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Neurological Disorders Flashcards

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1
Q

what are neurological disorders associated with?

A

an abnormality of or injury to the brain

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2
Q

what is involved in the process of neurological examination?

A

neurologist asks about history of patient/family history
-neurologist observes behaviours while taking history to assess mental status, motor control, speech abnormalities
-neurologist performs basic cognitive tests (memory and attention)
-assess function of cranial nerves
-follow up testing using imaging (EEG, CT, MRI)

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3
Q

what are common causes of TBI?

A

-car accidents, combat, sports

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4
Q

why is the incidence of TBI hard to determine?

A

many go unreported

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5
Q

who is at higher risk of TBI?

A

males between ages 15 and 30

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6
Q

sports account for what % of all TBI?

A

20

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7
Q

what sports are most dangerous for TBI?

A

football, hockey, rugby, lacrosse, soccer

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8
Q

there is a long term decrease in ______ ______ following TBI

A

glucose metabolism

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9
Q

what are open head injuries?

A

TBI where skull is penetrated by an object (bullet, shrapnel)

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10
Q

what are closed head injuries

A

any blow to the head that does not penetrate the skull

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11
Q

what is a coup?

A

damage to the brain at the site of the blow caused by the brain impacting with the skull

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12
Q

what is a contrecoup?

A

damage to the brain at the opposite side of the skill from the site of injury (coup) caused by the brain rebounding from the initial injury and impacting the skull

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13
Q

what is shearing?

A

twisting/breaking of nerve fibers caused by the rapid movement of the brain inside the skull

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14
Q

what is a hematoma?

A

mass of blood trapped in the skull

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15
Q

what is an edema?

A

swelling that can result in pressure on the delicate cranial nervous tissue

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16
Q

boxers and football players may suffer from _____ _______, which is another form of chronic traumatic encephalopathy, also known as ‘punch drunk syndrome’

A

dementia pugilistica

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17
Q

what is true about the correlation between duration of unconsciousness (coma) and severity of head injury?

A

longer the coma, the greater the possibility of impairment or death, correlates with mortality, intellectual impairment and deficits in social skills

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18
Q

injuries can also result from ____ _____ throughout the brain and are associated with…

A

widespread trauma, loss of complex cognitive functions and efficiency

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19
Q

how can behavioural changes from head injuries impact a patient?

A

may make them more susceptible to further head injuries

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20
Q

which type of assessment is most valuable in gaining information about TBI?

A

behavioural assessment

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21
Q

what is the scale used to quantify unconsciousness and recovery of consciousness?

A

Glasgow Coma Scales

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22
Q

what 3 scales does the Glasgow Coma Scale employ?

A

1) eye opening
2) motor response
3) verbal resopnse

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23
Q

on the Glasgow coma scale, a score of what is associated with severe head injury?

A

8 or less

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24
Q

in recovering from a TBI, when does most recovery occur?

A

first 6-9 months

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25
Q

which cognitive function recovers the slowest after TBI?

A

memory

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26
Q

if the damage involves this structure, the prognosis for recovery is not as good…

A

brainstem

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27
Q

what are seizures?

A

spontaneous, abnormal discharges of neurons that result from injury, infection, or tumors

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28
Q

when is epilepsy diagnosed?

A

after at least 1 seizure, but typically after multiple

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29
Q

what is the prevalence of seizures?

A

about 1 in 20 individuals

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30
Q

what are symptomatic seizures?

A

seizures associated with a known cause, such as infection, trauma, fever, or another disorder

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31
Q

what are idiopathic seizures?

A

spontaneous seizures without any known or obvious causes

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32
Q

is there a genetic aspect to seizures?

A

yes, likely a genetic predisposition influenced by numerous genes

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33
Q

what are some common symptoms related to many types of epilepsy?

A

-aura, loss of consciousness, movement

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34
Q

what are precipitating factors in individuals susceptible to seizures?

