Neurological Pathology Flashcards
Define multiple sclerosis.
- chronic autoimmune disease of demyelination
- demyelination is found within the CNS, acute episodes are caused by focal inflammation
List symptoms of multiple sclerosis.
- loss of proprioception
- increased urinary urgency
- neuropathic pain
- fatigue
- spacisity
- sensory symptoms
What would you expect to find in the lumbar puncture of someone with multiple sclerosis?
- oligoclonal bands
Define myasthenia gravis.
- neuromuscular junction disorder where antibodies reduce the amount of ACh in the synapse
List symptoms of myasthenia gravis.
- muscle weakness
- diplopia (double vision)
- ptosis
How would you treat myasthenia gravis?
- ACh inhibitors
- steroids
- surgery
Give two causes of myasthenia gravis.
- a thymic tumour (10%)
- thymic hyperplasia (70%)
Define motor neuron disease.
- progressive disease affecting upper and lower motor neurones in the spinal cord
How would you investigate motor neuron disease?
- electromyography (EMG)
What is the approximate survival rate for motor neuron disease?
- three years
Define epilepsy.
- sudden synchronous discharge of cerebral neurons which may be focal or generalised
What investigations would you carry out into epilepsy?
- EEG
- MRI
- ECG
- serum calcium
How would you treat epilepsy?
- sodium valproate
- carbamezipine
- buccal midazolam (if seizure >5mins)
Define a cluster headache.
- recurrent bouts of extremely painful, unilateral headaches that usually last 15min-3hrs
How would you treat a cluster headache?
- verapamil (to stop bouts)
- subcutaneous sumatriptin (acute treatment)
How would you treat a migraine?
- NSAIDs
- triptans
- beta blockers
Define paryoxsmal haemicrania.
- frequent, less severe headaches
Define trigeminal neuralgia.
- electric-shock like pain that starts in the course of the manibular nerve
How would you treat trigeminal neuralgia?
- carbamezepine
- microvascular decompression
Define spina bifida.
- congenital defective closure of the distal neural tube
Name and define the types of spina bifida.
occulta - outer part of the vertebra are not completely fused
meningocele - meninges herniate posteriorly, forming a cyst filled with CSF
mylomeningocele - nerve also herniate
Define meningitis.
- inflammation of the meninges which can be bacterial or viral
List symptoms of meningitis.
- stiff neck
- fever
- altered mental state
- petechial skin rash
- high RR and HR
How would you investigate meningitis?
- blood cultures
- lumbar puncture
- CT
Define encephalitis.
- inflammation of the brain tissue
How would you treat encephalitis?
- IV antivirals
- anticonvulsants
Define Duchenne’s MD.
- x-linked recessive disorder where dystrophin is missing in muscle
How would you investigate Duchenne’s MD?
- muscle staining
- biopsy
How would you treat Duchenne’s MD?
- steroids
- physiotherapy
Define subarachnoid haemorrhage.
- spontaneous arterial bleeding into the subarachnoid space, usually caused by a popped berry anaeurysm
Define Parkinson’s syndrome.
Parkinson’s is a loss of dopaminergic neurons caused by Lewy body dementia
List symptoms of Parkinson’s syndrome.
- bradykinesia
- pill-rolling tremor
- rigidity
- postural inability
How would you treat Parkinson’s syndrome?
- levodopa
- MAO-B inhibitor
- dopamine agonist
Define Alzheimer’s disease.
- a type of dementia characterised by progressive impairment of congitive function in an altert patient
How would you treat Alzheimer’s disease?
- cholinesterase inhibitor
- NDMA antagonist
Define Guillian-Barre syndrome.
- acute demylinating polyneuropathy with an immune-mediated, post-infective presentation
Describe the presentation of Guillian-Barre syndrome.
- paralysis 1-3 weeks after an infection
- weakness starts distally and moves proximally
- sensory loss
How would you investigate Guillian-Barre syndrome?
- nerve conduction studies
- lumbar puncture
How would you treat Guillian-Barre syndrome?
- immunoglobulins
- LMW heparin
