Neurological Signs and Consciousness Disorders Flashcards
What are the signs of cerebellar dysfunction?
Dysdiachokinesia Ataxia Nystagmus (Coarse) Intention Tremor Slurred Speach (dysarthria) Hypotonia
What are the causes of cerebellar dysfunction?
Posterior Fossa Tumour Alcohol Sclerosis (Multiple) Trauma Rare Inherited (Freidrichs Ataxia) Epilepsy Medication Stroke
What are the signs of an UMN Lesion?
Hypertonia Hyperreflexia Muscle Weakness Late Atrophy Positive Babinskis Possible Clonus
What are the signs of a LMN Lesion?
Hypotonia
Hyporeflexia
Early Atrophy
Fasciculations
What is a stroke?
acute focal loss of brain function lasting more than 24 hours or leading to death
What is a TIA?
acute focal loss of brain function which resolves completely within 24 hours
What is Myasthenia Gravis?
Autoimmune reaction which blocks the ACh receptors on the post synaptic membrane.
Means ACh is just broken down by AChesterase
What are the signs of Myasthenia Gravis?
Easy fatiguing muscles
Extraoccular muscles most visible, cannot hold upward gaze for very long
Treatment for MG?
AChesterase inhibitors
Immunosupressants
What is a spinal stroke?
An infarct/haemorrage of the arteries that supply the spinal cord.
Most common in ASA
What are the signs of a spinal stroke?
Starts with muscle weakness, loss of sensation (but still have DCML sensations)
Acute
Pain
Areflexia
How can the signs of spinal stroke progress?
Get UMN Lesion signs
What is insomnia?
Causes?
Mechanism?
When you cannot get to sleep/maintain it or it is poor quality
Normally has a psychological cause, anxiety, depression etc
Increase in cortical activity increases feedback to the RF which prevents sleep
What is narcolepsy?
Causes?
Poor control of the sleep-wake cycle.
Due to a loss or decrease in orexin (from visual system) means that there is spontaneous sleep.
Can have emotional triggers
What is Parasomnia?
Sleep paralysis or abnormal movements when asleep.
What is Sleep Apnoea?
When the upper respiratory tract narrows during sleep causing hypoxia, waking the patient.
Also leads to snoring
Normally due to obesity and loss of tone in the airways
What is brain death?
When there is no EEG activity, complete damage of the brain stem and cortex
What is Locked In Syndrome?
When there is compression of the basilar/pontine arteries
Leads to complete loss of motor control.
Can spare the eyes
What is a PVS?
A persistent vegetative state EEG is variable, can have sleep cycles. Eyes can spontaneously open and can have reflexes/response to stimuli from brainstem. Due to widespread cortical damage Variable EEG
What is a Coma?
Widespread Cortical damage.
No voluntary movements, eyes don’t open.
Variable EEG
No sleep cycle
What GCS defines a Coma?
<8
What is Delirium?
An acute confusional state.
Can be due to illness/infection/fractures/age
Takes a long time to resolve
Have impaired awareness and fluctuating arousal
What could a constricted but responsive pupil mean?
Metabolic lesion e.g. drugs
What are the signs of CN III Lesion?
Blown Pupil
Down and Out
Ptosis
