neuro-chris

Question 1

MS-defn

Answer 1

loss of myelin = inflammation = neurological loss

Question 2

MS - neuro signs§

Answer 2

optic neuritis
sensory disturbance
motor weakness
fatigue

so both sensory and motor signs

Question 3

diagnosis pathway to MS

3

Answer 3

1- absence of alternative diagnosis
2- two different incidence
3- 2 different areas of brain impacted

Question 4

why wouold you look at CSF for MS

Answer 4

oligoconal bands not found in plasma

autoantibodies

Question 5

what is myasthenia gravis

Answer 5

autoantibodies to AChR at NMJ

80% thymic hyperplasia association

Question 6

what is the muscle fatigue impacted by in myasthenia gravis

Answer 6

it gets worse with use 
ptosis - muscles around eye are weak
diplopia
dysarthria
dysphagia

Question 7

neuro exam with patient with myasthenia gravis

Answer 7

power reduced after use

but reflex normal

Question 8

investigation for myasthenia gravis?

Answer 8

bloods- autoantibodies
emg-
ct/mri - for thymic

Question 9

lambert eaton myasthenic syndrome

Answer 9

autoantibodies against presynaptic VGCC at NMJ
= build up of ACh at junction
so muscle weakness but it improves with use

Question 10

how does the LEMS compare to MG in re to muscle fatigue?

neuro exam?

Answer 10

muscle weakness improves with use

hyporeflexia

Question 11

MND- defn

Answer 11

ubiquitinated proteins in cytoplasm

= death of corticospinal

Question 12

MND signs

Answer 12

wasting of thenar muscles

wasting of tongue

Question 13

parkinsons defn

Answer 13

loss of dopaminergic neurones in substantia nigra

misfolded alpha synuclein builds up

lewy body and lewy neurites

Question 14

classical parkinsonian triad?

Answer 14

resting tremor
rigidity
bradykinesia - slow movement

Question 15

6 M’s of Parkinson?

Answer 15

monotonous hypotonic speech
micrographia 
march a petit pas [slow walk, lean forward]- shuffling gait
misery- depression
memory loss - dementia

hypomimesis- expressionless face