Neuro- DDx Flashcards
UMN tone
Hypertonia
UMN reflexes
Hyperreflexia, abnormal reflexes (clonus)
UMN sensation
Decreased
UMN voluntary movements
Synergic patterns
LMN tone
Hypotonia
LMN reflexes
Hyporeflexia or absent
LMN sensation
Decreased
LMN involuntary movements
Denervation-fasciculations
LMN voluntary movements
Weak or absent
basal ganglia tone
Rigidity (increase in tone, not velocity dependent)
Basal ganglia reflexes
Decreased or normal
Basal ganglia involuntary movements
Resting tremors (pill rolling)
Basal ganglia voluntary movements
Bradykinesia, akinesia
Cardinal signs of PD
“TRAP”
Tremor
Rigidity
Akinesia
Postural Instability
H&Y I
Minimal or absent; unilateral if present
H&Y II
Minimal bilateral or midline involvement; balance not impaired
H&Y III
Impaired righting reflexes; BALANCE affected
H&Y IV
All symptoms present and severe; standing and walking possible only with assistance.
H&Y V
Confined to bed or wheelchair
PD other signs and symptoms q
- early loss of smell
- constipation
- mask-like phase
- OH
- restrictive lung disease
- depression
- dementia
On phase levodopa
Dyskinesia
Off phase levodopa
Dystonia
MS
Progressive demyelination of neurons in the CNS (lack of communication between brain and body)
MS cranial nerve involvement
CN V; optic neuritis, trigeminal neuralgia
Unique signs and symptoms of MS
- Lhermitte’s
- Uhthoff’s
- Charcot’s
- CN II
Charcot’s triad
“SIN”
Scanning speech
Intention tremor
Nystagmus
Progressive relapsing
Steady increase in disability with superimposed attacks
Secondary progressive
Initially RR, symtpoms increase without periods of remission
Primary progressive
Steady increas in disability without attacks/exacerbations
Relapse remitting
Short duration attacks with full or partial recovery, may or may not leave lasting symptoms/deficits
ALS
UMN + LMN
Death of motor neuron (sensation intact)
ALS signs and symptoms
- muscle atrophy, fasciculations
-spasticity, hyperrreflexia - Dysphagia, dysarthria (bulbar)
- pseudobulbar affect (emotional lability)
- cervical spine extensor weakness
- respiratory muscle weakness
GBS
LMN
Autoimmune (after an infection)
Acute inflammatory demyelination
GBS signs and symptoms
G- gloves and stocking
B- bilateral
S- symmetrical
- decreased reflexes/areflexia
-fatigue
GBS cranial nerve involvement
VII, IX, X, XI, XII