A

-drugs
-emotional stress
-fever
-hormonal changes
-hyperventilation
-sensory stimuli
-sleep/sleep deprivation
-trauma

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35
Q

what are focal seizures?

A

begin in one location in the brain and the electrical activity spreads to involve other brain regions

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36
Q

what are the 2 types of focal seizures?

A

-focal aware
-focal impaired

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37
Q

what is a focal aware seizure?

A

person is conscious

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38
Q

what is a focal impaired seizure?

A

person generally aware that seizure is beginning, performs automatic behaviours, has a fixed posture, loses conscious awareness of the condition

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39
Q

what is another name for a focal impaired seizure?

A

complex partial seizure

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40
Q

what are generalized seizures?

A

when seizure activity takes place in both hemispheres without a clear focus

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41
Q

what are generalized seizures characterized by?

A

loss of consciousness and breathing stops (Tonic phase) and stereotypical motor behaviour (clonic phase)

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42
Q

what are akinetic seizures?

A

typically only seen in children, collapse suddenly and without warning

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43
Q

what are myoclonic seizures?

A

large seizures characterized by flexion or extension of whole body

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44
Q

what are dissociative seizures?

A

like focal seizures, but no EEG change
-pts report feeling cut off from body and surroundings
-not usually treated with drugs
2/3 in every 10,000 people

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45
Q

what pharmaceuticals can be used to end seizures?

A

GABA agonists or glutamate antagonists

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46
Q

what sort of drugs are used to inhibit the development of seizures on their propagation?

A

-GABA agonists
-sodium channel blockers
-anesthetics and anticonvulsants

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47
Q

what other treatment do 30-40% ofthe population rely on to control their seizures?

A

-DBS or surgery to remove areas where seizures start

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48
Q

what are the main types of seizures

A

-focal
-generalized
-akinetic
-myoclonic
-dissociative

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49
Q

what are tumors?

A

mass of new tissues that grows independent of cells and does not have physiological purpose

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50
Q

tumors can also be called….

A

neuroplasms

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51
Q

what do brain tumors originate from

A

glia or other supporting cells, as the neurons cannot grow and divide

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52
Q

what type of tumors generally do not reoccur after removal?

A

benign

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53
Q

what type of tumors are progressive?

A

malignant tumors

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54
Q

what are encapsulated tumors?

A

tumors that are localized to a distinct location but put pressure on surrounding tissue

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55
Q

what are infiltrating tumors?

A

tumors that interact with surrounding cells and either destroy them or interfere with their function

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56
Q

what do tumor symptoms result from?

A

increased pressure inside the skull as the mass is competing for more space normally occupied by healthy brain tissue

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57
Q

what are symptoms of a tumor?

A

-headache
-vomiting
-slowing of HR
-double vision
-convulsion

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58
Q

what are the 3 types of brain tumor?

A

Glioma
Meningioma
Metastatic tumor

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59
Q

what are glioma?

A

-arise from glial cells and infiltrate surrounding brain

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60
Q

what % of brain tumors is made up of glioma?

A

45

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61
Q

what are meningioma?

A

tumors associated with the protective meninges that surround the brain. they are benign and encapsulated

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62
Q

how do meningioma cause symptoms?

A

by compressing adjacent brain tissue

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63
Q

what are metastatic tumors?

A

tumor cells from elsewhere in the body that start to grow in the brain. usually more than one, making prognosis poor and treatment difficult

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64
Q

why does radiation therapy work better for brain tumors?

A

chemo drugs too large to pass through BBB

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65
Q

where does the pain of a headache occur?

A

dura mater, arteries and veins of the brain, cranial and cervical nerves

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66
Q

what does headache pain result from?

A

pressure, displacement, or inflammation

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67
Q

what does the World Federation of Neurology define migraine as?

A

” a familial disorder characterized by recurrent attacks of headache”

68
Q

migraine impacts _____% of the population at some point in their lives?

