Condition Identification Flashcards
After viral illness
Asymmetric flaccid weakness
Absent reflexes
Bowel and bladder dysfunction
Acute flaccid paralysis (can be caused by West Nile virus
Fatal disease
Tongue weakness
Upper motor neuron and lower motor neuron degeneration
ALS
Gradual or sudden onset of progressive and persistent muscle weakness/fatigue
Lower motor neuron syndrome
Symptoms for 1+ year
If they previously had polio: Post polio syndrome
Length dependent
Commonly Symmetric
Loss of DTR
Stocking and glove distribution
Polyneuropathy
Note: hundreds of causes
Orthostatic hypotension
Arrhythmia
Urinary retention
Constipation
Abnormal sweating
Autonomic neuropathy
Neuropathic pain
Autonomic dysfunction
Inability to feel pain or temp
Small fiber neuropathy
Paresthesias > severe radicular back pain > weakness
Facial weakness
Symmetric weakness
Areflexia
Progresses over course of 1 month, will recover naturally
ADIP/ Guillane Barre Syndrome
Mostly Relapsing-remittent
Proximal and distal symmetric weakness —-> atrophy
Hyporeflexic or areflexic
Slowly progresses over weeks to months
Chronic inflammatory demyelination polyneuropathy
Sharp or aching pain asymmetrically in hip and thigh, spreads to leg and foot
Pain -> weakness in proximal LE -> weakness progresses distally
Diabetic lumbosacral radiculoplexus neuropathy
Distal weakness and atrophy
Length dependent sensory loss
Absent/decreased reflexes
Onset before 20
Foot deformities
Hereditary motor and sensory neuropathy (Charcot Marie tooth disease)
Autoimmune disorder
Younger woman and older men
Easily Fatiguable
Gets better with rest
Ptosis, dysphasia, diplopia, dysarthria,
Weakness
Myasthenia Gravis
Proximal weakness
Sensation intact
DTR can be normal or slightly reduced
Myopathy
Subacute/chronic onset of proximal weakness
Variable pulmonary/cardiac involvement
May be related to malignancy, auto immune disorder, or HIV
Polymyositis or dermatomyositis
Proximal leg and distal arm weakness (quads and fingers)
Asymmetric
Muscle atrophy
Dysphasia
Most frequent myopathy In patients over 50
Inclusion body myositis
Progressive muscle weakness and atrophy
Prolonged muscle contractions
Unable to relax certain muscles
Genetic
Myotonic dystrophy type 1
Atrophy and weakness of facial and shoulder muscles
Facioscapulohumeral dystrophy
weakness of ocular and throat muscles
Genetic
Oculipharyngeal muscular dystrophy
Genetic, usually happens in young people
Progressive weakness and stiffness in shoulder and upper arms
Emery Dreifuss Muscular dystrophy
Commonly follows infection or vaccine
Mostly affects children
Bilateral symmetric inflammatory changes on brain MRI
Usually Monophasic
Acute disseminated encephalomyelitis
ADEM
Acute spinal cord dysfunction
Back pain, sphincter dysfunction, paraparesis
Maybe first episode of MS
MRI shows 2 different vertebral segments with inflammation
Acute transverse myelitis
Pain w/ eye movement
Acute onset of visual problems
Loss of color
Unilateral swollen optic disc
Afferent pupillary defect
Optic neuritis
Patient had optic neuritis, then at a later point had transverse myelitis
Likely multiple sclerosis due to separation of space and time
Leading cause of non traumatic disability
Higher rates in north
Affects all systems of body
Pt has had 2 separate instances of auto immune problems with their nervous system
Multiple sclerosis
Can be relapsing remittent, or progressive
Exact cause unknown
Reduces life expectancy 7 to 14 years
First flare up can look like optic neuritis or transverse myelitis
Multiple sclerosis
UMN spastic weakness
Ataxia, tremor, scanning speech
Spinothalamic lesions
Llhermites phenomenon- electric sensation passing down the back and limbs w/ neck flexion
Trigeminal neuralgia
Cognitive problems
Fatigue
Newer medications work better but come with more risk of infection due to immunosuppressive
Multiple sclerosis
Patient is on immunosuppressant drugs
Disease comes from infection that is
Asymptomatic in 86% of the population
Usually fatal in one year if not caught
Can mimic a MS attack
Progressive multi focal leukoencephalopathy PML
Transverse myelitis + optic neuritis (often bilateral)
Pt presents with transverse myelinitis lesions in over 3 vertebral levels
More severe than MS
neuromyelitis optica
Usually affects young children
Monophasic
Presents like MS (optic neuritis, transverse myelitis)
similar to acute disseminated encephalomyelitis
Good recovery prognosis
Myelin oligodendrocyte glycoprotein antibody disease (MOG)
Chronic alcoholics
Wide base of support
Ataxic gait (little ataxia with heel to shin test)
Arm coordination is still good
Sometimes nystagmus, hypotonia, dysarthria
Rostral vermis syndrome
Typically in children w/ medulloblastoma
Little or no limb ataxia
Axial disequilibrium and staggering gait
Spontaneous nystagmus and rotated head postures
Caudal vermis syndrome
D/t infarcts, tumors, abscess
Incoordination/ ataxia w/ ipsilateral movement, especially those that require fine motor control
Cerebellar hemispheric syndrome
Caused by infections, hypoglycemia, hyperthermia, paraneoplastic, hereditary
Bilateral Cerebellar signs affecting limbs, trunk, and cranial musculature
Pancerebellar syndrome
Ataxia in young children
Loss of ability to ambulate after 10-15 years
Foot deformities
Areflexia
Scoliosis
Sensory loss
Genetic
Friedreich ataxia
