Neuro Flashcards
Causes of corticospinal motor disorders
- neural migration problem
- ischaemia
- cerebral tumor
- arterial ischaemic stroke
- encephalomyelitis
- hemiplegic migraine
- post-ictal paresis
PC corticospinal motor disorders
UMN
- weakness: shoulder AD, F elbow, pronation forearm
Causes of basal ganglia motor disorders
M-WASH Mitochondrial cytopathies Wilsons Acquired: - ischaemia - CO poisoning - post-cardiopulmonary bypass Syndenhams Huntingtons
Acquired basal ganglia problems
Ischaemia
CO poisoning
post-cardiopulmonary bypass
PC basal ganglia motor disorders
- dystonia– can’t get going
- dyskinesia
- -> chorea
- -> athetosis
Causes of cerebellar motor disordes
GAPP
Genetic– ataxia/tel, friederichs, ataxic CP
Acute- drug/alcohol
Posterior fossa tumor
Post-viral-varicella
PC cerebellar dysfunction
nystagmus dysarthria-- scanning speech dysmetria-- past pointing dysdiadochokinesia \+ Romberg Wide Gait
PC Peripheral motor disorders
WEAKNESS
- muscle fatiguability
- muscle cramps
- hypotonia
- delayed motor milestones
- waddling gait
- GOWERS SIGN
Dx myopathy
CPK
Bx
US/MRI
DNA
Dx neuropathy
nerve conduction studies
Bx (rare)
EMG
DNA
Anterior horn cell path
- Spinal muscular atrophy
2. Polio
Spinal muscular atrophy
autosomal recessive
SMN= survival motor neurone–> degen LMN
3 TYPES
Type 1 SMA=
Werdnig Hoffman
PC Werdnig Hoffman
IN UTERO: decrease fetal movements
arthrogryphosis
CANNOT SIT
LMN- HYPOTONIA:
tongue fasciculations
decrease DTR’s
lack anti gravity movement hip flexors
intercostal recessions
death werdnig hoffman
1 year old– respiratory failure
Type 2 SMA
CAN SIT :)
Type 3 SMA
Ku-gel-berg Wel-an-der
CAN WALK :)
Peripheral nerve problems
- Hereditary motor and sensory neuropathy
- Acute post-infectious polyneuropathy
- Bell’s Palsy
HMSN– type 1…
Peroneal atrophy= Charcot Marie Tooth
Pathophysiology CMT
myelin structural problems
– demyelination–> remyelination
= onion bulb formation
Inheritance CMT
AD
PC CMT + age
1 - 10 year old
- symmetrical DISTAL
- motor: distal atorphy
- sensory: distal paraesthesia
- pes cavus and hammer toes–> gait problems
rarely– unable to walk
PC GBS
2-3 weeks post…
viral URI
campy
---> ascending paralysis \+ loss reflexes \+weakness \+ autonomic \+ BULBAR--> can't swallow, rest depression= death
Recovery GBS
95% recover 2 years later
Dx GBS
- CSF: albuminocytologic dissasociation
2. Nerve conduction studies: decreased
Tx GBS
- SUPPORTIVE
- IVIG
- plasma exchange
NOT STEROIDS– slow down progression
Causes of Bells Palsy
IDIOPATHIC
[post-HSV-adults]
Compression cp angle Ramsy Hunt HTN--> coarct a/w Bells Sarcoidosis Lyme disease
PC age MG
> 10 yo
Dx MG
- Edrophonium= Tensilon Test
- Antibodies
- Anti-MUSK= antimuscle Specific Kinase
Tx MG
- Neostigmine, pyridostigmine
- Steroids
- Azathioprine
- Plasma exchange
- Thymectomy
Duchennes genes
del Xp21 DMD gene
Symptoms age duchennes
about 3 yo
Dx age duchennes
5.5yo
Can’t walk age duchennes
10-14 yo
Complications of duchennes
Scoliosis
DCM
Resp F
Dx Duchennes
increase CPK
Tx duchennes
- exercises, passive stretches, splints
- orthotics
- lengthen achilles
- sitting posture
- truncal brace
- CPAP, NIPPV
- support
- steroids–> ambulatory