MS/huntington/tourette Flashcards
Double vision, nystagmus, blindness, blurry vision
MS
Focal weakness Gait difficulties – Ataxia Fatigue and weakness Numbness or tingling Dizziness and Vertigo Pain Emotional Changes Bladder dysfunction Tremor Headache Seizures
MS
Lumbar puncture in MS
Lumbar puncture – may show evidence of chronic inflammation in the CNS including mild protein elevation, mild increase in leukocytes
MRI? in MS
MRI with gadolinium shows areas of demyelination
Evoked Potential Tests
Evoked Potential Tests – measure electrical signals sent by the brain in response to stimuli. It can be visual stimuli or electrical stimuli. Lesions and nerve damage to the optic nerves, brainstem or spinal cord can be detected.
To Treat MS attacks (3)
Corticosteroids high dose (oral prednisone) intravenous methylprednisolone (Solu-Medrol) Plasmapheresis has been shown to be beneficial
Beta interferons Glatiramer acetate (Copaxone) Fingolimod (Gilenya) Natalizumab (Tysabri) Mitoxantrone Teriflunomide (Aubagio)
To Slow progress of MS
To Treat Symptoms
- physical tx
- an oral medication may improve walking speed
Physical therapy – will involve stretching and strengthening exercises and the use of devices that can make it easier to perform daily tasks.
Dalfampridine (Ampyra) an oral medication may improve walking speed
___ and ___ help with spasticity
___ helps with fatigue
Baclofen and Tizanidine (Zanaflex) help with spasticity
Amantadine helps with fatigue
what can be a precipitant of MS
viral infection
MS ages
18-45
sensory complaints in limbs followed by vision loss
MS
elevated immunoglobulin G index, oligoclonal bands, increased myelin basic protein
MS
optic neuritis tx
high dose IV corticosteroids
cyclophosamide or azathtioprine
immunosuppressive agent that may arrest course of secondary progressive form MS
Huntington’s disease
- inherited?
- chromosome?
- offspring
- age of symptoms
- progressive?
Autosomal dominant inheritance pattern
Offspring have a 50% chance of inheriting the gene for Huntington’s found on chromosome 4
Symptoms typically do not appear until age 30
This is a progressive neurodegenerative disease
progressive chorea and dementia
-mortality
Huntington’s disease
fatal within 15-20 years
Huntington’s disease early mental changes
behavioral, irritability, moodiness, antisocial behavior that progress to an obvious dementia
Huntington’s disease early physical signs
restlessness or fidgetiness but eventually severe choreiform movements and dystonic posturing occur
Fidgetiness Restlessness Chorea – jerky random uncontrolled movements Rigidity Writhing Abnormal posturing Difficulty swallowing Difficulty speaking
Huntington’s disease
Brain CT with Huntingtons
Brain CT may show cerebral atrophy and atrophy of the caudate nucleus
MRI and PET scans with Huntingtons
shown decreased glucose metabolism in an anatomically normal caudate nucleus
huntingtons tx
There is no cure and the disease is progressive. Life expectancy is typically 20 years following onset of symptoms.
Supportive care
Counseling
Speech therapy
Occupational therapy etc
Treatment for chorea
Typical and atypical neuroleptics -olanzapine, risperidone, haloperidol
Dopamine depleting agents – tetrabenazine
Treatment for chorea
Typical and atypical neuroleptics -olanzapine, risperidone, haloperidol
Dopamine depleting agents – tetrabenazine
