Neurological Dysfunction

Question 1

Meningitis

Answer 1

• inflammation of the membranes of the spinal cord or brain caused by flu, strep, e. coli, Lyme disease, etc
• bacterial or viral
  Cardinal Sx: headache
  Other Sx: neck pain, stiffness, sore throat, nausea, vomiting, confusion, drowsiness, myalgia
  Possible Sx: lumbar and posterior thigh pain
  Treatment: supportive symptomatic therapy - bed positioning, PROM, skin care, safety measures if confusion is present

Question 2

Encephalitis

Answer 2

• severe infection & inflammation of the brain
  Causes: rabies and herpes,
  Sx: headache, fever, drowsiness
  Tx: provide supportive symptomatic therapy

Question 3

Brain Abscess

Answer 3

Infectious process in which there is a collection of pyogenic material in the brain parenchyma
Sx: headache, fever, brainstem compression, focal signs CNII & VI
Tx: supportive symptomatic therapy

Question 4

Acquired Immunodeficiency Syndrome (AIDS)

Answer 4

Viral syndrome characterized by acquired & severe depression of cell-mediated immunity
Sx: motor deficits (ataxia, weakness, tremor, loss to disorientation), peripheral neuropathy, dementia complex
Tx: anti-HIV drugs, palliative and supportive therapy

Question 5

Hemisphere Lesion - Cortex and Internal Capsule - MCA Syndrome

Answer 5

LE MORE SPARED
Sx: contralateral hemiplegia of face, UE, LE; contralateral hemisensory loss; homonymous hemianopsia; impaired consciousness
Localized Features: nonfluent aphasia; perceptual deficit; loss of conjugate gaze to opposite side; sensory ataxia

Question 6

Hemisphere Lesion - Cortex and Internal Capsule - ACA Syndrome

Answer 6

UE MORE SPARED
SX: contralateral hemiplegia; contralateral hemisensory loss; homonymous hemianopsia; impaired consciousness
Localized Features: apraxia; akinetic mutism

Question 7

Hemisphere Lesion - Primary Visual Cortex; Occipital Lobe - PCA Syndrome

Answer 7

SX: contralateral sensory loss; involuntary movement; transient contralateral hemiparesis; homonymous hemianopsia
Localized Features: visual agnosia; memory defect; dyslexia; central thalamic pain; Weber’s syndrome; oculomotor n. palsy

Question 8

Internal Capsule Lesion - Posterior Limb - Lacunar Stroke

Answer 8

SX: contralateral hemiplegia UE & LE

- NO aphasia and visual deficits RARE

Question 9

Midbrain Lesion

Answer 9

SX: contralateral hemiplegia

Localized Features: contralateral CN III palsy

Question 10

Medial Inferior Pontine Syndrome

Answer 10

Ipsilateral SX: cerebellar ataxia, nystagmus, paralysis of conjugate gaze to side of lesion, diplopia
Contralateral SX: hemiparesis, impaired sensation

Question 11

Lateral Inferior Pontine Syndrome

Answer 11

Ipsilateral SX: ataxia, nystagmus, vertigo, facial paralysis, paralysis of conjugate gaze to the side of the lesion, deafness, tinnitus, impaired facial sensation
Contralateral SX: impaired pain & temp sensation

Question 12

Pontine Lesion - Locked-In Syndrome

Answer 12

SX: tetraplegia, lower bulbar paralysis (CNV-XII), mutism
Preserved: consciousness, vertical eye movements & blinking

Question 13

Medial Medullary Syndrome

Answer 13

Ipsilateral SX: paralysis of half of tongue

Contralateral SX: hemiplegia, impaired sensation

Question 14

Lateral Medullary Syndrome (Wallenberg’s)

Answer 14

Ipsilateral SX: ataxia, vertigo, nystagmus, loss of pain & temp to face, sensory loss
Contralateral SX: loss of pain & temp to body & face
Localized Features: Horner’s Syndrome, dysphagia, impaired speech

Question 15

Horner’s Syndrome

Answer 15

• miosis
• ptosis
• decreased sweating