A

5-20

69
Q

migraines are often ______ and preceded by _______

A

unilateral, aura or mood disturbance

70
Q

explain the occurrence of a classic migraine:

A

-start with an aura
-depolarization spreads to surrounding neurons, causing IPSPs, neurons inhibited from firing
-headache associated with blood flow returning to normal and the pain comes from a large volume of blood being pumped through vasoconstricted veins

71
Q

what are auras thought to be caused by in migraines?

A

vasoconstriction of cerebral arteries that results in loss of blood flow to occipital cortex

72
Q

what is the prevalence of classic migraines?

A

12% of all migraine sufferers

73
Q

what differentiates a common migraine from a classic migraine?

A

no aura

74
Q

what are cluster headaches?

A

unilateral headaches that recur for days or weeks before disapperaring

75
Q

what are treatments for headache?

A

-pharmaceutical agents
-behaviour or lifestyle changes

76
Q

what is a possible reason for headache occurences decreasing with age?

A

learn to cope with stress better

77
Q

what can headaches be symptoms of?

A

many diseases of nervous system, such as tumors, head trauma, infection, and hypertension

78
Q

what are the characteristics and locations of headaches associated with?

A

causes

79
Q

what are muscle-contraction headaches results of?

A

persistent contraction of muscles of scalp and neck due to stress

80
Q

what are non-migranious vascular hadaches?

A

just that, vascular headaches associated with dilation of arteries and can be caused by fever, eating disorders, high altitude, food, chemicals, odors

81
Q

why are nervous system infections so serious?

A

because the affected neurons/glia usually die, and that is permanent damage

82
Q

how can infections enter the nervous system
?

A

-spread from elsewhere in body
-gain access to brain from surgery or other open head injuries

83
Q

how can infections damage the brain?

A

-interfering with blood supply –> death of cells and brain tissues
-disrupting metabolism of glucose or oxygen –> no energy for cells
-altering neuronal membranes —> cant keep proteins etc
-forming pus –> can create absesses
-causing swelling

84
Q

how can one diagnose infections of nervous system?

A

analyze composition of CSF

85
Q

What are the types of CNS infections?

A

viral
bacterial
mycotic
parasitic

86
Q

how do viral infections work?

A

virus has and RNA or DNA genome and invades a host cell to replicate
-some viruses attack nervous system preferentially while others attack cells throughout body

87
Q

name examples of viral infections

A

Zika
West Nile

88
Q

how do bacterial infections work?

A

cell division

89
Q

what happens in bacterial meningitis?

A

meninges are infected by bacteria and become inflamed

90
Q

what are brain abscesses?

A

pockets of pus produced by bacteria that destroy the cells in the area

91
Q

what are mycotic infections?

A

fungal infections of brain by yeasts, mold, and mushroomsx
-rare, brain is usually resistant

92
Q

when can an individual be at a higher risk for mycotic infection?

A

following cancer or tuberculosis

93
Q

how do parasitic infections work?

A

parasites are living organisms that live inside a host organism usually to their detriment

94
Q

what is malaria?

A

a parasite transmitted by mosquitoes, infects brain capillaries and results in local hemorraghes

95
Q

toxoplasma gondii is an example of what type of infection?

A

parasitic

96
Q

how is toxoplasma gondii transmitted?

A

causes toxoplasmosis and is transmitted from rats to domestic cats who eat them and then to humans who clean litter box

97
Q

what do most treatments of CNS infections involve?

A

managing symptoms more than removing infectious agent, especially for viruses

98
Q

apraxia:

A

inability, in the absence of paralysis or other motor or sensory impairments, to make or copy voluntary movements, usually follows damage to neocortex

99
Q

ataxia:

A

failure of muscular coordination or irregularity of muscular action. follows cerebellar damage

100
Q

athetosis:

A

ceaseless slow, sinuous, writing movements especially in the hands, due to abnormal function of extrapyramidal system

101
Q

catalepsy:

A

muscular rigidity in which voluntary movements are reduced or absent but posture is maintained. feature of Parkinsons, due to dopamine loss

102
Q

cataplexy:

A

complete loss of movement and posture during which muscle tone is absent but consciousness is spared

