Neurological Weakness Flashcards

1
Q

Name 6 diseases/conditions that cause neurological weakness

A
  • stroke
  • tumour
  • Bell’s palsy
  • multiple sclerosis
  • motor neurone disease
  • myasthenia gravis
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2
Q

Which part of brain is responsible for motor function?

A

prefrontal cortex

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3
Q

Describe three parts of motor neuron

A
  • upper motor neuron
  • lower motor neuron
  • NMJ
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4
Q

Where is upper motor neuron (start / end)?

A
  • in the CNS
  • start = cell bodies in motor prefrontal cortex
  • via = internal capsule
  • end = nucleus in brain stem
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5
Q

Where is lower motor neuron (start / end)?

A
  • outside CNS
  • start = brain stem
  • end = NMJ
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6
Q

Is the lower motor neuron of hypoglossal nerve inside / outside CNS?

A

Outside.

Only upper motor neuron is inside CNS

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7
Q

What are 4 sets of facial muscles?

A
  • face, mouth
  • jaw, chewing
  • tongue
  • swallowing, speech
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8
Q

What motor nerves innervate 4 sets of muscles?

A
face, mouth
- VII (facial n)
jaw, chewing
- V (trigeminal n)
tongue
- XII (hypoglossal n)
swallowing, speech
- X (vagus n)
- (IX glossophyngeal n = sensory)
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9
Q

What are the clinical tests for each of 4 sets of muscles?

A
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)
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10
Q

If issue with jaw muscles, does jaw point towards / away from weak side?

A

Jaw points TOWARDS weak side
(think - same as tongue)
side that opens more causes deviation

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11
Q

If issue with tongue muscles, does tongue point towards / away from weak side?

A

Tongue points TOWARDS weak side

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12
Q

If issue with swallowing muscles, does uvula point towards / away from weak side?

A

Uvula points AWAY from weak side

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13
Q

What is most common nerve to cause issues in the face?

A

Facial n. (VII)

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14
Q

What are 2 main types of weakness?

A
  1. Weakness of one side of face
  2. Weakness of tongue / swallowing / speech m.m.
    - usually bilateral
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15
Q

What are the diseases that affect upper motor neurones?

A
  • stroke
  • tumour (also lower)
  • motor neuron disease (also lower)
  • multiple sclerosis (also lower)
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16
Q

Which diseases affect lower motor neurones?

A
  • Bell’s palsy
  • motor neuron disease (also upper)
  • multiple sclerosis (also upper)
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17
Q

Which disease affects the motor neuron junction?

A

myasthenia gravis

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18
Q

What do motor neuron disease and myasthenia gravis have in common?

A
  • affect neurons
  • diffuse, bilateral symptoms
  • (can) affects all muscles
19
Q

What is multiple sclerosis?

A

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)
20
Q

What is myasthenia gravis?

A
  • autoimmune disorder

- antibodies against cells at NMJ

21
Q

What is motor neuron disease?

A
  • progressive disease

- U & L motor neurons affected

22
Q

Where do tumours affect in neuron issues?

A

U or L motor neuron - depends where tumour is

23
Q

Which disease(s) affects both upper and lower motor neurons?

A
  • motor neuron disease

- (multiple sclerosis) - usually in brain/brain stem

24
Q

Which diseases have diffuse and bilateral symptoms?

A
  • motor neuron disease
  • myasthenia gravis
  • (multiple sclerosis)
25
Q

If one side of face is affected - what are possible diseases?

A
  • stroke
  • tumour
  • multiple sclerosis
  • Bell’s palsy
26
Q

Which types of diseases get symptoms in:

  1. mins - hours
  2. hours - days
  3. days - weeks
  4. weeks - months
A
  1. mins - hours
    - vascular
    - eg stroke
  2. hours - days
    - inflam, immune, infection
    - eg multiple sclerosis (inflam), myasthenia gravis (immune), Bell’s palsy (immune/infection)
  3. days - weeks
    - tumour
  4. weeks - months
    - degenerative
    - eg motor neuron disease, Parkinsons, alzheimer’s
27
Q

What disease exception is there with regards to time taken for symptoms to show?

A

TB is an infection, but takes years to show symptoms

not hours - days

28
Q

How long for symptoms to show in multiple sclerosis?

A

hours - days

29
Q

How long for symptoms to show in tumour?

A

days - weeks

30
Q

How long for symptoms to show in stoke?

A

mins - hours

31
Q

How long for symptoms to show in myasthenia gravis?

A

hours - days

32
Q

How long for symptoms to show in Bell’s palsy?

A

hours - days

33
Q

How long for symptoms to show in motor neuron disease?

A

months - years

34
Q

What is likely cause if:

  • one side of face affected
  • bottom half only
A
  • stroke
  • tumour
  • ie UPPER motor neuron
35
Q

What is likely cause if:

- whole side of one side of face affected?

A
  • Bell’s palsy

- LOWER motor neuron

36
Q

What is bulbar palsy?

A
  • jaw, chewing, tongue, swallowing, speech affected
  • symmetrical
  • bilateral
37
Q

Is bulbar palsy unilateral or bilateral?

A

bilateral

38
Q

What causes bulbar palsy?

A
  • motor neuron disease

- myasthenia gravis

39
Q

What are common symptoms for myasthenia gravis?

A
  • 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)
40
Q

What are differences in symptoms between myasthenia gravis and motor neuron disease?

A

myasthenia gravis

  • affects the eyes
  • symptom onset hours-days

motor neuron disease

  • rarely affects eyes
  • symptom onset months - years
41
Q

Does multiple sclerosis have unilateral or bilateral effects?

A
  • When symptoms begin - often unilateral

- later stages in disease = increase in scarring - therefore symptoms usually bilateral (can be symmetrical)

42
Q

Which diseases can affect the jaw, chewing, tongue, swallowing, speech?

A
  • myasthenia gravis
  • motor neuron disease
  • multiple sclerosis
43
Q

Which disease can affect:
jaw, chewing, tongue, swallowing, speech
AND
one side of face?

A

multiple sclerosis