Generalized Lower Motor Neuron Disease Flashcards
what can cause abnormal synaptic transmission?
immune mediated
toxins
what are the postural reactions like with generalized lower motor neuron disease?
normal to abnormal
where can the lesion be with lower motor neuron disease?
motor neuron
nerve root
nerve
synapse
muscle
which nerves can be tested for nerve conduction?
ulnar
radial
peroneal
tibial
what is the most important acquired acute generalized lower motor neuron disorder?
geriatric onset of laryngeal paralysis and polyneuropathy
what are the long peripheral nerves?
recurrent laryngeal nerve
sciatic nerve: tibial branch
what neoplasias can cause myasthenia gravis?
thymoma
osteosarcoma
anal sac adenocarcinoma
what are the early clinical signs of idiopathic distal axonopathy or geriatric onset of laryngeal paralysis and polyneuropathy?
voice change, clearing throat often
unspecific hind end weakness
difficulty to jump, splaying out
is there a causative treatment option for idiopathic distal axonopathy or geriatric onset of laryngeal paralysis and polyneuropathy?
no- idiopathic origin
what are the focal clinical signs of myasthenia gravis?
megaesophagus
facial, pharyngeal, laryngeal weakness
is repetitive nerve stimulation reliable for myasthenia gravis?
yes
what is the fulminate form of myasthenia gravis related with?
thymoma
high mortality
what can increase the survival time of myasthenia gravis?
immune suppressive treatment
what can you give to improve transmission at the synapse with myasthenia gravis?
pyridostigmine CRI
prednisone
pyridostigmine PO
what can you use to diagnose polyradiculoneuritis (coonhound paralysis)?
electrodiagnostics: EMG, nerve conduction
what can lead to primary demyelination?
inflammatory
toxins
what can lead to abnormal muscle contraction?
myositis
dystrophy
what are the most important acquired acute generalized lower motor neurons disorders?
geriatric onset of laryngeal paralysis and polyneuropathy
myasthenia gravis
idiopathic polyradiculoneuritis
botulism
tick paralysis
what is the etiology of idiopathic distal axonopathy or geriatric onset of laryngeal paralysis and polyneuropathy?
disorder of long peripheral nerves
inability to transport metabolites from neurons of spinal cord to peripheral nerve ending via fast transporter system
distal axonopathy with secondary demyelination
what is electrodiagnostic testing helpful for with idiopathic distal axonopathy or geriatric onset of laryngeal paralysis and polyneuropathy?
characterization of nerve dysfunction
what antibodies are present in myasthenia gravis?
nicotinic receptor antibodies
striated muscle antibodies sometimes: titin or ryanodine receptor
what happens in immune mediated receptor damage in myasthenia gravis?
complement
endocytosis
receptor block
what diagnostics can be done for myasthenia gravis?
tensilon test
acetyl choline receptor antibody titers
repetitive nerve stimulation
radiographs/CT
how common is muscle weakness with myasthenia gravis?
50%
what can you do to neutralize antibodies in myasthenia gravis?
plasmapherisis, plasma exchange, multiple sessions
IgG intravenous
what histopathologic changes occur with polyradiculoneuritis?
ventral nerve roots
proximal nerves
nerves distally less affected
infiltration of PMN, macrophages, later lymphocytes
axonal degeneration, demyelination
how can you treat polyradiculoneuritis?
supportive care
prednisone
intravenous IgG
plasmaphoresis, plasma exchange
tumor removal if present
what is the most important finding of generalize lower motor neuron disease?
decreased or absent spinal reflexes
