NEURO WK 3 Flashcards
MND
motor neurone disease
degenerative
weakness, older men
riluzole
what symptom is one of the main causes of death in MND??
RESPIRATORY FAILURE
Subtypes of MND (umbrella term) and what is the most common ?? **
ALS - most common, upper and lower
Progressive Bulbar palsy
PLS - upper
PMA - lower
RED FLAG SIGNS OF RESPIRATORY FAILURE AND TREATMENT
upper motor signs vs. lower motor
upper - hyperreflexia, hypertonia, spasticity
lower - hyporreflexia, hypotonia, muscle wasting and fasciculations (twitching)
condition affecting the NEUROMUSCULAR JUNCTION
MG
clinical features of MG
tiredness
Presynaptic issues (2) - RARE
postsynaptic issues - MORE COMMON
diagnostic test for MG, and treatments for MG
what is associated with MG
- anti-AChR IgG** in serum (elisa test)
- Repetitive nerve stimulation - gradually reducing responses indicates NMJ dysfunction
ACh inhibitor - pyridostigmine
steroids
Thymectomy - association w thymoma
WHAT DRUGS TO AVOID IN MG
antibiotics
fluoroquinolone antibiotics (e.g., ciprofloxacin, levofloxacin)
examination of muscle and power grading
EMG
most common muscular dystrophy??
duchenne’s
gower’s sign
x-linked recessive
Be aware of treatable muscle disorders – polymyositis, dermatomyositis and rhabdomyolysis
myotonia
delayed relaxation of muscles after voluntary contraction or after a mechanical stimulus
rhabdomyolysis triad !!!
elderly man collapsed on ground and can’t get up
muscle pain/weakness
dark urine
decreased urine output
Understand the differences between peripheral neuropathy, radiculopathy, mononeuropathy and mononeuritis multiplex. Where are the nerves damaged??
GBS
ascending weakness
Campylobacter illness
glove and stocking distribution
IvIg and plasmapheresis
Understand the difference between axonal and demyelinating neuropathies
AXONAL - affecting the axon
eg. diabetes
DEMYELINATING - affecting the myelin sheath eg. MS, GBS
acute vs chronic demyelinating neuropathies
acute - GBS
chronic - MS
Differentiate between small and large fibre neuropathies - large fibre motor, large fibre sensory, small fibre, autonomic. symptoms, power, sensation and reflexes
KNOW THE DIFFERENT PATTERNS OF SENSORY LOSS
central loss
glove and stocking
What is Parkinson’s ?? main cause? triad
loss of dopaminergic neurones in the substantia nigra
rigidity, bradykinesia and resting tremor
PATHOLOGICAL HALLMARK OF PD
presence of Lewy bodies in certain regions of the brain, alpha synuclein
protein
Ix and Mx of Parkinson’s
DaTscan (SPECT imaging)
MRI/CT scan of head
levodopa
PARKINSON-PLUS SYNDROMES
MSA
PSP
DLB
T1, T2
definition of sleep
reversible loss of consciousness and reduced responsiveness to the surrounding environment.
stages of sleep
non REM
REM
what are the 2 peaks of drowsiness / peak patterns?
2pm-4pm
early morning
