Chap 26: Neurological Disorders Flashcards
What are the major categories of neurological disorders ?
- TBI
- Epilepsy
- Tumors
- Motor disorders of the spinal cord
- Motor disorders of the basal ganglia
- Headache
- Infection
- Cerebral Vascular (stroke)
What is thrombosis ? Embolism ?
Thrombosis
- blood coagulation in a vessel that forms a plug or clot
Embolism
- when a clot from a large vessel is forced into a smaller one
- most often in the middle cerebral artery
What is an Angioma ? Aneurysm?
Angiomas
- collection of abnormal vessels that divert normal blood flow
Aneurysm
- vascular dilations from weakened vessel elasticity (creates buldge that is at risk for bursting)
When are anti-coagulants used for stroke treatment ?
- for ischemic stroke ONLY
- within 3-5 hours of onset
What are the common symptoms of stroke (FAST) ?
- Numbness in arm, face, leg especially on one side
- Sudden confusion, trouble speaking or understanding language
- Sudden trouble walking, dizziness, balance control
- Sudden severe headache
What is a hyperkinetic vs hypo kinetic motor disorder?
Hyper
- excessive movement
- includes Huntingtons and Tourettes
Describe the cause and characterization of Huntingtons
Cause
- dominant allele when transferred through genetics
- decrease of activity in the inhibitory pathway (for motor movement) from loss of cells in putamen and globes pallidus
Characterization
- abnormal movements and intellectual decline
- patients live roughly 12 years from onset
Describe the cause and characterization of Tourettes ?
Cause
- increase in size of putamen, decrease in size of thalamus (affects the basal ganglia loops)
Characterization
Stage 1: multiple tics
Stage 2: inarticulate cries w/ tics
Stage 3: emission of articulation words: echolalia and coprolalia
What are the 4 main symptoms of Parkinsons ?
- Muscle rigidity
- Postular disturbance
- tremor
- involuntary movement
What are 3 causes of Parkinson’s ?
- Idiopathic: cause is unknown (random)
- Postencaphalitic: unique pattern of brain damage to the substantial nigra
- Drug-induced: from ingestion mainly of major tranquiliizers
What are 4 motor disorders of the spinal cord?
- Myasthenia Gravis
- Para/quadra/hemiplegia
- Brown-séquard syndrome
- MS
Describe Myasthenia Gravis
- failure of function in muscular neurotransmitters
- rapid muscular fatigue without activity or exercise
- symptoms: double vision, droopy eyes, weak voice, cant chew or swallow, cant hold head up
What is the treatment course for Myasthenia Gravis ?
- acetylcholine therapy
Describe MS & its treatment
- loss of myelination on the motor neurons
- degenerates motor functions, patient may lose sensation in the face, limbs and body
Treatment - immune surpassants (ex. Lemtrada) to restrict the body from attacking the myelin
Describe para/quadra and hemiplegia
Paraplegia
- cut at the thoracic level
- loss of sensation in lower limbs
Quadraplegia
- cut at the cervical level
- loss of sensation of all extremities
Hemiplegia
- loss of sensation to contralateral half of body to which damage occurs
Which 2 reflexes are lost in hemiplegia ?
- abdominal
- cremasteric
Describe the two pathways of the Basal Ganglia ?
- Indirect
- when dominating, the thalamus shuts down and movement is not produced - Direct
- when dominating, the thalamus becomes overactive and movement is amplified
What is Brown-Séquard Syndrome ?
unilateral transection through the spinal cord
- same side as cut looses sensation of touch and pressure
- ipsilateral side of cut looses sensation of temperature and pain
What are 3 main types of tumors ?
- Glioma
- 45% of brain tumors, arising from glial cells accumulating in brain substance - Meningioma
- tumor of the meninges, growing outside of the brain benign - metastatic
- tumor cells from elsewhere in the body that travel to the brain
- commonly come from the lungs or breasts
What are the 3 symptoms stages of seizures in epilepsy ?
- onset of an aura
- subjective experience classifying the onset of a seizure - loss of consciousness
- complete collapse or staring off into space (non responsive) - movement
- shaking and other movement associated with seizure episode
What are the 4 classifications of seizures ?
- Focal
- starts in one area and spreads - Generalized
- bilaterally symmetrical, stereotypical seizure - Akinetic
- short duration, common in children - Dissociative
- no discernible EEG change
Who is most susceptible to TBI ?
- children and the elderly
- males between age 15 and 30
What are 2 forms of closed-hear injuries and what are 2 repercussions ?
Types:
1. coup: Damage at the site of the blow
2. Countercoup: Damage that came from the site of the blow projecting the brain to hit the opposite side of the skull
Repercussions
1. impairment of specific functions associated with site of damage
2. generalized impairments from widespread trauma
What brain area damage is associated with poorer outcomes ?
Damage to brainstem
- causes dysphasia, hemiparesis