103
Q

chorea:

A

“to dance”, refers to a wide variety of ceaseless jerky movements that appear well coordinated but are performed involuntarily

104
Q

hemiplegia:

A

complete or partial paralysis to half of the body. usually follows damage to contralateral motor cortex

105
Q

palsy

A

usually refers to persisting movement disorders due to brain damage acquired perinatally

106
Q

paralysis

A

complete loss of movement or sensation in a part of the body, permanent after damage to motor neurons, temporary after damage to motor cortex

107
Q

paraplegia

A

paralysis or paresis of the lower torso and legs following spinal cord damage

108
Q

spasticity

A

increased tone in muscle groups that maintain posture against the force of gravity, if the limb is moved against the rigidity, resistance will initially increase and then tone will suddenly melt (clasp-knife reflex). thought to be produced by damage to the extrapyramidal motor fibers

109
Q

tardive dyskinesia:

A

slow, persistent movements, particularly of the mouth and tongue. usually follows long term treatment with anti-psychotic drugs

110
Q

Myasthenia Gravis

A

severe muscle weakness characterized by muscle fatigue after little activity or exercise

111
Q

who is myasthenia gravis most common in?

A

women, age of onset in the 30s

112
Q

what are the initial symptoms of myasthenia gravis?

A

drooping eyelids, difficulty chewing and swallowing

113
Q

when do myasthenia gravis symptoms usually occur and how can they typically be alleviated?

A

at the end of the day, relieved by sleep

114
Q

how does myasthenia gravis happen?

A

Ach receptors at neuromuscular junction are destroyed by immune system

115
Q

what is multiple sclerosis?

A

when myelin sheaths are attacked and destroyed in the motor and sensory tracts, means of attack could either be bacteria, virus, or antibodies

116
Q

where does the loss occur in MS?

A

in patches throughout the nervous system

117
Q

what is the symptomatic pattern of MS?

A

symptoms are off and on

118
Q

what is the prevalence of MS?

A

slightly more common in females than males (3:2), more common in northern hemisphere

119
Q

in paraplegia, where is the damage?

A

at level of thoracic spine, leading to loss of information for legs

120
Q

in quadriplegia, where is the damage?

A

at the level of the cervical spine, loss of information for all 4 limbs

121
Q

what is Brown-Sequard syndrome?

A

when just one side of spinal cord is damaged, impacting only some of the ascending and descending pathways

122
Q

what is hemiplegia?

A

loss of voluntary movements on one side of body and changes to some reflexes

123
Q

how does hemiplegia happen?

A

results from damage to cortex and basal ganglia contralateral to side of motor impairment

124
Q

in whom are most cases of hemiplegia found and why?

A

most common in older adults as a result of rupture of blood vessels due to high BP

125
Q

Babinski sign:

A

in intact individuals, will flex toes downward after stimulus to bottom of foot

126
Q

what is the babinski sign in hemiplegic individuals:

A

extend toes

127
Q

what are hyper-kinetic distonic syndromes

A

syndromes that increase motor activity

128
Q

examples of hyperkinetic-distonic syndromes?

A

Huntingtons, Tourettes

129
Q

what are hypokinetic-rigid syndromes?

A

syndromes that decrease movements

130
Q

example of a hypokinetic rigid syndrome

A

Parkinsons

131
Q

what behaviours are characteristic of Huntington disease?

A

writhing and twisting movements (choreas)

132
Q

what does Huntington disease result in?

A

intellectual deterioration and personality changes

133
Q

what is the age of onset for Huntington?

A

30-50 years

134
Q

what are symptoms of Huntington disease?

A

impairments of recent memory, slowed information processing, emotional changes such as depression and anxiety

135
Q

how is Huntington disease cause?

A

by a mutation of huntington gene (dominant) which results in a defective protein that accumulates in basal ganglia

136
Q

what does the cortex of Huntington patients show?

A

thinning and shrinkage

137
Q

in the basal ganglia, what is the indirect pathway inhibitory for?

