrocytes is also suspected |
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What happens as MS exacerbations occur? |
Neural fxn is lost permanently |
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MS pathophysiology |
Demyelination = slowed or blocked conduction Early lesions occur as small areas of inflammation, but progresses to become firm demyelinated plaques, absent of oligodendrocytes |
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Why does MS get remission periods |
If initial inflammation subsides, neural function may return Lasts months to years with incomplete recovery from relapses (rarely steady progression from onset) |
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MS manifestations |
Initially see: weakness, numbness, burning, tingling, unsteady limb May disappear after a few days to weeks (but examination shows residual defects)Vary considerably between individuals MRI shows presence of multiple lesions in brain or spinal cord CSF has lymphocytosis and elevated Ab's |
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MS treatment |
Remission or partial remission can be induced with glucocorticoids, immunosuppression, or interferon |
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MS drug therapy |
Corticosteroids Immunosuppressive therapy Immunomodulators Muscle relaxants CNS stimulants Acetylcholinesterase inhibitors Tricyclic antidepressants Anti-seizure drugs |
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Immunomodulators |
Do we have to know??? |
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Parkinsonism |
Clinical syndrome characterized by tremor, rigidity, bradykinesia, and postural inability Sometimes, mild intellectual deterioration |
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Causes of Parkinsonism |
Most common is Parkinson's Disease (idiopathic) Others: encephalitis, severe CO poisoning, MPTP, and neuroleptic drug toxicity |
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Extrapyramidal effect |
Can do voluntary movements, but see defects in lower brain actions (arm swings, tremors) Excessive ACh stimulated inhibition of motor cortex |
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Connection between dopamine and voluntary movements |
Reduced dopamine = more inhibition on voluntary movements Therefore, we needs neurons to either make more dopamine or block ACh |
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Why do Parkinson's symptoms occur |
Imbalance between the amount of ACh and dopamine secreted in the basal nuclei (need balance between activation and inhibition) Destruction of dopaminergic neurons in substantia nigra Results in excessive ACh stimulated inhibition of motor cortex |
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What usually controls movement |
Movement "programs" from the motor cortex are normally inhibited by GABA secreted from the basal nuclei onto the thalamus |
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What controls the amount of GABA produced |
Increased by ACh Decreased by dopamine |
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Manifestations of Parkinson's |
Tremor Rigidity and bradykinesia Postural instability |
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Parkinson's tremors |
More pronounced at rest Enhanced by stress or anxiety Usually begins in 1 limb (hands) but can be present in all limbs |
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Parkinson's - rigidity and bradykinesia |
Increased resistance to passive movement Slow voluntary movements Reduction in automatic extrapyramidal movements (not swinging arms) Effective movement can sometimes be regained in an emergency |
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Parkinson's - postural instability |
Person tends to lean forward Shuffles Complicated by slow voluntary movements |
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Parkinson's treatment |
No cure Restore balance bw ACh and dopamine |
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Parkinson's complications |
Increase as disease progresses Motor symptoms Weakness Akinesia Neuro problems Depression, anxiety Dementia |
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Surgical care of Parkinson's |
Deep brain stimulation |
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Myasthenia graves patho |
Autoimmune Make Ab that bind to, block, and destroy ACh receptors at the postsynaptic neuromuscular junction |
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Myasthenia graves symptoms |
Only affects skeletal muscles Don't have sensory nerve attack |
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Guillon barre |
Affects peripheral motor nerves See both muscle and sensory problems |
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Amyotrophic lateral sclerosis |
Scarring in laterocorticospinal tract of spinal cord Without muscle growth (profound muscle atrophy) throughout body |
