Neuro Disorders Flashcards
What is Parkinson’s dz?
Degenerative disorder of CNS assoc w/ Lewy bodies & loss of dopaminergic neurons of the substantia nigra pars compacta
What are Lewy bodies composed of?
Alpha-synuclein intracellular inclusion
What are the sx of Parkinson’s dz?
- Tremor
- Cogwheel
- Rigidity
- Akinesia
- Postural instability
What is Huntington’s dz?
AD CAG trinucleotide repeat disorder
What is Huntington’s dz char by?
- Chorea
- Aggression
- Depression
- Dementia
What causes neuronal death in Huntington’s dz?
NMDA-R binding & glutamate toxicity
What will be seen on imaging with Huntington’s dz?
Atrophy of striatal nuclei (main inhibitors of movement)
How does Hemiallismus present?
Sudden, wild flailing of 1 arm +/- ipsilateral leg
What is the char lesion of Hemiballismus?
Contralateral subthalamc nucleus
What is the presentation of Chorea?
Sudden, jerky, purposeless movements
What is the characteristic lesion of Chorea?
Basal ganglia
(Huntington’s)
What is the presentation of Athetosis?
Slow, writhing movements esp seen in fingers
What is the characteristic lesion of Athetosis?
Basal ganglia
(Huntington’s)
What is the presentation of Myoclonus?
Sudden, brief, uncontrolled muscle contraction
Jerks, hiccups, common in metabolic ABN such as renal & liver failure
What is the presentation of Dystonia?
Sustained, involuntary muscle contractions
Writer’s cramp, blepharospasm (sustained eyelid twitch)
What is the presentation of Essential tremor (postural tremor)?
Action tremor; exacerbated by holding posture/limb position
What causes Essential tremors?
Genetic predisposition
What do pt w/ essential tremors self medicate w/?
Alcohol
What is the tx for essential tremors?
Beta blockers or Primidone
What is the presentation of a Resting tremor?
Uncontrolled movement of distal appendages (Most nocticable in hands)
Tremor alleviated by intentional movement
What is the characteristic lesion of a Resting tremor?
Parkinson’s dz
What is the presentation of an Intention tremor?
Slow, zigzag motion when pointing/extending toward a target
What is the characteristic lesion of an Intention tremor?
Cerebellar dysfunction
What is the consequence of a bilateral Amygdala lesion?
Klüver-Bucy syndrome–hyperolrality, hypersexuality, disinhibited behavior
What is Amygdala lesion assoc w/?
HSV-1
What is the consequence of a Frontal lobe lesion?
Disinhibition & deficits in concentration, orientation & judgement
May have reemergence of primitive reflexes
What is the consequence of a Right Parietal lobe lesion?
Spatial neglect synd
(Agnosia of the contralateral side of the world)
What is the consequence of a Reticular activating system (midbrain) lesion?
Reduced levels of arousal & wakefulness
What is the consequence of a bilateral Mammillary body lesion?
Wernicke-Korsakoff synd
What is Wernick-Korsakoff synd?
Confusion, opthalmoplegia, ataxia, confabulation, personality chagnes, memory loss (anterograde & retrograde amneisa)
What is Wernicke-Korsakoff synd assoc w/?
Thiamine (B1) def & excessive alcohol use
What can Wernicke-Korsacoff synd be precipiated by?
Giving glucose w/o B1 to a B1-def pt
What is the consequence of a Basal ganglia lesion?
May result in tremor at rest, chorea or athetosis
(Parkinson’s dz)
What is the consequence of a Cerebellar hemisphere lesion?
Intention tremor, limb ataxia, loss of balance & fall toward side of lesion
What is the consequence of a Cerebellar vermis lesion?
Truncal ataxia & dysarthria
What is the consequence of a Subthalamic nucleus lesion?
Contralateral hemiballismus
What is the consequence of a Hippocampus lesion?
Anterograde amnesia–inability to make new memories
What is the consequence of a Paramedian pontine reticular formation (PPRF) lesion?
Eyes look away from side of lesion
What is the consequence of a Frontal eye field lesion?
Eyes look toward lesion
What is Central pontine myelinolysis?
Acute paralysis, dysarthria, dysphagia, diplopia & loss of consciousness
What can Central pontine myelinolysis cause?
“Locked in syndrome”
What causes Central pontine myelinolysis?
Commonly iatrogenic, caused by overly rapid correction of Na+ levels (hyponatremia)→ massive axonal demyelination in pontine white matter
What is Aphasia?
Higher-order inability to speak (language deficit)
What is Dysarthria?
Motor inability to speak (movement deficit)
What is Broac’s aphasia?
Nonfluent aphasia w/ intact comprehension
What is Broca’s area?
Inferior frontal gyrus of frontal lobe
What is Wernicke’s aphasia?
Fluent aphasia w/ impaired comprehension
What is Wernicke’s area?
Superior temporal gyrus of temporal lobe
What is Global aphasia?
Nonfluent aphasia w/ impaired comprehension
Both Broca’s & Wernicke’s areas affected
What is Conduction aphasia?
Poor repetition but fluent speech, intact comprehension
What causes Conduction aphasia?
Arcuate fasiculus
