Neurological Conditions Flashcards
What structures are affected in conditions associated with upper motor neurone lesions?
Cerebral hemispheres
Cerebellum
Brainstem
Spinal Cord
What structures are affected in conditions associated with lower motor neurone lesions?
Anterior horn cells (motor neurone that projects from the anterior portion of the grey matter in the spinal cord to the skeletal muscle)
Motor nerve roots
Peripheral motor nerves
What are the three classifications of nerve injuries?
Neuropraxia
Axonotmesis
Neurotmesis
Define Neuropraxia
A class of nerve injury associated with focal segmental demyelination of a nerve
Usually caused by compression injuries, causes a transient loss of sensation/function lasting several days – weeks.
Involves demyelisation followed by remylination.
Usually no lasting clinical damage
Define Axonotmesis
A more severe class of nerve injury associated with damage to an axon and potential damage to the endoneurium and perineurium (depending on severity)
Associated with crush injuries/severe compression of a nerve causing degeneration of the axon
Can resolve without surgical intervention if endoneurium and perineurium are intact, will require surgical intervention if not intact
Likely sensory and motor defects distal to site
Define Neurotmesis
The most severe grade of nerve injury involving complete nerve transaction - disruption of myelin sheath, axon, endoneurium, perineurium and epineurium
Cannot self resolve, requires surgical intervention but will most likely produce complete sensory and motor deficit of the injured nerve
What is a stroke?
A clinical syndrome characterised by rapidly developing signs of focal or global disturbance of cerebral function that last for > 24 hours due to an infarction or haemorrhage within the brain
Ischaemic Stroke - an episode of neurological dysfunction caused by focal, cerebral, spinal or retinal cell death due to infarction following vascular occlusion or stenosis
Haemorrhagic Stroke - Rapidly developing neurological dysfunction due to a focal collection of blood from within the brain parenchyma or ventricular system (intracerebral haemorrhage) , or bleeding into the arachnoid space (subarachnoid haemorrhage) that is not caused by trauma
TIA - Transient Ischaemic Attack: A sudden focal deficit lasting from seconds to 24 hours with complete recovery
What are the some risk factors for stroke?
Hypertension
Hypercholsterolaemia
Erythrocytosis - Raised haematocrit and haemoglobin concentration
Severe Carotid Stenosis
Cardiovascular Disease
Previous Stroke
Smoking
Excessive Alcohol Consumption
Obesity
Diabetes
What is cerebral palsy?
A term that refers to a group of movement and posture disorders, caused by an acquired pathology within the developing brain during the prenatal, neonatal or early infancy period
What are some risk factors than can contribute to the development of cerebral palsy?
During pregnancy…
Smoking
Alcohol/ drug use
Intrauterine Infection
Placental insufficiency
Genetics (studies have shown that a small incidence of CP can be attributed to genetics, not a commonly thought of cause however)
Folic acid deficiency
Eclampsia
During birth…
Premature and low birth weight
Foetal distress
Asphyxia/ hypoxia
After birth…
CNS infections e.g Meningitis, Encephalitis
Head trauma
How is cerebral palsy classified?
There are three main types of CP, differentiated by their symptoms:
Spastic - Involves muscle tightness and spasms
Athetoid (Dyskinetic) - Involves poor motor control, affecting muscle movement
Ataxic - Involves poor balance and mobility, causing falls and an irregular gait
These are further classified based on what parts of the body are affected:
Diplegic - Affecting the arms more than the legs
Quadriplegic - Affecting all limbs
Hemiplegic - Affecting one side of the body (left or right)
Paraplegic - Affecting the legs more than the arms
