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Neuro MSK > Dymeyleination & ataxia > Flashcards

Dymeyleination & ataxia Flashcards

1
Q

MRI usually shows ____ with acute disseminated encephalomyelitis (ADEM)

A

bilateral symmetric inflammation

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2
Q

is ADEM mono or polyphasic

A

mono

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3
Q

ADEM usually occur due to

A

infection or vaccine

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4
Q

sx of acute transverse myelitis

A

back pain
sensory level noted
sphincter disturbance
paraparesis

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5
Q

acute transverse myelitis is usually limited to ____ vertebral segments

A

2

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6
Q

_____ could be the 1st episode of MS

A

transverse myelitis

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7
Q

optic neuritis sx

A

loss of red vision
monocular blurring or loss
central blind spot
pain with eye movement

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8
Q

_____ is a very common initial symptoms of MS

A

optic neuritis

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9
Q

what is the leading cause of non-traumatic disability in young adults?

A

MS

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10
Q

Dawson’s fingers indicates

A

MS

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11
Q

vitamin ____ levels should be checked with MS

A

D

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12
Q

risk factors for MS

A

vit D deficiency
young, 20-30
female

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13
Q

what is the most common type of MS?

A

relapsing-remitting sclerosis

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14
Q

what is MS?

A

movement of autoreactive T cells and demyelinating antibodies from the systemic circulation into the CNS through disruptions of the blood-brain barrier

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15
Q

what is the most common symptom of MS?

A

spastic paraparesis

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16
Q

which pathways are affected later in MS?

A

cerebellar

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17
Q

what is the most common sensory tract lesion in MS?

A

spinothalamic

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18
Q

what is Lhermitte’s Phenomenon?

A

electric sensation passing down the back and limbs upon flexion of the neck
occurs with MS

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19
Q

which CN has neuralgia due to MS?

A

trigeminal (CN 5)
bc 1st 1/2 of it is oligodendrocytes

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20
Q

what is internuclear ophthalmoplegia?

A

occurs with MS
d/t medial longitudinal fasciculus
inability to adduct ipsi eye
nystagmus with contra eye abduct

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21
Q

what is Uhthoff’s phenomenon?

A

seen with MS
condition is worsened with heat

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22
Q

____ dementia is seen with MS. what is it?

A

subcortical
information processing, visuospatial, memory, and executive function issues

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23
Q

MS is diagnosed when there is new lesions within ___ months on an MRI

A

3

24
Q

what are oligoclonal bands? what do they indicate?

A

presence of 2 or more antibody clones
indicates damaged blood-brain barrier or immunoglobulin production in the brain

25
Q

MS diagnosis requires _____ for a diagnosis

A

evidence of at least 2 areas of damage at different times

26
Q

MS diagnosis needs a separation in _____ and _____

A

time and space

27
Q

what treatments affect the long term prognosis of MS?

A

disease modifying treatments

28
Q

what is progressive multifocal leukoencephalopathy?

A

severe demyelinating disease of CNS d/t reactivation of JC virus infecting oligodendrocytes

29
Q

difference between progressive multifocal leukoencephalopathy and MS flare up

A

progressive multifocal leukoencephalopathy = change mental status

30
Q

spasticity is especially noted in the ___ with MS

A

LE

31
Q

what is D-alfampridine (ampyra)?

A

NOT a disease modyfing therapy
increases walking speed (by 35%)
works at NMJ

32
Q

neuromyelitis optica is a combo of what diseases?

A

transverse myelitis and optic neuritis

33
Q

how does neuromyelitis optica differ from transverse myelitis?

A

neuromyelitis optica - >3 vertebral levels involved

34
Q

what is the most aggressive type of NMO? least?

A

most - AQP4
least - MOG

35
Q

what issue are present with vestibular disorder?

A

vertigo
nystagmus

36
Q

what issues are present with cerebellar disorder?

A

vertigo
nystagmus
dysarthria
limb ataxia
unable to stand with feet together

37
Q

what issues are present with sensory disorder?

A

limb ataxia
vibration and position sense impaired
depressed or absent ankle reflexes
can’t stand with feet together eyes closed

38
Q

function of vermis

A

proximal limb
truncal coordination

39
Q

function of lateral hemispheres of cerebellum

A

motor planning for extremities
appendicular movements

40
Q

function of flocculonodular lobe

A

balance
vestibuloocular reflex

41
Q

T/F: ataxia can be present with brainstem lesions

A

T
peduncle connect

42
Q

limb/trunk/gait ataxia is ____ (ipsi/contra) to cerebellum lesion

A

ipsi

43
Q

main clinical manifestations of cerebellar dysfunction

A

dysmetria
dysdiadokinesia
impaired checking
hypotonia
mutism, scanning, dysarthria
oculomotor deficit, nystagmus, abnormal saccades

44
Q

what speech symptoms is characteristic of cerebellar lesions?

A

scanning

45
Q

causes of acute ataxia

A

intoxication
vascular lesions: strokes
trauma
infections

46
Q

causes of subacute ataxia

A

brain tumors
alcholic-nutritional
vit E
paraneoplastic
demyelinating causes (MS)

47
Q

causes of chronic ataxia

A

friedreich ataxia
spinocerebellar ataxia
multisystems atrophy (Parkinson’s like)
hereditary metabolic diseases: lipid, mitochandria

48
Q

rostral vermis syndrome is usually seen with

A

chronic alcoholics

49
Q

rostral vermis syndrome sx

A

WBOS
axial ataxia
gait ataxia

50
Q

caudal vermis syndrome is typically seen in

A

children with medulloblastoma

51
Q

caudal vermis syndrome sx

A

axial dysequilibrium
staggering gait
little to no limb ataxia
spontaneous nystagmus

52
Q

features of cerebellar hemispheric syndrome

A

incoordination/ataxia of ipsi
poor fine motor control

53
Q

features of pancerebellar syndrome

A

bilateral cerebellar signs affecting limbs, trunk, and cranial musculature

54
Q

spinocerebellar ataxias have a cerebellum that appears

A

small and atrophic

55
Q

friedreich ataxia is a _____ disease affecting the ____, _____, ____

A

mutli-organ
heart, brain, nerves

56
Q

Friedreich ataxia sx

A

loss of ambulation after 10-14 years
foot deformities
scoliosis
loss of proprioception: foot slap and toe gripping

Neuro MSK (15 decks)

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