Neuro Problems Flashcards
2 main elements needed for MS diagnosis
dissemintaiton of CNS lesions in both space and time
what happens with MS?
demyelinating event in teh DNS
what lesions are present w/ MS and how are they seen?
Cerebral of spinal plaque with adiscrete region of demyelination w/ relative presevation of axons . Seen w/ MRI
what is found in the CSF of people w/ MS?
oligoclonal bands
clinical presentation of MS
parethesiasis in upper and lower extremities
monocular vision loss (due to optic neuritis)
Diploplia (internuclear opthalmoplegia0
ataxia, intention tremor (cerebellar involvement)
urinary difficulties
memory loss, personality changes
type of MS w/ attacks followed by complete remission
relapsing-remitting
Type of MS where the dz is gradually worsening
secondary progressive
type of MS that presents later in life and has a steadily progressive course
primary progressive
MS type where patients have laregely progressive dz exacerbated by acute attacks and little remission
relapsing progressive
first line therapy for acute attack of MS
high does parenteral corticosteroids
does pregnant women w/ MS experience more or fewer symptoms
fewer, they are usually symptom free during pregnancy
presents with flat, uniformly hyperpigmented macules that ppear during the first year and after birth, suggested by the presence of 6 or more. Can also have optic pathway glioma (by age 3 usually)
Neurofibromatosis type 1
raised, often pigmented hamartomas of the iris that are a specific finding for neurofibromatosis type 1. They don’t affect vision
LIsch nodules
what causes myasthenia gravis?
antibody-mediated, T-cell dependent immunologic attack directed at proteins in the postsynaptic membrane of the neuromuscular junction
most common presenting symptom of myathenis gravis
ptosis and/or diplopsia
other symptoms of myasthenia gravis
dysarthria
dysphagia
fatigable chewing
first line therapy for myasthenia gravis
AchE inhibitiors (pyridostigmine)
what surgery can help patients w/ myasthenia gravis
thymectomy (if they don’t have mUSK antibody- associated MG w/o thyoma)
3 main symptoms of Parkinson’s
tremor, bradykinesia, rigidity
what type tremor is seen w/ parkinson’s
pill-rolling, rest tremor, most noticeable when body isn’t engaed in purposeful activities
when do you see a tremor w/ essential tremor?
when the affected limb is being used
Partial seizure with preserved consciousness
Simple
Simple partial seizure resulting in rhythmic motor activity
Jacksonian
Characterized by repetitive automatisms and impaired consciousness.
Complex partial
2 types of generalized seizure
Tonic-clonic
Absence
What type seizure is an aura associated with
Simple partial seizure
what does a diagnosis of dementia require?
memory loss and at least oen other cognitive dysfunction (aphasia, apraxia, agnosia, disturbances of executive function)
Dementia results from ischemic injury
vascular dementia
dementia due to intraneuronal inclusions w/ aggregations of synaptic protein (alpha-synuclein)
Lewy Body Dementia
presents w/ gait abnormality, incontinence and dementia
normal pressure hydrocephalus
dementia characterized by fluctuation of cognitiion (drowsiness, staring into space, diorganized speech) visual hallucinations, parkinsonism
Lewy body dementia
confirmatory score of dementia on MMSE
24 out of 30 (or less)
Tx of normopressure hyrdocephalus
placement of a ventriculoperitoneal shunt
mainstay of medical treatment for AD
cholinesterase inhibitors
NMDA receptor blocker used for dementia
memantine
what drug may frontal temporal dementia respond to
trazodone
druation of a migraine
4-72 hours
HA with unilateral, retroorbital sharp or knife-like pain. often occur w/ lacrimation and nasal congestion
cluster HA
thunderclap HA, worst HA of my life
SAH
acute tx for migraine HA
triptans
prevention tx for migraines
propranolol, amitriptyline
acute tx for tesnsion HA
APAP, apsiring
prevention tx for tension HA
amitriptyline
acute tx for cluster HA
oxygen, triptan
Prevention tx for cluster HA
verapamil
what color with CSF be with a SAH
yellow discoloration- indicative of hemorrhage or there will be RBCs
