Neurology- CNS infections & Vitamins Flashcards
Neurologic manifestations in Lyme disease
Radiculopathies
meningitis
cranial neuropathies (facial palsy)
Infectious cavernous sinus thrombosis
Facial/ophthalmic venous system is valveless, infections spread to the car venous sinus. Inflammation causes thrombosis and intracranial hypertension.
Signs and symptoms of cavernous sinus thrombosis
- Headache (progresses to intolerable)
- Low-grade fever
- Vomiting
- Periorbital Edema & Papilledema
- Binocular Palsies
- Hypo/Hyperesthesia (V1/V2 distribution)
Diagnosis of cavernous sinus thrombosis
MRI with venography
Tx cavernous sinus thrombosis
Broad- spec IV Abx.
Prevention or reversal of cerebral herniation
Diagnosis: 45yo alcoholic male, 3 wks headache, nuchal rigidity, impaired adduction eye, leukocytic CSF
Tuberculous Meningits.
↑risk in alcoholics, substance abuse, malnutrition, HIV, immunomod meds.
Signs and symptoms of TB meningitis
WEEKS (slow TB replication) Headache N/V Fever Neck stiffness Malaise Cranial Nerve palsy (impaired adduction)
Normal CSF levels:
WBC: 0-5
Glucose: 40-70
Protein: <40
Bacterial Meningitis CSF levels:
WBC: > 1,000
Glucose: < 40
Protein: >250
TB meningitis CSF levels:
WBC: 100- 500
Glucose: <45
Protein: 100-500
lower levels compared to bacterial, higher than viral.
Viral meningitis CSF levels:
WBC: 10-500
Glucose: 40-70 (normal)
Protein: <150
RBC: variable (elevated with Herpes)
GBS CSF levels
WBC: 0-5 (normal)
Glucose: 40- 70 (normal)
Protein: 45-1,000
Diagnosis TB meningitis
Imagining: normal or basal meningeal enhancement with small strokes.
Rapid Diagnosis: acid fast stain, Nucleic acid amplification.
Confirmation: culture
S&S meningeococcal meningitis
severe myalgias petechiae fever headache N/V Progression in HOURS
S&S herpes encephalitis
<1wk Fever Headache Focal Neurologic deficit Confusion Seizures
