Neurology Flashcards
1
Q
What is Brown-Sequard syndrome?
A
- hemisection of spinal cord
- most common cause = penetrating trauma
- most cases = cervical region
2
Q
Signs and symptoms of Brown-Sequard syndrome
A
- total ipsilateral loss of position, light touch, vibration sensation at lesion level
- contralateral loss of pain/temperature below lesion
- sphincter disturbances
- ipsilateral spastic paraparesis
3
Q
Diagnosis of Brown-Sequard syndrome
A
- radiographs for trauma
- MRI for extent of injury
- neuro exam for level of injury
4
Q
Treatment of Brown-Sequard syndrome
A
- spine immobilisation
- steroids decreased swelling
- therapy
- surgery
5
Q
What is Charcot Marie Tooth?
A
- heterogenous group of inherited peripheral neuropathies
- autosomal dominant
6
Q
What are the 4 major categories for Charcot Marie Tooth?
A
- CMT1
- CMT2
- CMT3
- CMTX
7
Q
Signs and symptoms of Charcot Marie Tooth
A
- muscle weakness in lower limbs
- highly arched/very flat feet
- curled toes
- awkward/high step and difficult using ankle muscles
- lack of sensation to arms and feet
- poor circulation → cold peripheries
- wasting of muscles in lower legs
- fatigue
8
Q
Diagnosis of Charcot Marie Tooth
A
- bloods
- CSF examination
- MRI brain, SC
- genetic studies
- nerve conduction studies
- nerve biopsy if genetic studies inconclusive
9
Q
Treatment of Charcot Marie Tooth
A
- no cure
- supportive therapy
- analgesia
- surgical correction of spinal deformity
- avoid neurotoxic drugs eg vincristine
10
Q
What is DMD?
A
- progressive muscle wasting and weakness
- X linked recessive
- results in damage to dystrophin gene → dystrophin strengthens muscle fibres and protects from injury
11
Q
Signs and symptoms of DMD
A
- presents in early childhood
- progressive proximal muscular dystrophy with characteristic pseudohypertophy of calves
- major milestones delayed
- recurrent falls
- speech delay
- fatigue
12
Q
Diagnosis of DMD
A
- serum creatinine kinase → v high
- genetic analysis
- muscle biopsy with assay for dystrophin protein
- muscle strength test
- gait assessment
13
Q
Complications of DMD
A
- join contractures
- respiratory failure
- cardiomyopathies, HF
- gastric dilation
- learning difficulties
14
Q
Treatment of DMD
A
- MDT care
- vaccines → influenza/pneumococcal
- physiotherapy
- vitD/bisphosphonates
- corticosteroids
- end of life care
15
Q
What is Lamber Eaton?
A
- disorder of neuromuscular transmission
- caused by impaired presynaptic release of acetylcholine
- caused by autoimmune attack of VG Ca2+ channels
