Lecture 12 - Neurological Disorders Flashcards

1
Q

What’s the difference between a neurologic & psychiatric disorder ?

A
  • Neurologic : symptoms resulting from physical dysfunctions in the brain & NS
  • Psychiatric : mental health & emotional symptoms resulting from chemical imbalances in the brain, developmental challenges or life experiences
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2
Q

What are the main types of cerebral vascular disease (CVA/stroke) ?

A
  • Ischemia
  • Cerebral hemorrhage
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3
Q

What is the definition of a stroke ?

A

Interruption of blood flow to the brain, leading to oxygen deprivation & infarction (cell death)

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4
Q

What are the two main types of cerebral ischemia ?

A
  • Thrombosis : blockage at the place of formation
  • Embolism : blockage that has traveled to a smaller vessel
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5
Q

What are the two types of traumatic brain injury ?

A
  • Open head injury
  • Closed head injury (concussion)
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5
Q

What is a Transient Ischemic Attack (TIA) ?

A

Temporary period of symptoms similar to those of a stroke, caused by a temporary decrease in blood supply to part of the brain

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6
Q

What are some examples of neurological disorders ?

A
  • CVA/stroke
  • Traumatic brain injury
  • Tumors
  • Epilepsy
  • Headache
  • Infections of the brain
  • Disorders of motor neurons & spinal court
  • Disorders of basal ganglia
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7
Q

What’s cerebral hemorrhage ?

A

Bleeding within the brain, which can occur in extra-dural, sub-dural or subarachnoid areas

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8
Q

What are some causes of cerebral hemorrhage ?

A
  • Trauma
  • Angiomas (arteriovenous malformations, AVMs)
  • Aneurysm (balloon-like of blood vessels)
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9
Q

What are some treatment options for ischemic stroke ?

A
  • Anticoagulant therapy to remove or dissolve a clot (within 3-5h)
  • Neuroprotectant drugs that limit the changes leading to cell death
  • Aspirin to reduce the likelihood of blood clotting (preventive)
  • Vasodilators to dilate blood vessels
  • Drug to reduce blood pressure
  • Salty solutions or steroids to reduce cerebral edema
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10
Q

How can one prevent a stroke ?

A

Improve lifestyle : better diet & increased physical activity

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11
Q

What are some disorders of motor neurons and the spinal cord ?

A
  • Multiples sclerosis
  • Hemi- Para- & Quadriplegia
  • Brown-Sequard syndrome
  • Poliomyelitis
  • Myasthenia Gravis
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12
Q

What are some disorders of the basal ganglia ?

A
  • Parkinson’s
  • Huntington’s
  • Tourette’s syndrome
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13
Q

What are common causes of traumatic brain injury ?

A
  • Car accident
  • Sport injuries
  • Industrial accidents
  • Combat injuries
  • Contact sport (20% of cases)
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14
Q

What characterizes an open head injury ?

A
  • Skull & brain are penetrated
  • Not always loss of consciousness
  • recovery can be rapid & spontaneous (plasticity)
  • Symptoms are highly specific, depend on location of penetration
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15
Q

What characterizes a closed head injury ?

A
  • Caused by a blow to the head
  • Often involved loss of consciousness (duration indicates severity)
  • Can result in post-traumatic amnesia
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16
Q

What are the effects of a closed head injury ?

A
  • Coup : injury at the site of impact
  • Contrcoup : injury on the opposite side of impact
  • Shearing : tearing of bain tissue
  • Hemorrhage & hematoma
  • Edema : swelling
  • Altered & diminished glucose metabolism
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16
Q

What are the primary symptoms of a closed head injury ?

A
  • Functions related to the site of coup, contrecoup or shearing
  • Typically affects frontal or temporal lobes
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17
Q

What are the secondary symptoms of a closed head injury ?

A
  • Inability to concentrate
  • Mental slowing
  • Fatigue
  • Increased sensitivity to sensory inputs
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18
Q

What protein is associated with Chronic Traumatic Encephalopathy (CTE) ?

A

Tau proteins

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19
Q

What are the consequences of repeated concussions ?

A
  • Chronic traumatic encephalopathy (CTE)
  • Dementia pugilisticia or Boxer’s dementia
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20
Q

What are the different types of brain tumors ?

A
  • Glioma
  • Meningioma
  • Metastatic
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21
Q

What is a meningioma ?

A
  • Type of brain tumor originating from arachnoidal cells
  • Encapsulated, located outside the brain (typically benign)
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22
Q

What is a glioma ?

