Miscellaneous Neuro Flashcards
Multiple Sclerosis
Most common acquired dz of myelin
Autoimmune against myelin sheath
Results in multiple areas of scarring
characterized by relapse and recovery
Which part of the brain does MS affect?
the white matter
Areas affected by MS
Optic nerve speech and swallow muscle strength gait and coordination balance Positional and vibratory sense
MS Epidemiology
Occurs btw ages of 15-50
Females > Males
Northern latitude populations
Symptoms of MS
Weakness, numbness, tinging and unsteadiness of a limb. (Lhermitte's symptoms) Unilateral visual impairment, diploplia Fatigue, muscle weakness Spastic paraparesis Mental disturbance
Signs of MS
Optic neuritis Opthalmoplegia Nystagmus Hyperflexia Babinski sign Absent abd reflex Labile, changed mood
MS Dx
Neuroimaging
IV gadolinium enhances acute lesions
Lesions are multifocal, hyperintense
CSF can be helpful when MRI not confirmatory
Mild MS Tx
Healthy lifestyle
Physical therapy
Symptomatic MS Tx
Corticosteroids - mainstay INterferon 1a, b Methotrexate Tysabri Symptomatic Tx
Cerebral Palsy
Not caused by problems in muscles and nerves
Caused by abnormalities in brain that control muscle movements.
A disease of childhood
Kids with CP are generally born with it
Cerebral Palsy Cause
Damage to young developing brain
During pregnancy: Infxn, hypoxia, prematurity
During birth: Asphyxia
After birth: Brain infxns, head injuries
4 Classifications of Cerebral Palsy
Spastic
Athetoid
Ataxic
Mixed
Spastic CP
Most common type, 70%
Damage to corticospinal tract, motor cortex or pyrimidal tract.
Hypertonia
Athenoid (Dyskinetic) CP
20% of all cases Have trouble holding self upright Often show involuntary motions Fine motor movements are very hard May not be able to hold onto things
Ataxia CP
Problems with balance, especially while walking. 10% of cases Damage to cerebellum Hypotonia and tremors Motor skills are difficult
Classic CP Symptoms
Spasticity
Unsteady gait
Dysarthria
Decreased muscle mass
CP in Newborns and babies S/S
Floppy movements
Unable to roll over
Unable to sit, crawl, walk
Birth defects can be associated
CP Dx
Most children are diagnosed by 18 months of age
Parents are usually the first to notice
Gracile shafts, ballooning metaphysis
CP prognosis
Brain damage does not progress
but
Symptoms worsen
CP Tx
Physical and occupational therapy
Symptomatic relief
Speech therapy
Atrophic Lateral Sclerosis (ALS)
Lou Gehrig’s Disease
Incurable fatal neuromuscular dz characterized by progressive muscle weakness and paralysis
Brain and spinal cord neurons affected.
5,000 new diagnosis each year
ALS S/S
Progressive muscle atrophy
Affects upper and lower motor neurons
Cognitive fxn is generally spared
Respiratory issues (Bipap used)
Which muscles are usually spared is ALS?
Bowel, bladder, sphincters and eyes.
ALS prognosis
Disease course is usually 2-5 years
ALS causes
Heriditary factor, rare.
Idiopathic
Military veterans at increased risk
Chronic concussions may be linked
ALS Dx
Presence of upper and lower motor neuron deficits
Clinical diagnosis
Rx Tx for ALS
Riluzole (Rilutek)
May be neuroprotective
Lengthens survival by several months
Wernike-Korsakoff Syndrome (WKS)
Results from chronic alcoholism
Caused by thiamine deficiency (B1)
Characterized by confusion, amnesia, confabulation (making up memories)
WKS S/S
Acute weakness EOM paralysis Nystagmus Taxia Peripheral neuropathy Diploplia
WKS Dx
MRI will show lesions of werkine’s
clinical diagnosis
WKS Tx
Thiamine IV or IM, followed by PO
Start thiamine before giving glucose
