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BDS3 BAMS Diseases of Human Systems > Neurology - Degenerative > Flashcards

Neurology - Degenerative Flashcards

1
Q

How does MS occur

A

it is a CNS lesion only

due to demyelination of axons

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2
Q

What is the distribution of MS

A

patchy

there is progressive functional los

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3
Q

What is the etiology of MS

A

susceptibility acquired during childhood
possible altered hist reaction an infective agnet
background genetic/immune factors

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4
Q

What are signs of MS

A 
muscle weakness
spasticity
altered reflexes
tremor (intention)
optic atrophy
proprioceptive loss
loss of touch
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5
Q

What are symptoms of MS

A 
muscle weakness
visual disturbance
paraesthesia
autonomic dysfunction 
dysarthria
pain
balancing/hearing loss
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6
Q

What are MS investigations

A

history and exam
MRI
CSF analysis
visual evoked potentials

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7
Q

What is looked for in the CSF analysis in MS investigation

A

reduced lymphocytes

increase IgG protein

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8
Q

What is the outcome of relapsing and remitting type of MS

A

acute exacerbations and periods of respite

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9
Q

What is the outcome of primary and progressive type of MS

A

slowly steady progressive deterioration

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10
Q

What happens in the relapsing and remitting type of MS

A

damage builds up with each episode

many will eventually develop progressive form ‘secondary progressive’

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11
Q

What happens in the primary progressive type of MS

A

cumulative neurological damage

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12
Q

What is the symptomatic management of MS

A

antibiotics, antispasmodics, analgesia, steroids

physiotherapy and occupational therapy

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13
Q

What is MS therapy consist of

A

physiological and occupational have a role with functional loss
for relapsing and remitting type there is also disease modifying therapies
can use stem cell transplant to reboot the immune system

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14
Q

What are the dental aspects of MS

A

limited mobility and psychological disorders
treat under LA
orofacial motor and sensory disturbance - suspect in young patients
chronic orofacial pain possible
enhanced trigeminal neuralgia risk - suspect in younger patients

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15
Q

What is MND due to

A

degeneration in the spinal cord in the corticospinal tracts and anterior horns

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16
Q

What is the presentation of MND

A 
progressive loss of motor function 
limbs
intercostal
diaphragm 
motor cranial nerves VII-XII
17
Q

What is MND death due to

A 
ventilation failure
aspiration pneumonia (swallowing/cough)
18
Q

What may an MND patient notice

A 
weakness in ankle or leg slurred speech
weak grip
muscle cramps and twitches
weight loss
emotional lability
19
Q

What is the treatment for MND

A

none effective
physiotherapy and occupational therapy
riluzole - some get 6-9 months life extension
aspiration prevention (PEG tube feed and reduce salivation)

20
Q

What are dental aspects of MND

A

difficulty in acceptance of dental care due to muscle weakness of head and neck
realistic treatment planning
drooling and swallowing difficulties

21
Q

What is Parkinson’s disease due to

A

degeneration of dopaminergic neurons in the basal ganglia of the brain (substantial nigra)

shortage of dopamine results in difficulty of message passing from thinking to doing part of brain

22
Q

What are clinical signs of Parkinson’s

A

bradykinesia
rigidity
tremor

23
Q

What is the bradykinesia (PD)

A

slow movement slow imitation of movement

24
Q

What is rigidity due to in PD

A

increased muscle tone

25
Q

What is the tremor due to in PD

A

slow amplitude

can progress to on/off movement disorder - often after tx

26
Q

What are the manifestations of PD than can be seen in clinical observations

A

impaired gait and falls
impaired use of upper limbs
mask like face
swallowing problems

27
Q

What is the tx of parkinsons

A

physiotherapy and occupational therapy

these work to maintain function as high a level for as long as possible

28
Q

What is the medical treatment for parkinsons disease

A

dopamine

dopamine analogues

29
Q

What are the different forms of dopamine analogues

A

tablets
injection
infusion

30
Q

What is the dopamine drug

A

levodopa

31
Q

What is the surgical tx for PD

A

sterostatic surely - deep brain stimulation

stem cell transplant

32
Q

What are the dental aspects of pD

A

difficulty accepting tx
temor at rest of body
often facial tremor reduces on purposeful movements e.g mouth opening

dry mouth - anticholinergic effect of drugs

drug interactions

BDS3 BAMS Diseases of Human Systems (11 decks)

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