Neurological Weakness Flashcards
Name 6 diseases/conditions that cause neurological weakness
- stroke
- tumour
- Bell’s palsy
- multiple sclerosis
- motor neurone disease
- myasthenia gravis
Which part of brain is responsible for motor function?
prefrontal cortex
Describe three parts of motor neuron
- upper motor neuron
- lower motor neuron
- NMJ
Where is upper motor neuron (start / end)?
- in the CNS
- start = cell bodies in motor prefrontal cortex
- via = internal capsule
- end = nucleus in brain stem
Where is lower motor neuron (start / end)?
- outside CNS
- start = brain stem
- end = NMJ
Is the lower motor neuron of hypoglossal nerve inside / outside CNS?
Outside.
Only upper motor neuron is inside CNS
What are 4 sets of facial muscles?
- face, mouth
- jaw, chewing
- tongue
- swallowing, speech
What motor nerves innervate 4 sets of muscles?
face, mouth - VII (facial n) jaw, chewing - V (trigeminal n) tongue - XII (hypoglossal n) swallowing, speech - X (vagus n) - (IX glossophyngeal n = sensory)
What are the clinical tests for each of 4 sets of muscles?
face, mouth - SMILE jaw, chewing - OPEN MOUTH tongue - STICK OUT TONGUE - LISTEN TO SPEECH swallowing, speech - COUGH - SAY 'AHHH' - SWALLOW - LISTEN TO SPEECH - CAN YOU FEEL THIS? (glossopharyngeal n)
If issue with jaw muscles, does jaw point towards / away from weak side?
Jaw points TOWARDS weak side
(think - same as tongue)
side that opens more causes deviation
If issue with tongue muscles, does tongue point towards / away from weak side?
Tongue points TOWARDS weak side
If issue with swallowing muscles, does uvula point towards / away from weak side?
Uvula points AWAY from weak side
What is most common nerve to cause issues in the face?
Facial n. (VII)
What are 2 main types of weakness?
- Weakness of one side of face
- Weakness of tongue / swallowing / speech m.m.
- usually bilateral
What are the diseases that affect upper motor neurones?
- stroke
- tumour (also lower)
- motor neuron disease (also lower)
- multiple sclerosis (also lower)
Which diseases affect lower motor neurones?
- Bell’s palsy
- motor neuron disease (also upper)
- multiple sclerosis (also upper)
Which disease affects the motor neuron junction?
myasthenia gravis
What do motor neuron disease and myasthenia gravis have in common?
- affect neurons
- diffuse, bilateral symptoms
- (can) affects all muscles
What is multiple sclerosis?
Multiple patches of inflam along neurons, resulting in scarring (sclerosis)
- often in brain and brain stem.
- When symptoms begin - often unilateral
- later stages in disease = increase in scarring - therefore symptoms usually bilateral (can be symmetrical)
What is myasthenia gravis?
- autoimmune disorder
- antibodies against cells at NMJ
What is motor neuron disease?
- progressive disease
- U & L motor neurons affected
Where do tumours affect in neuron issues?
U or L motor neuron - depends where tumour is
Which disease(s) affects both upper and lower motor neurons?
- motor neuron disease
- (multiple sclerosis) - usually in brain/brain stem
Which diseases have diffuse and bilateral symptoms?
- motor neuron disease
- myasthenia gravis
- (multiple sclerosis)
If one side of face is affected - what are possible diseases?
- stroke
- tumour
- multiple sclerosis
- Bell’s palsy
Which types of diseases get symptoms in:
- mins - hours
- hours - days
- days - weeks
- weeks - months
- mins - hours
- vascular
- eg stroke - hours - days
- inflam, immune, infection
- eg multiple sclerosis (inflam), myasthenia gravis (immune), Bell’s palsy (immune/infection) - days - weeks
- tumour - weeks - months
- degenerative
- eg motor neuron disease, Parkinsons, alzheimer’s
What disease exception is there with regards to time taken for symptoms to show?
TB is an infection, but takes years to show symptoms
not hours - days
How long for symptoms to show in multiple sclerosis?
hours - days
How long for symptoms to show in tumour?
days - weeks
How long for symptoms to show in stoke?
mins - hours
How long for symptoms to show in myasthenia gravis?
hours - days
How long for symptoms to show in Bell’s palsy?
hours - days
How long for symptoms to show in motor neuron disease?
months - years
What is likely cause if:
- one side of face affected
- bottom half only
- stroke
- tumour
- ie UPPER motor neuron
What is likely cause if:
- whole side of one side of face affected?
- Bell’s palsy
- LOWER motor neuron
What is bulbar palsy?
- jaw, chewing, tongue, swallowing, speech affected
- symmetrical
- bilateral
Is bulbar palsy unilateral or bilateral?
bilateral
What causes bulbar palsy?
- motor neuron disease
- myasthenia gravis
What are common symptoms for myasthenia gravis?
- can’t stick tongue out far / weak tongue
- slurred speech
- eyes - double vision when looking L / R
- hard to move eyes L / R
- eyelids droop (bilateral) - eyes are usually affected (both eyes)
What are differences in symptoms between myasthenia gravis and motor neuron disease?
myasthenia gravis
- affects the eyes
- symptom onset hours-days
motor neuron disease
- rarely affects eyes
- symptom onset months - years
Does multiple sclerosis have unilateral or bilateral effects?
- When symptoms begin - often unilateral
- later stages in disease = increase in scarring - therefore symptoms usually bilateral (can be symmetrical)
Which diseases can affect the jaw, chewing, tongue, swallowing, speech?
- myasthenia gravis
- motor neuron disease
- multiple sclerosis
Which disease can affect:
jaw, chewing, tongue, swallowing, speech
AND
one side of face?
multiple sclerosis
