Definitions Flashcards
Stroke
An ACUTE ONSET of FOCAL NEUROLOGICAL DEFICIT of the CNS (excluding spinal cord) from VASCULAR ONSET
Transient Ischaemic Attack (TIA)
Acute onset neurological deficit of ischaemic origin with speedy recovery within 5-20min (mostly within 2h)
(Not epileptic)
Stroke risk factors
HT (leads to fromation of artherosclerosis - thrombosis), Atrial fibrillation (embolism) & valve lesions
Syncope
Transient, brief loss of consciousness resulting from a short-lived decrease in cerebral blood flow
Epilepsy
Paroxysmal electrical disturbance of cerebral neurons which may give rise to dysfunction of the motor system, sensory system, behavior, consciousness and autonomic function.
Status Epilepticus
Continuous tonic clonic seizure activity for >30 min
OR
A series of epileptic seizures during which function is not regained between ictal events in a 30 minute period
Headache
Pain that is experienced in the distribution of the opthalmic division of the trigeminal nerve and of the second and third cervical roots
Horner’s Syndrome
Interrupted sympathetic supply to eye
-classic triad: miosis (constricted), partial ptosis, anhidrosis (loss of hemifacial sweating)
Vertigo
Hallucination of spinning movement of patient self or their surroundings, accompanied by autonomic symptoms (sweating, pallor, tachycardia, nausea, vomiting)
Dizziness
Hallucination of movement other than spinning - forwards, backwards, to the sides or up/downwards
Narcolepsy
Tetrad
- excessive daytime somnolence (sleepiness)
- cataplexy (muscle weakness/paralysis and fully aware)
- sleep paralysis
- hypnogenic hallucinations
Sleep apnoea syndrome
- Alternating snoring and apnea during sleep: >10 apnea episodes in 1hr, or more than 10 episodes of oxygen desaturations or awakenings per hour
- diagnosis suspected if other conditions present:
- excessive daytime somnolence
- snoring
- night restlessness
- abnormal awakenings
- night time insomnia
- obesity
- pulmonary HT
- RHS heart failure
- Polycythemia
apnoea
Cessation of airflow for >10s
Sleep drunkenness
-unable to be woken up at a specific time
3 Components of consciousness
- cognitive (intellect)
- conative (drive/will)
- affective (emotion)
Immediate memory
- working/soundboard memory
- ability to repeat just-received verbal, melodious or spatial information immediately
Anterograde memory
- the ability to learn new information - closely related to episodic memory
- learn/remember a number of items, recall 5min later
Episodic memory
-a form of explicit memory (accessible to consciousness) which is specific regarding personal experience of time, place and context
(Emotional impact capping of the event)
-closely related to anterograde memory (same pathway)
Retrograde memory
-long term memory: ability to recall previously learned info
Cerebral hemisphere functions
- Orientation
- General knowledge
- Hallucinations / illusions / delusions
- Memory
- Calculation and Concentration
- Emotional state / drive
- Insight / intellect
- Category fluency
- Folstein mini mental
Delirium
-aka confusion
Def: an acute, reversible, diffuse, organic cerebral hemisphere failure or dysfunction, with disturbance of consciousness
- decreased level of consciousness
- disturbance of sleep-wake cycle (sometimes inverted)
- impaired attention (inability to focus, maintain or shift attention)
- disturbance of working memory (gives rise to anterograde memory problem with disorientation for time, place and person)
Dementia
Deterioration of memory and cognitive function compared to previous level of functioning determined by history of deterioration in capabilities and by dysfunctions determined by clinical examination.
-diagnosis can only be based on behavior (clinical - no tests)
Causes of Dementia
- Primary dementia: Alzheimers, Pick’s disease
- Neurological diseases associated with dementia:
- Parkinsons, Huntingtons chorea, MS, hydrocephalus - Systemic diseases
- hypothyroidism, hypophosphatemia, uraemia, Wernickes encephalopathy
Cortical dementia
Alzheimers
Subcortical dementia
Parkinsons, Huntingtons
-basal ganglia, deep white matter, thalamic nuclei involvement
Gerstmann syndrome
- finger agnosia
- right left disorientation
- acalculia
- agraphia
Aphasia
Acquired disorder of language
Language
- Ability to receive language symbols by means of vision and hearing at cerebral hemisphere level
- to interpret the symbols at Wernicke’s area
- to send language symbols via arcuate fasciculus to Broca’s area
- to execute the language symbols by means of speech, writing or mime
Coma
Depressed level of consciousness with increasing degrees of drowsiness and sleepiness, and difficult to arouse.
