Neurology III highlights Flashcards
Which form of MS has the best prognosis?
RRMS has best prognosis
What are the 8 most common MS Sx?
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1) Sensory disturbance
2) Weakness
3) Visual loss: optic neuritis
4) Ataxia
5) Diplopia
6) Vertigo
7) Fatigue
8) Facial pain
What is the disease course of MS?
1) Relapse-remitting**
2) Primary progressive
3) Secondary progressive
4) Clinically isolated syndrome
What is a condition you should think of when you hear “demyelination”?
MS
What is most common above and below 45 degrees?
MS
1) What is one part of MS etiology?
2) What is an important part of MS Tx?
1) Low sunlight exposure/ Vit D can influence
2) Refer to neurology
MS:
1) Important part of evaluation?
2) LP?
1) MRI + contrast (gadolinium): white lesions in gray matter
2) Oligoclonal bands
MS:
1) Is there one way to test it?
2) What are some diagnostic criteria?
1) No single specific diagnostic test; may be clinical, neuroimaging, and/or laboratory criteria
2) Clinical Diagnostic criteria:
-2 or more documented (self reported or clinician observed) episodes of neurologic symptoms AND
-focal symptoms/signs of CNS (>2hrs >1 mo interval)
MS diagnosis:
What type of diagnosis can dx in absence of reported symptoms?
Imaging (MRI of brain and spinal cord w. plaquesassociated with MS and multifocal areas of demyelination (often periventricular))
1) What makes up 85% of MS cases (most common type)?
2) What is the prognosis of this type?
1) Relapsing-remitting multiple sclerosis (RRMS) (85% most common type)
2) Best prognosis
List 4 different patterns of MS
1) Relapsing-remitting multiple sclerosis (RRMS)
2) Secondary progressive multiple sclerosis (SPMS)
3) Primary progressive multiple sclerosis (PPMS)
4) Clinically isolated syndrome (CIS)
___________ is gold standard imaging modality for MS and may Dx prior to meeting the clinical criteria
MRI
High dose IV corticosteroids are the treatment of choice for patients with _____ MS flare-up symptoms
acute
What % of optic neuritis pts will develop MS?
50% will develop MS
What should you do for pts with optic neuritis?
Refer urgently to neuro or ophtho
Myasthenia Gravis:
1) What are 2 Key aspects of presentation?
2) Pathophys main cause?
1) Fatigueable weakness; worsens throughout the day, improves with rest
2) Thymic dysfunction
What is a key aspect of CRPS?
Localized to one limb
Key aspect of CRPS Tx?
Early
Guillain -Barré:
1) Typical presentation?
2) Pathophys?
1) Rapidly progressive paralysis targeting Bilat peripheral nerves (distal limbs) typically ascending,
2) Demyelination of peripheral nerves
What condition is typically ascending?
Guillain -Barré
True or false: if there’s well-defined sensory loss, it’s probably not Guillain -Barré
True
True/ false: asymmetric weakness is a sign of Guillain -Barré
FALSE, not a sign
Guillain -Barré:
1) What is it usually preceded by?
2) What Txs have NOT shown benefits?
1) Infections esp URI, GI (Campylobacter)
2) Close monitoring (1/4 will need intubated), IVIG, plasmapheresis, steroids have not shown benefits
What Tx is contraindicated in acute inflammatory demyelinating polyneuropathy but helpful in chronic?
Corticosteroids
Cerebral palsy (CP):
1) What do the etiologies result in?
2) What is a common secondary issue?
1) Brain injury that affects muscle tone, movement, posture, & balance
2) Hip pain/dislocation
What is the most common movement issue associated with CP?
Spasticity
CP: ___% traced to perinatal brain injury
92%
Most Sx associated with CP are disorders of __________
movement
What is the most common peripheral neuropathy? Where does it usually begin?
Diabetic polyneuropathy; distal lower extremities (classic “stocking and glove” distr.)
True or false: Diabetic polyneuropathy Sx are largely sensory
True
