Intoxications and Infections of the CNS Flashcards
Where does the tetanus toxin come from?
Tetanus is an exotoxin produced from Clostridium tetani
It is either produced anaerobically in dirty wounds or from a non-sterile needle or drug abusers
How does the tetanus toxin produce an effect?
After hours to weeks, the exotoxin binds to interneurons of the CNS, preventing release of inhibitory glycine and GABA —> motor disinhibition
(generalized seizures, painful spasms etc)
How is a tetanus diagnosis made?
Clinically
How is tetanus treated?
ICU care, neuromuscular blockade, sedation, anticonvulscents, tetanus immune globulins and antibiotics
Where does the botulism toxin come from?
Exotoxin of clostridium botulinum- produced anaerobically in improperly canned or prepared food.
How does the botulinum toxin produce an effect?
The botulinum exotoxin binds to presynaptic nerve terminals preventing the release of ACh
Administration of what aids in the release of ACh from the pre-synaptic cleft?
Guanidine
How is botulism diagnosed?
Clinical picture, EMG tests, bioassay
How does lead poisoning manifest in adults?
Peripheral neuropathy
How does lead poisoning manifest in children?
Encephalopathy, abdominal pain
How does organic solvent toxicity manifest in patients?
Encephalopathy or peripheral neuropathy
What are symptoms associated with CO poisoning?
Early: headache, vomiting, blurred vision
Later: coma, seizures, or cardiopulmonary arrest
Survivors of CO poisoning may have what lasting effects?
Amnesia and parkinsonianism
What drugs cause stroke syndromes in atypical patients?
Cocaine (most common), amphetamines, PCP, and LSD
What are the neurological symptoms caused by acute alcohol intoxication?
social disinhibition, impaired consciousness, cerebellar dysfunction
secondary head trauma
very high levels may lead to coma, death
What are the neurologic symptoms caused by alcohol withdrawal?
early, hypersympathetic stage (tremulous, sweaty, tachycardic);
limited number of convulsive seizures 12 hrs-3 days after drinking stopped;
later stage of delirium tremens, 3-4 days after drinking stopped, with fluctuating motor and autonomic activity, confusion, hallucinations
How do we treat alcohol withdrawal?
treat with benzodiazepines for sedation and seizure control, provide hydration and metabolic support, thiamine
What is acute Wernicke Encephalopathy?
nystagmus, ophthalmoplegia, gait ataxia, confusion…acute phase of Wernicke-Korsakoff syndrome
How is wernike encephalopathy corrected?
thiamine supplimentation
What is korsakoff psychosis?
Korsakoff psychosis (amnesia, confabulation) is the chronic phase of Wernicke-Korsakoff syndrome.