Neurology Flashcards
What are features of an acute cranial nerve III palsy?
Blown dilated pupil
Eye in down and out position
What is the most likely and most urgent cause of an acute cranial nerve III palsy?
Posterior communicating artery aneurysm expanding (but not yet ruptured)
What is a Lewy body and what diseases is it associated with?
Aggregation of alpha-synuclein
Lewy body dementia
Parkinson’s disease
What causes Parkinson’s disease
Loss of dopamingeric neurons in substantia nigra causing excessive cholingeric activity
Findings in Parkinson’s disease
Cogwheel rigidity Narrow shuffling gait Resting tremor Postural instability Akinesia Micrographia Masked facies
what does a positive Romberg indicate
Problem with propioception (dorsal columns/ML) or the vestibular apparatus
How would a cerebellar lesion appear on Romberg testing?
Positive Romberg test with eyes open and closed
Next best test for multiple sclerosis
MRI – white matter plaques
Best confirmatory test for multiple sclerosis
CSF analyses with IgG oligoclonal bands
Immunologic treatment for multiple sclerosis
IFN-B
Stepwise, sharp, sudden decline i cognitive function ad motor changes in setting of HTN
Vascular dementia from multiple lacunar infarcts
How do vascular and Alzheimer’s dementia differ?
Vascular dementia is a more sudden, sharp decline in cognition and Alzheimer’s is more of a gradual decline
What are the 2 histologic findings associated with Alzheimer’s disease?
neurofibrillary tangles
Hyperphosphorylated Tau
Memory loss, changes in personality and social behavior
Frontotemporal degeneration/Pick’s disease
Memory loss, slow gait, hypomimia, rigidity, micrographia
Parkinson’s disease
