Neuro Flashcards
Causes of dementia
alzheimers chronic ETOH use huntingtons chorea parkinsons hypothyroid pernicious anemia depression normal pressure hydrocephalus bismuth poisoning
ETOH use dementia
malnutrition and thiamin deficiency
Parkinsons etiology and tx
depletion of dopamine –> exaggerated ACh effect
Tx: anticholinergic therapy for tremors/ cholinesterase inhibitors (donepezil, rivastigamine, galantamine)
Huntingtons dz
dementia, chorea
autosomal dominant
Reversible causes of dementia
hypothyroid pernicious anemia depression normal pressure hydrocephalus bismuth poisoning
Most sensitive test for B12 deficieny
serum methylmalonic acid (mma)
Normal pressure hydrocephalus presentaion
dementia
abnormal gait
urinary incontinence/urgency
Cerebellar disease findings
intention tremor
nystagmus
ataxia
dysmetria
Impaired cerebellar fxn can be caused by
multiple sclerosis stroke midbrain tumor mercury poisoining Wilson's disease hereditary cerebellar degeneration
Familial (essential) tremor cause, presentation and tx
- autosomal dominant inheritance
- intention and postural tremor w/ otherwise normal exam
- propranolol
Myasthenia gravis etiology, presentation, diagnosis
- autoimmune disorder
- variable weakness of skeletal muscles
- present of anti-acetylcholine receptor antibody, dx established by response to short acting anticholinesterase
CRP used to:
- assess rick for recurrent ischemic events after CABG or PCI
- Predict future coronary events or stroke
- monitor RA, giant cell arteritis, PMR
Antiphospholipid antibody (APA) syndrome
- can be primary or associated with SLE
- increased risk of thrombosis
- spontaneous abortion in first trimester
- lifelong anticoagulation
Amaurosis fugax
transient, monocular loss of vision for 1-2 mins due to ipsilateral carotid atherosclerotic disease causing retinal emboli
Vertebrobasilar artery insufficiency manifestation
impaired speech, double or blurred vision, vertigo, ataxia, weakness
Positive neuro symptoms
Irritated nerve
- Sensory: burning, tingling, visual hallucination
- Motor: muscle jerking, repetitive rhythmic mvmt
- Autonomic: hyperhydrosis
Negative neuro symptoms
Nerve not functioning
- Sensory/Motor: weakness, loss of sensation, visual loss
- Autonomic:impotence, anhydrosis, lightheadedness
Causes of Bell’s palsy
mono, lyme dz, sarcoidosis
1/2 cases unknown but thought to be viral related
CN VII fxn
Facial nerve
- close eyes, frown, wrinkle forehead, smile
- salivary glands
- taste on anterior 2/3 tongue
- sensory fibers to external ear
Bell’s palsy vs central CN VII palsy
BP- unable to wrinkle forehead on affected side
CN VII- inability to tightly close eyes but can wrinkle forehead
CN V
Sensory and motor
- motor fxn to close jaw and move side to side
Myasthenia gravis effect on eyes
abnormal EOM and ptosis but pupil size always normal
Primary CN III palsy vs DM related CN III palsy
Primary- abnormal EOM, lateral deviation of eye and dilated pupil
DM- pupil usually normal
B12 deficiency manifestations
vibratory and proprioception loss initially
progresses to ataxia and weakness
dementia
Lyme dz and cranial nerve
can affect any but most common VII
DM and CN involement
most common causes palsy of CN III, IV, VI (EOM)
pupil size remains normal
DM autonomic and sensory neuropathy
Autonomic- orthostatic hypotension, gastroparesis, retrograde ejaculation
Peripheral- sensorimotor, N/T/B in feet, loss of vibratory, proprioceptive, light touch, and temp sensations
wenicke’s encephalopathy manifestations
encephalopathy: confusion
oculomotor: eye mvmt disorder
ataxia: due to peripheral neuropathy, cerebellar degeneration, and vestibular degeneration
