Neuro 2 Flashcards
spinal cord stuff neurofibromatosis
Central cord syndrome (syrinx)
- mechanism of injury
- presentation
- diagnosis?
- Rx?
- forceful hyperextension of spondylotic neck
- loss of sensor and motor function upper body»_space;> lower body- typically in ‘shawl’ region
- MRI spine
- neurosurgical intervention
Brown-Sequard syndrome
- mechanism f injury
- presentation
hemicord lesion
- knife/bullet injury or MS
- lose ipsilateral soft touch/propioception and weakness AND contralateral loss of pain and temp
Anterior cord syndrome
- mechanism of injury
- clin features
involves tracts in anterior two- thirds of spinal cord
- compression injury or vascular
- complete loss of motor,pain and temp below injury but retains propioception and vibration
Cauda equina syndrome
- aetiology
- clin features
- Rx
- disc herniation, lumbar stenosis
- bilateral leg weakness, bladder and rectal incontinence, ,asymmetrical multiradicular pain
- dexamethason and surgical decompression
Lumbar spinal stenosis
- causes
- symptoms
- best inv
- treatment
- usually degenerative joint disease
- pain worse with back extension (walking downhill), unilateral leg pain and weakness
- MRI
- NSAIDs and physio (same as OA)
Syringomyelia
- usual site affected
- clin features
- associations?
cysts in spinal cord usually C8/T1
- intrinsic muscle weakness and loss of spinothalamic function
- chiari malformation
Guillian Barre syndrome
- define
- associations
acute demyelinating disease including peripheral and cranial nerves
most commonly associated with C. jejuni (can be any bacteria or virus)
Signs and symptoms of GBS
symmetrical ascending weakness areflexia autonomic dysfunction - bilateral Bell's palsy - reduced distal propioception and vibration
what is the miller-fisher variant of GBS?
like GBS but presents with opthalmoplegia, areflexia and ataxia
investigations and treatment of GBS
Ix: MRI
lumbar puncture: raised protein
Rx: IV Ig- takes wks-months to recover
CIDP
- define
- clin features
inflammation of the nerve roots and peripheral nerves with destruction of the myelin sheath
- symmetrical weakness of hip and shoulder muscles with impaired motor and sensory function, areflexia
CIDP
- inv
- treatment
- nerve conduction tests, lumbar puncture (raised protein), MRI
- iv Ig and steroids
Charcot-Marie-Tooth syndrome (HMNS)
- inheritance
- clin features
- management
- AD
- onset in puberty with thickened enlarged nerves esp common peroneal (foot drop absent ankle jerks)
symmetrical muscle atrophy and loss of sensation - supportive management (physio)
treatment of Bell’s palsy
if present within 72 hours give pred
movement disorder presents in <40yrs what is main differential?
Wilson’s disease