A

voluntary movement

138
Q

Huntington disease is associated with a ____ in activity in the ______ pathway due to cell loss in the _____ _____and ______, resulting in

A

decrease
indirect
globus pallidus
putamen
…a decrease in inhibition of movement

139
Q

what are the 3 stages of progression in Tourettes synrome:

A

1) tics of face, limb, body
2) tics accompanied with inarticulate cries
3) echolalia and coprolalia added to tics and cries

140
Q

age of onset of Tourettes

A

2-15 years

141
Q

Tourettes patients have a _____ putamen and a ____ thalamus

A

larger, smaller

142
Q

Tourettes patients also exhibit __________ difficulties

A

visuospatial

143
Q

symptoms of Parkinsons are divided into 2 groups, what are they

A

positive and negative symptoms

144
Q

why are positive symptoms of Parkinsons given that title?

A

describe abnormal behaviours that have been gained

145
Q

why are negative symptoms of Parkinsons given that title?

A

describe normal behaviours that have been lost

146
Q

positive symptoms of Parkinsons:

A

-tremors
- muscular rigidity due to excitation of both flexor and extensor muscles at same time
-involuntary movements

147
Q

negative symptoms of Parkinsons:

A

-postural disorders prevent individual from maintaining the posture of a body part
-righting disorders involve inability of patients to stand up from laying down
-locomotive disorders involve difficulty walking
-speech disturbances include the lack of prosody in the voice
-Akinesia is a poverty or slowness of movement

148
Q

often, cause of Parkinsonism is

A

idiopathic

149
Q

postencephalitic form is

A

due o damage of cells at substantia nigra following encephalitis

150
Q

drug- induced Parkinson disease:

A

can result from drugs used to treat schizophrenia, is reversible

151
Q

recreational drugs and Parkinsonism:

A

ie: synthetic form of heroin can cause permanent damage to dopamine cells and cause Parkinsons

152
Q

parkinson diesase is observed when:

A

dopamine levels are reduced by more than 90% below normal levels

153
Q

cure for parkinson disease?

A

no

154
Q

some pharmaceutical therapies for Parkinsons:

A

-L-dopa: cross BBB and be converted to dopamine to convert what has been lost
-monoamine oxidase inhibitory and tricyclic antidepressants enhance dopamine neurotransmission
-anticholinergic drugs are used to block the acetylcholine signaling that increases when dopamine decreases
-DBS
-stem cells to replace lost domapine nneurons

155
Q

what is a cerebral vascular accident (stroke)

A

sudden appearance of neurological symptoms as a result of blood supply being interrupted

156
Q

what is an infarct

A

region of the brain that is directly impacted by the stroke and is characterized by dead and dying cells

157
Q

3 types of cerebral vascular disorders:

A

-cerebral ischemia
-migraine stroke
-cerebral hemorrahage

158
Q

what is cerebral ischemia

A

when a blood vessel is blocked, preventing enough blood from reaching the brain

159
Q

what is thrombosis

A

a clot in the vessel that has remained where it was formed

160
Q

what is an embolism

A

a clot or other plug that formed in a larger vessel and moved until it was stuck in a smaller vessel

161
Q

what is a migraine stroke

A

when blood flow is interrupted by a constriction of the blood vessel, cause of vascular spasm not known

162
Q

what is a cerebral hemmorhage

A

when a blood vessel fails, resulting in bleeding into the brain. causes can include high BP, trauma, toxic chemicals

163
Q

what are angiomas

A

abnormal blood vessels that divert the normal flow of blood. result in abnormalities in the pattern and amount of blood flow

164
Q

what are aneurysms

A

when the normal elastic walls of blood vessels is defective, leading to vessel walls ballooning out and weakening structure of the vessel

165
Q

what is the goal of ideal treatment of cerebral vascular diseases

A

to restore blood supply, not always possible

166
Q

what kind of drugs can be effective to block cell death

A

drugs to block excitation and calcium channels

Psych 377 (11 decks)

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