Deck 11 Flashcards
Acute neuro lesions
Could be vascular, episodic or infective
Subacute neuro lesions
could be inflammatory, neoplastic or infective
Chronic neuro lesions
could be degenerative, neoplastic or infective
movement based neuro lesions
consider basal ganglia, cerebellum (ipsilateral) or corticospinal
sensation based neuro lesions
could be dorsal column (crosses after nuclei in medulla) or spinothalamic (cord cross)
Cord lesions
Generally bilateral unless brown sequard syndrome
Brainstem lesions
ipsilateral CN sign, contralateral peripheral nerve sign
Brainstem infarction often has vertigo as finding
nerve root pattern
pain at nerve root, then on corresponding dermatome
focal nerve lesion
isolated lesions (although if multiple then mononeuritis multiplex) Could be diabetes or vasculitis
Peripheral neuropathy
Sensory defect, may have weakness. Typically distal, symmetrical, glove and stocking. Typical of diabetes
muscle disease features
weakness only, no sensory issues
Myasthaenia gravis
arms, legs, eyes and mouth
Progressive weakness over the course of the day. NMJ pathology
Problem at right optic nerve
monocular vision loss (R)
optic chiasm lesion
Bitemporal heminaopia)
If pituitary tumour, may get superior quadrantanopia
If craniopharyngioma, carotid aneurysm or meningioma then may get inferior quadrantanopia
Right optic tract lesion
honomymous hemianopia (left visual field defect)
Problem at right temporal lobe (optic lesion)
Meyers loop - superior quadrantanpia of left visual field
Problem at right parietal lobe (optic lesion)
causes inferior quadrantic heminaopia of left visual field
Problem at cortex (e.g. right) - optic lesion
contralateral (left) homonoymous hemianopia (macula sparing)
CNIII lesion
ptosis, mydriasis, down and out eye (unopposed SO)
CNIV lesion
nasal upshot, vertical diplopia. Head tilts away from affected side
CNVI lesion
abduction issue, slight adduction in forward gaze
CNVII lesion
See frontal sparing in UMN lesion, or complete paralysis in Bell’s or ramsay hunt
CNX lesion
uvula deviates away from affected side, soft palate fails to rise
CNXII
tongue deviates towards affected side