Clin Neuro Flashcards
muscle weakness increases with activity and decreases with rest
Myasthenia Gravis
initial symptom of MG
ptosis or diplopoia
curtain gaze
relieved by ice pack
MG
decreased Ach receptors
MG (post synaptic)
MG may be related to which organ tumor
Thymic tumor
diagnostic exams for MG
Edeophonium (mestinon)- (+) immediately improves
Neostigmine
Single fiber EMG -most sensitive!! (+) increase jitter
Treatment for MG
since pathophy is dec. Ach Receptors, gusto natin nandun lang si Ach so we may give Cholinesterase inhibitors pyrostigmine (mestinon) ang neostigmine
for ocular: Pyridostigmine + steroids
NMJ Paraneoplastic
Lamber Eaton
Small Cell CA
NMJ improves with brief exercise
Lambert Eaton
Reduced Ca channels in presynaptic channels
Lamber Eaton (presynaptic)
most specific exam for lamber eaton
Repetitive Nerve stimulation
(+): increment or decrement 5hz
treatment of lambert eaton
3,4 DAP
Blocks K channels prolonging depolarization and enhancing release ach vesicles
Neuropathy
Most common cause of acute paralysis
GBS
PE of GBS
sensory loss
arreflexia
ascending paralysis
autonomic disturbances
ECG FINDINGS OF GBS
reduction in amplituted if muscle AP
Slowed conduction velocity and conduction block in motor nerves
CSF EXAM IN GBS
acelluler or few lympho
INCREASE CAF PROTEIN (CYTOALBUMINOLOGIC DISSOCIATION)
patho findings GBS
perivascular or perivenous lymphocytic infiltrates
anterior corticospinal
MOTOR
decussates as lower medulla (lateral corticospinal)
decussates as SC (ACS)
Tract of Lissauer
Ant and Lateral spinothalamic tracts
Anterior spinothalamic
Crude touch
Jesus held his hands anteriorly for people to touch
Lateral Spinothalamic
pain and temp
Jesus hands were placed laterally when crucified
Posterior column or Dorsal column medial lemniscus
Fasciculus gracilis and cuneatus Fine touch Propioception Vibration two point discrimination
SC injury in the cervical area
Central Cord Syndrome “walking quadriplegics” UE> LE remember arrangment of fiber in spinothalamic tract: Cervical (medial) thoracic, lumbar, sacral MOI: hyperextension of the neck
Contralateral: loss of touch, pain and temp
Ipsilateral: Weakness
Anterior cord Syndrome
