MND

Question 1

general definition of MNDs

Answer 1

progressive neurodegenerative disorder affecting motor neurons

Question 2

general manifestations of MND

Answer 2

UMN: spasticity, hyperreflexia, weakness

LMN: atrophy, hyporefelxia/areflexia, weakness

Question 3

typical MND

Answer 3

both UMNL and LMNL

ALS

Question 4

LMN

Answer 4

polio and post polio syndrome

Question 5

discuss ALS

Answer 5

most common MND

aka lou gehrig’s disease

progressive painless assymetric muscle weakness

2 forms:

1. sporadic
2. familial

Question 6

pathophysiology of ALS

Answer 6

degeneration of Betz cells, ant horn cellls of SC, lower motor neuron of CN V, VII, X, XI, XII

amyotrophy - muscle wasting

lateral sclerosis - hardening of ant and lat corticospinal tracts

Question 7

what are betz celss

Answer 7

largest layer of pyramidal cells in 5th layer of precentral gyrus

Question 8

epidimiology of ALS

Answer 8

40-60 yo

MALE

can be sporadic or familial

Question 9

clinical hallmark of ALS

Answer 9

UMN and LMN signs coexist

Question 10

common initial findings in ALS

Answer 10

assymetrical hand weakness c atrophy and fasciculations

diff fine motor tasks

foot drop

shoulder weakness

Question 11

discuss spinal or limb onset ALS

Answer 11

UMN and LMN features

Question 12

discuss bulbar onset ALS

Answer 12

CN 5, 7, 9, 10, 11, 12

speech probs

tongue fasciculations

PBA

Question 13

pathgomonic features of ALS

Answer 13

hyperreflexia c hoffman and babinski

weakness, atrophy and fasciculations

UMN and LMN

Question 14

advanced manifestations of ALS

Answer 14

axial weakness and dropped head syndrome

cramps

gait impairment: foot drop and spastic gait

• sensory, autonomic, bowel and bladder, EOM prob
• basically lahat pag super sever

Question 15

el scorial criteria for ALS

Answer 15

UMN and LMN findings in cranial, cervical, thoracic and lumbosacral

suspected: pure LMN in 2 or more

possible: UMN and LMN in one but UMN or LMN in 2 or more

lab supported: UMN and LMN in one c EMG

probable: more than 2 with UMN and LMN and some UMN or LMN

definite: UMN and LMN in 3 or more

Question 16

awaji ALS criteria

Answer 16

for lab shit

Question 17

diagnosis of ALS

Answer 17

EMG for denervation

transcranial magnet stim for UMN

MRI to r/o other shit

Question 18

prognosis for ALS

Answer 18

depends on type of onset, respi function and age

bulbar: 2-3 yr survival

only 4% survive more than 10 yrs

Question 19

pharmacotherapy for ALS

Answer 19

none that alter progression

riluzole and edaravone can only treat sx

Question 20

infectious MND

Answer 20

poliomyelitis and post polio syndrome

Question 21

discuss poliomyletis

Answer 21

from poliovirus via fecal-oral route

affects ant horn and brainstem

acute flaccid paralysis (bulbar or spinal) following exposure

can resolve on its own or not

Question 22

clinical manifestation of polio

Answer 22

fever and GI tract prob muna

assymm weakness and atrophy of legs or bulbar muscles

polio gait or lurching gait

no sensory prob

no meds to treat; vaccine lang

Question 23

stages of polio

Answer 23

prodromal: flue like sx then gagaling

pre-paralytic: babalik ule fever kasi nasa CNS na virus

paralytic: 2-5 days or 2-3 wks p magkaka paralysis na

Question 24

discuss post-polio syndrome

Answer 24

slowly progressive assym muscle weakness in pt c history of polio

basta gumaling na from polio then balik 15-40 yrs p