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Casey: Neurology > Neuralgias > Flashcards

Neuralgias Flashcards

1
Q

Body part affects is supported against gravity, no muscle contraction

A

Resting tremor

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2
Q

Produced by voluntary muscle contraction

A

Action tremor

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3
Q

Present during visually-guided, target-directed motion

A

Intention tremor

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4
Q

aka benign familial tremor

A

Benign essential tremor

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5
Q

MC movement disorder worldwide* ; insidious development, SLOW progression; unilateral progresses to bilateral; usually starts with postural distal arm tremor; Neuro exam NORMAL!

A

Benign essential tremor

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6
Q

Amplitude increases with stress, fatigue, CNS stimulants, voluntary activity; DECREASES with ETOH, beta-blockade, reset

A

Benign essential tremor

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7
Q

Tx of Benign essential tremor

A

Primidone or Propranolol (better tolerated)

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8
Q

Neurodegenerative disorder resulting form DECREASE in dopaminergic transmission in basal ganglia

A

Parkinson’s Disease

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9
Q

4 Cardinal Signs= Tremor, Rigidity, Bradykinesia, Postural impairment

A

Parkinson’s Disease

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10
Q

Tremor that is worse at REST; Resting tremor MC sign; One limb or one side of body for months to years; spares head

A

Parkinson’s disease

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11
Q

Rigidity (increased resistance to passive movements)–> flexed posture; “cogwheel rigidity”; NO weakness; NO change in DTRs

A

Parkinson’s disease

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12
Q

Slowness of movements; effects voluntary movements and speech; seen in Parkinson’s

A

Bradykinesia

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13
Q

Classic “festinating gait”; short fast steps (trying to keep up with the forward center of gravity); freezing w/ direction change or when entering small space

A

Parkinson’s disease

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14
Q

“mask-like” face, decreased blinking, dementia 6x normal rate, micrographic (small handwriting), hypophonia, depression, akinesia

A

Parkinson’s disease

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15
Q

Loss of melanin-containing dopaminergic neurons in substantial nigra; LEWY BODIES in basal ganglia

A

Parkinson’s Disease

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16
Q

GOLD STANDARD in tx of Parkinson’s; converted to dopamine in the brain–> Dopamine itself cannot cross BBB!

A

Levodopa

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17
Q

SE include nausea, dyskinesias (sudden, uncontrollable, jerky movements of extremities)

A

Levodopa

18
Q

Includes Ropinirole; used in Parkinson’; possibly neuroprotective; stimulate dopamine receptor directly (D3); can add-on to dopamine when levodopa alone no longer effective (or SEs intolerable)

A

Dopamine agonists

19
Q

Includes Benzotropine; used in Parkinson’s primarily to alleviate tremor; Decreases the imbalance between dopamine and acetylcholine, increasing dopamine levels.

A

Anticholinergics

20
Q

Antiviral flu drug, also anti-dyskinetic for mild symptoms; NMDA receptor antagonist–>increases presynaptic dopamine release; may also help with chorea in Huntington’s!

A

Amantidine

21
Q

Includes Selegiline; used in Parkinson’s; decreases dopamine breakdown and increases dopamine in the striatum; may be neuroprotective

A

MAO-B Inhibitors

22
Q

Surgically implanted neurostimulator in subthalamic nucleus; blocks abnormal signs that cause PD symptoms; only for pts whose symptoms are UNCONTROLLED BY MEDS!

A

Deep Brain Stimulation

23
Q

AUTOSOMAL DOMINANT neurodegenerative disorder; Disease of the YOUNG; Triad= motor, cognitive, and psychiatric symptoms; insidious onset, no cure; fatal in 15-20yrs!

A

Huntington’s disease

24
Q

“the dance”-primarily involuntary movement in HD; involuntary, irregular, rapid, uncontrolled, excessive movement

A

Chorea

25
Q

Abnormal eye movements, slow or uncoordinated fine motor control, dysarthria, dysphagia, gait disturbance

A

Huntington’s disease

26
Q

Psychiatric symptoms include depression, mania, OCD, apathy, anxiety

A

Huntington’s disease

27
Q

Decrease in GABA (GABA is inhibitory), decrease in Ach, increase in dopamine

A

Huntington’s disease

28
Q

Defective gene on 4th chromosome-> has excess repeats of glutamine “CAG” sequence (40+ repeats= will have HD; 70+ repeats- will have juvenile HD)

A

Huntington’s disease

29
Q

Inherited neurobehavioral disorder characterized by sudden involuntary, repetitive muscle movements and vocalizations

A

Tourettes

30
Q

Dx: multiple motor and one or more vocal tics at some time during the disorder that are NOT explained by another medical condition and directly observed or recorded; Tic episodes several times a day, almost every day >1 year

A

Tourettes

31
Q

Initially in head and face; includes blinking, face twice, head jerk, shrug, neck stretch, sniffing

A

Motor tics

32
Q

Sudden, involuntary, recurrent, and often loud; include grunt, throat clearing, sign, bark, hiss, snort, sniff; advanced includes repeating words or phrases out of context

A

Vocal tics

33
Q

Used in the tx of tourettes to decrease behavior problems; include Haloperidol, fluphenazine, risperidone

A

Dopamine antagonists/antipsychotics

34
Q

Movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both

A

Cerebral palsy

35
Q

Associated conditions include epilepsy, developmental delay, behavioral issues/learning disabilities, and fxs

A

Cerebral palsy

36
Q

Compression at the superior thoracic outlet resulting from excess pressure place on a neurovascular bundle passing between the anterior scalene and middle scalene muscles; Adson’s sign (loss of radial pulse in arm when rotating head to ipsilateral side), costoclavicular maneuver (shoulders drawn downward and back)

A

Thoracic outlet syndrome

37
Q

Intermittent, progressive chronic disorder involving aberrant firing of the trigeminal nerve (CN V)–> usually 2nd and 3rd branches; UNILATERAL lancing paroxysmal facial pain

A

Trigeminal Neuralgia

38
Q

Found in those >50; in younger pts, should make you think of MS*

A

Trigeminal Neuralgia

39
Q

Symptoms include stabbing, shocking, ‘live wire’; pain can be severe and cause muscle spasm (tic); episodes last a day to several weeks

A

Trigeminal neuralgia

40
Q

Pain triggered by LIGHT touch and vibration, but NOT firm pressure; Pts will hold face VERY still to avoid triggering

A

Trigeminal neuralgia

41
Q

Tx of trigeminal neuralgia; Decreases hyperactivity of trigeminal nerve nucleus

A

Carbamazepine (1st line) & Phenytoin

42
Q

Experience of pain from a NON-PAINFUL stimulus, such as light touch; May be present in Post-herpetic neuralgia

A

Allodynia

Casey: Neurology (7 decks)

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