MS, neurotransmitter, hypothalamus, amygdala Flashcards
acute inflammatory demyelinating polyradiculopathy - result in (symptoms)
- symmetric/paralysis (beginning in lower extremities)
- facial paralysis (in 50%)
- autonomic regulation (eg. cardiac irregulation, hypertension, hypertension)
- sensory abnormalities
acute inflammatory demyelinating polyradiculopathy - lab
increased CSF protein with normal cell count (albuminocytologic dissociation)
acute inflammatory demyelinating polyradiculopathy - increased protein in CSF can cause
papilledema
acute inflammatory demyelinating polyradiculopathy - treatment
- Respiratory support (critical until recovery)
- plasmapheresis
- IV immunoglobins
NO ROLE FOR STEROIDS
Multiple sclerosis epidemiology - MC in
women, 20-30 years old, whites living further from equator
Multiple sclerosis - patients can present with
- optic neuritis (sudden onset of vision resulting in Marcus Gunn pupils)
- intrenuclear ophthalmoplegia
- hemiparesis
- hemisensory symptoms
- bladder/bowel incontinence
- intention tremor
Multiple sclerosis - Charcot classic triad
MNEMONIC –> SIN
- Scanning speech (dysarthria)
- Intention tremor (also Internuclear opthalmoplegia and Incontinence)
- Nystagmus
Multiple sclerosis - gold standard
MRI
Multiple sclerosis - findings in CSF
increased IgG + myelin basic protein
Multiple sclerosis - … are diagnostic
oligoclonal bands
Multiple sclerosis - treatment
- slow progression treatment –> disease modifying therapies (eg. β-interferon, natalizumab)
- treat acute flares –> IV steroids
- symptomatic treatment –> cathetirazation, muscarinic antagonists, baclofen, GABA b receptor agonists, opioids
Adrenoleukodystrophy - pathophysiology / mode of inheritance
X-linked genetic disorder –> disrupts metabolism of very-long-chain fatty acids –> excessive buildup (accumulation) in nervous system, adrenal glands and testes
Adrenoleukodystrophy - coarse of disease
Progressive disease that can lead to
1. long-term coma/death and 2. adrenal crisis
demyelinating and dysmelinating diseases - types
- Multiple sclerosis
- Acute inflammatory demyelinating polyradiculopathy
- Acute disseminated (postinfectious) encephalomyelitis
- Charcot-Marie-Tooth disease
- Krabbe disease
- Metachromatic leukodystrophy
- Progressive multifocal leukoencephalopathy
Acute disseminated (postinfectious) encephalomyelitis? / course
multifocal periventricular inflammation and demyelination after infection or certain vaccination
- rapidly progressive multifocal neurologic symptoms
Acute disseminated (postinfectious) encephalomyelitis is usually caused by (examples)
- infection –> measles, VZV
2. certain vaccinations –> rabies, smallpox
Charcot-Marie-Tooth disease - AKA … / mode of inheritance
hereditary motor and sensory neuropathy (HMSN)
AD
Charcot-Marie-Tooth disease - definition and mechanism
Group of progressive hereditary nerve disorder related to the defective production of proteins involved in the structure and function of peripheral nerves or the meylin sheath
Charcot-Marie-Tooth disease - symptoms and signs
- foot deformities (pes cavus)
- lower extremities weakness
3 .sensory deficits
Krabbe disease - pathophysiology
deficiency of galactocerebrosidase –> buildup (accumulation) of galactocerebroside and psychosine destroys myelin sheath
Krabbe disease - findings (symptoms, signs, histology etc)
- peripheral neuropathy
- Developmental delay
- Optic atrophy
- Globoid cells
Metachromatic leukodystrophy - pathophysiology
deficiency of arysulfatase A –> buildup (accumulation) of sulfatides –> impaired production and destruction of myelin sheath
Metachromatic leukodystrophy - findings (symptoms, signs, histology etc)
- central and peripheral demyelination with ataxia
2. dementia
Progressive multifocal leukoencephalopathy - mechanism/definition / course
demyelination of CNS due to destruction of oligodendrocytes
- rapidly progressive, usually fatal
Progressive multifocal leukoencephalopathy - associations, risk factors etc
- associated with JC virus
- Seen in 2-4% of AIDS patients
- increased risk with natalizumab, rituximab
norepinephrine - change in disease
increased in anxiety
decreased in depression
Dopomine - change in disease
increased in Huntington
decreased in Parkinson
decreased in depression
increased in Schizophrenia
5-HT - change in disease
Decreased in anxiety
decreased in depression
INCREASED IN PARKINSON
ACH - change in diseases
increased in Parkinson
decreased in Alzheimer
decreased in Huntington
GABA - change in disease
decreased in anxiety
decreased in Huntington
anxiety - changes in neurotransmitters
increased norepinephrine
decreased 5-HT and GABA
depression - changes in neurotransmitters
decreased norepinephrine, dopamine and 5-HT
Huntington disease -changes in neurotransmitters
decreased GABA, ACH
increased dopamine
Parkinson disease - changes in neurotransmitters
decreased dopamine
increased ACH
INCREASED SERETONIN
Alzheimer disease - changes in neurotransmitters
decreased ACH
increased glutamate
Schizophrenia - changes in neurotransmitters
increased dopamine
hypothalamus - function
mnemonic TAN HATS
Thirst and water balance, Adenohypophysis control, Neurohypophysis hormones, Hunger, Autonomic regulation, Temperature regulation, Sexual urges
hypothalamus - ADH vs oxytocin sccording to source
Supraoptic nucleus –> ADH
Paraventricular nucleus –> oxytocin
Lateral area of hypothalamus - function
regulates hunger
ventromedial area of hypothalamus - function
regulate satiety
hypothalamus - parasympathetic and sympathetic are regulated by
- parasympathetic: anterior hypothalamus
2. sympathetic: posterior hypothalamus
Limbic system - definition/function/responsible/structures
collection of neural structures involved in emotion long-term memory, oflaction, behavior modulation, ANS function (1.feeding 2.fleeing 3.fighting 4. feeling 5. sex)
structures: 1. hippocampus 2. amygdala 3. fornix
4. mammillary bodies 5. cingulate gyris