A
  • Type of brain tumor arising from glial cells
  • Infiltrating, can be benign or malignant
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23
What is a metastatic brain tumor ?
- Type of brain tumor originating from other parts of the body - Often presents as multiple tumors in the brain
24
What are common symptoms of brain tumors ?
- Functional impairments depending on the location - Convulsions or seizures - Increased intracranial pressure, leading to : headache, vomiting, papilledema, bradycardia, mental dullness, diplopia
25
What are the treatment options for brain tumors ?
- Surgery - Radiotherapy - Chemo
26
What's epilepsy ?
- Neurological disorder characterized by recurrent seizures - Involved disturbances in consciousness & cognitive function
27
What's the difference between symptomatic & idiopathic seizures ?
- Symptomatic : seizures with a known cause such as infection, trauma or tumor - Idiopathic : spontaneous seizures often triggered by stress, sleep deprivation or drugs
28
What are the three common characteristics of epilepsy ?
- Aura - Loss of consciousness - Muscle contractions/jerking
29
What are focal (partial) seizures ?
- Seizures that originate from one point in the brain & spread - Symptoms are related to the cortical regions first affected
29
What are the two types of focal seizures ?
- Simple : consciousness is retained - Complex : loss of consciousness occurs
30
What are generalized seizures ?
Seizures that involved the whole brain
31
What are akinetic seizures ?
Seizures of short duration, typically occur in children
32
What are the stages of generalized seizures ?
- Clonic - Tonic - Postictal depression
33
What are myoclonic seizures ?
Seizures characterized by massive muscle contractions, can occur in children & adults
34
What are dissociative seizures (NEAD) ?
Seizures than resemble epileptic seizures but have no clear EEG pattern, often associated with psychological trauma
35
What treatments are available for epilepsy ?
- Vagus nerve stimulation - DBS - Surgery to remove focus - Drug treatment : inhibit seizure development (30-40% medication fails)
36
What is status epilepticus ?
Life-threatening condition where a seizure does not stop, requiring immediate drug intervention (GABA agonist or glutamate antagonist)
37
What are the pain-sensitive structures involved in headaches ?
- Dura mater - Larger arteries & sinuses - Cranial (5, 9, 10) & crevice (1, 3) nerves
38
What are the different types of headaches ?
- Headache associated with neurological disease - Muscle contraction headache - Vascular headache - Migraine
39
What are the characteristics of classic migraine ?
- Aura followed by intense pain - Vaso-constriction & dilation
40
What are the characteristics of common migraine ?
- No aura - Less severe than classical migraine
41
What are the characteristics of cluster headache ?
- Pain on one side of head/face
42
What are the characteristics of ophthalmoplegic & hemiplegic migraine ?
- Includes loss of movement
43
What are the common routes through which pathogens invade the brain in cases of encephalitis ?
- Nose, ears or throat - Can also occur following trauma or surgery
44
What are the effects of infection on the brain ?
- Blood supply (clotting, thrombosis) - Glucose/oxygen metabolism - Neuron electrical properties - Formation of pus and edema - Indirect through inflammation and microglial activity
45
What are the types of infections that can affect the brain ?
- Viral - Bacterial - Mycotic (fungal) - Parasitic
46
What are the different types of viral infections ?
- Neurotrophic (rabies, polio) : can lead to neurodegeneration - Pantropic (herpes simplex) : latent & active period - Mosquito-born infections (Zika virus, West-Nile virus) : affect brain development of foetus
47
What are examples of bacterial infections ?
- Meningitis - Brain absecess : purulent & necrosis
48
What are examples of mycotic and parasitic infections that affect the brain ?
- Mycotic : fungi - Parasite : malaria & toxoplamosis
49
What neurological disorder is characterized by damage to the myelin sheath and affects both sensation and motor control ?
Multiple Sclerosis
50
What syndrome results from unilateral damage to the spinal cord, causing different symptoms on each side of the body ?
Brown-Sequard syndrome
51
What is the characteristic feature of poliomyelitis ?
- Paralysis or muscle weakness due to virus affecting acetylcholine synthesis
52
What are the symptoms of Myasthenia Gravis ?
- Severe muscle weakness - Diplopia (double vision) - Ptosis (drooping of eyelid) - Autoimmune-disease (affects acetylcholine transmission)
53
What are the characteristics of paraplegia ?
- Paralysis of lower limbs - Complete dissection at thoracic level
54
What are the characteristics of quadriplegia ?
- Paralysis of all 4 extremities - Absence of movement, sensations & reflexes (thermoregulation, bladder control) - Section at cervical level
55
What are the characteristics of hemiplegia ?
- Damage to contralateral basal ganglia & cortex - Loss of voluntary movement on one side - Altered reflexes, Babinski sign
56
What are the symptoms of unilateral damage to spinal cord ?
- Ipsilateral : loss of body awareness, fine-touch & pressure - Contralateral : loss of pain & temperature sensation
57
What are the possible causes of Parkinson's disease ?
- Idiopathic (unknown cause) - Post-encephalitic : encephalistis lethargica (sleeping sickness) - Drug-induces (pesticides, toxins, tranquillisers, synthetic heroin, D2 antagonists) - Gut-bacteria