Diseases Flashcards
What is locked in syndrome?
What causes it?
- A person is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except vertical eye movements and blinking. Higher brain order functions are functional within a nonfunctional body, feels like being “buried alive”.
- Caused by stroke to basilar artery in pons; traumatic brain injury; demyelination
What is a persistent vegetative state?
When is it considered persistent?
When is it considered permanent?
- Upper portions of brain are damaged and lower portions are spared
- The person can be partially awake but not truly aware
- It is persistent after 4 weeks
- It is permanent after 3 months
What condition is suspected from this brain MRI?
Locked in syndrome
What is Weber syndrome and what causes it?
A stroke to the PCA branches in the midbrain lead to damage of CN3 and cerebral peduncle fibers. Presents with ipsilateral CN3 palsy and contralateral weakness to upper and lower body.
What condition is suspected from this image?
Weber syndrome - damage to midbrain
What are the symptoms of parkinson’s disease?
HYPOkinesia
Difficulty initiating movement, bradykinesia (slow movements), shuffling gait, flexed posture, impaired balance, muscle rigidity, tremor
What causes parkinson’s disease?
In normal function, dopamine from the substantia nigra pas compacta is released onto the striatum. The dopamine can bind to D1 receptors with the result of exciting or enhancing the direct pathway (leading to increased likelihood of voluntary movement) or it can bind to D2 receptors with the result of inhibiting the indirect pathway (leading to increased likelihood of performing voluntary movement).
Loss of dopaminergic neurons in the substantia nigra pars compacta will thus result in diminished control over voluntary movement (hypokinesia).
What are the symptoms of huntington’s disease?
Involuntary jerking movements
Muslce rigidity
Muscle contracture
Slow or abnormal eye movements
Impaired gait, posture, balance
Difficulty with speech and swallowing
What causes huntington’s disease?
In normal function, dopamine from the substantia nigra pas compacta is released onto the striatum. The dopamine can bind to D1 receptors with the result of exciting or enhancing the direct pathway (leading to increased likelihood of voluntary movement) or it can bind to D2 receptors with the result of inhibiting the indirect pathway (leading to increased likelihood of performing voluntary movement).
HD is a trinucleotide repeat disorder that results in abnormal functioning of neurons in the striatum. Initially the indirect pathway is more affected –> hyperkinetic movements.
- What condition results from a stroke that affects the subthalamic nucleus?
- Which artery is suspected to be damaged in this condition?
- Hemiballism - ballistic movements in the limbs, usually one sided
- Deep branches of PCA
Not spinal cord b/c would have to have stroke that affects right dorsal column and left spinothalamic –> would require both PSA and ASA damage on both sides which is unlikely to only affect these 2 systems
Not medulla b/c would have to have stroke that affects both left medial lemniscus and left spinothalamic tract in medulla –> would require both VA and PICA damage which would likely result in more symptoms
Is contralateral (left) VPL of thalamus –> lacunar stroke, occlusion of deep penetrating artery of PCA
What is the name of the condition that this patient has?
In summary of the case below, the symptoms are:
- Slight ptosis of right eyelid
- Anhidrosis of right face (loss of sweat, sympathetic innervation)
- Miosis of right pupil (constriction of pupil, disruption of sympathetic innervation leading to unopposed parasympathetic input that constricts the pupil)
Horner’s syndrome
Describe the innervation that is involved in horner’s syndrome.
What is the most common cause of horner syndrome?
What would cause a horner like presentation where the lesion is in the first order neuron?
Wallenberg syndrome
What is an ICA dissection?
- The slurred speech with normal comprehension and fluency indicates it’s a motor issue
- Intact CN with facial weakness sparing forehead suggests UMN for CN7 (corticobulbar)
- Right leg and arm are weak (issue w/ left lateral corticospinal)
- Lesion is in brain
- Not explained by cortical lesion –> would cover entire precentral gyrus, too many arteries involved for that to happen without other damage
- Right sensory loss, aphasia, problems with visual field
- No
- Internal capusle (genu/posterior limb)
- What is this disease called?
- What causes this disease?
- How do you treat this disease?
- Wernicke-korsakoff syndrome
- Thiamine (Vit B1) deficiency, most commonly due to alcohol abuse and subsequent malabsorption
- Wernicke encephalopathy can be treated with Thamine. However, once the disease progresses to the point where the patient is displaying signs of Korsakoff syndrome it cannot be treated with thiamine any more.