Vegetative state
- appears awake with eyes open, retained sleep-wake cycle
- interaction absents, no focused or voluntary reaction to visual, auditory, touch or painful stimuli
3rd nerve palsy
- down and out
- severe/dense ptosis
- enlarged pupil (unreactive to light)
(Paralysis of superior, inferior and medial rectus muscles, as well as inferior oblique)
Horner Syndrome
- CONSTRICTED PUPIL
- retained pupillary light reflex
- MILD ptosis
- anhydrosis of forehead (involvement of sympathetic pathway - strokes of lateral medulla, pons, or midbrain)
Nystagmus
-rapid, involuntary, usually conjugate movement of the eyes, which may show a phasic, rotatory or pendular quality.
Bell’s Palsy
-LMN paralysis of facial nerve
Tremor
Rhythmic, repetitive movement of muscles around a joint
Tics
Involuntary repetitive brief movements or sounds that occur in a stereotype manner.
Tourette Syndrome
Both motor and vocal tics are present for >1y
Chorea
An Involuntary, non-repetitive, quick, semi-purposeful, jerky movement that generally appears more distally in the limbs.
Athetosis
Snake-like movements - slower and more proximal than chorea
Dystonia
syndrome of sustained muscle contraction, frequently causing twisting and repetitive movements or abnormal postures.
- simultaneous contractions of agonist and antagonist muscles are observed
- pain is frequently assoiated
Spasticity
Velocity dependent increase in tone (UMN)
-flexors of upper limbs and extensors of lower limbs
Clonus
A repetitive contraction-relaxation reaction of a muscle which may be elicited by movement that stretches the muscle rapidly and keeps it in this position
-UMN lesions (4+ DTR)
Rigidity
Increase in tone throughout range of muscle movement
- lead pipe
- cogwheel (due to underlying tremor)
- flexor muscles are more severely affected
Parkinson’s Disease
Specific progressive degenerative disease of predominantly the nigrostriatal tract, with a dopamine deficiency
Characteristics of Parkinson’s disease
- Resting tremor
Bradykinesia (with poverty of spontaneous, automatic and associated movements)(reaction time for initiation, cessation and correction of movements is prolonged) - Rigidity (lead pipe or cogwheel)
- Postural or gait disturbances (flexed posture, short shuffling steps, freezing, festinance, imbalance)
- Other - loss of weight, bladder dysfunction, depression, constipation
Parkinsonism
Bradykinetic rigidity with/without tremor caused by conditions other than idiopathic Parkinson’s disease
- gait disturbances and psychic impairment usually earlier in disease course
- UMN signs and cerebellar signs may appear
Myotonia
Inability of muscle to relax immediately after contraction
LMN Disease
- Muscle weakness
- Atrophy
- Decreased tone
- Diminished/absent DTR
- fasciculations
Guillain Barre Syndrome
Acute onset (days), symmetrical peripheral neuropathy with both proximal and distal weakness of all 4 limbs, with absent reflexes and raised CSF protein
- aka. AIDP - Acute inflammatory demyelinating polyradiculoneuropathy
- post-infection or post vaccination
UMN Lesions
- Muscle weakness
- Hemi, para or quadriplegic distribution
- increased tone (clasp-knife spasticity)
- increased DTR
- positive Babinski & Hoffmans reflexes
Stereognosia
Ability to observe the form or characteristics of objects by touch, without the use of auditory or visual cues
Apraxia
Dysfunction of the execution of learned movements that cannot be explained on the basis of
- weakness
- in-coordination
- sensory deficit
- lack of understanding / attention deficit
Ideomotor apraxia
Inability to perform learned motor movements
-can understand the command (can describe the action verbally)
Wernicke’s Encephalopathy
Triad of:
- Korsakov amnestic syndrome
- cerebellar ataxia
- nystagmus/ophthalmoplegia
Dysdiadochokinesia
Inability to perform rapid alternating movements of hands
Long term potentiation
Repetitive stimulation of hippocampal tissue leading to an increase in the response of the postsynaptic neuron
- increasing the excitability of the neuron
- strengthening of the synapse
Requires: activation of synapses, and depolarization of post synaptic membrane
