Misc Neuro Disorders Flashcards
Where are the areas of demyelination associated with MS located?
scattered in the white matter of the brain, spinal cord, and optic nerve
What is the most frequent earliest manifestation of MS?
optic neuritis
Where does no population with a high risk for MS exist?
between latitudes 40N and 40S
Clinical course of MS changes so that a steady deterioration occurs, unrelated to acute relapses
Secondary progressive disease
MS course that is Less common, Steady progression from onset. Disability develops at a relatively early stage
Primary progressive disease
How many patients with MS is the MRI clinically definite?
85%
What can be helpful in diagnosing MS if MRI is inconclusive?
CSF- elevated IgG, protein, myelin antibodies
Mainstay of tx for acute MS exacerbations
corticosteroids
Pharm tx that can modify the course of MS
Immune modifiers-Interferon 1a, Interferon 1b, Glatiramer acetate
Immunosuppressants used for progressive MS
Methotrexate (Rheumatrex), Cyclophosphomide (Cytoxan), Mitoxantrone (Novantrone), Azathioprine (Imuran)
NOT caused by problems in the muscles or nerves. caused by abnormalities in parts of the brain that control muscle movements
cerebral palsy
secondary orthopedic deformities, such as hip dislocation and scoliosis of the spine, are commonc
cerebral palsy
most common type of CP
spastic (70%)
type of CP where patients have trouble holding themselves in an upright, steady position for sitting or walking
Athetoid or Dyskinetic CP
Type of CP characterized by Hypotonia and tremors. Problems with balance, especially while walking
Ataxia CP
classical sx of CP
Spasticity, Unsteady gait, Dysarthria, decreased muscle mass
lack of muscle coordination when performing voluntary movements (ataxia). stiff or tight muscles and exaggerated reflexes (spasticity)
most common manifestations of CP
when are most children with CP diagnosed?
by 18 months (missed milestones, floppy tone, abnormal reflex)
when should babies develop hand preference?
not develop a hand preference until at least 12 months of age
Prognosis of CP
Brain damage does not progress. Symptoms DO become worse
incurable fatal neuromuscular disease characterized by progressive muscle weakness, resulting in paralysis.
ALS
cause of death for most people with ALS
respiratory failure
disease that mimics ALS in veterans and pro athletes
a chronic traumatic encephalopathy
earliest sx of ALS
Obvious weakness or muscle atrophy
key to diagnosis of ALS
presence of upper and lower motor neuron signs in a single limb
pharm tx for ALS
Riluzole (Rilutek)
Cause of Wernicke-Korsakoff Syndrome
chronic alcoholism; Deficiency of thiamine (vitamin B1)
Characteristics of Wernicke-Korsakoff
Confusion, Amnesia, Confabulation**
Tx of Wernicke-Korsakoff
supplemental thiamine IV/IM then move to PO.
Why should you start thiamine tx before giving any glucose?
the encephalopathy will be worsened by the glucose