ללא פרק ברור - מהמבחן

Question 1

paraneoplastic disorders

Answer 1

endocrine
LAMBERT-EATON SYNDROME
Paraneoplastic cerebellar degeneration
Encephalomyelitis
neuromyotonia (isaacs syndrome)
Limbic encephalitis

Question 2

paraneoplastic necrotizing myelopathy

Answer 2

anti-Hu
underlying tumor lung or breast, lymphoma, or leukemia. rapidly ascending flaccid paraplegia.
MRI- usually nonspecific or normal, but may show swelling of the spinal cord.
CSF - may contain inflammatory cells.
Treatment - underlying malignancy
improvement - uncommon.

Question 3

MYASTHENIC SYNDROME (LAMBERT-EATON SYNDROME)

Answer 3

autoimmune or paraneoplastic (cmall cell lung cancer)

CLINICAL FINDINGS -
proximal muscles of the limbs weakness
extraocular muscles - -spared (unlike MG)
dry mouth, constipation, and impotence

DIAGNOSIS - electropheresis, P/Q antibodys

TREATMENT - immunosupresive - steroid, azathiopirine
plasmapheresis

Question 4

NEUROMYOTONIA ( Isaacs syndrome )

Answer 4

rare, sporadic
continuous muscle stiffness, rippling muscle movements ( myokymia ), and delayed relaxation after muscle contraction.
AD or paraneoplastic

antibodies against voltage-gated potassium channels

Symptoms may be controlled with phenytoin

Question 5

Sarcoidosis

Answer 5

can produce mononeuropathy - involves cranial nerves, especially the facial nerve,
In some instances, a small-fiber neuropathy leads to pain, dysesthesias, and autonomic involvement.

rarely - polyneuropathy.

diagnosis:
X-rays - lungs and bones
ACE serum levels

Treatment
prednisone (speed recovery)

Question 6

connective tissue disorders associated with mononeuropathy multiplex

Answer 6

polyarteritis nodosa, rheumatoid arthritis, Churg-Strauss syndrome, and Wegener granulomatosis

Question 7

Blepharospasm

Answer 7

abnormal contraction or twitch of the eyelid - feel like they are clamping shut and will not open

botulinum toxin injections may help temporarily.

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