OnlineMedEd: Neurology - Weakness Flashcards
Multiple sclerosis most commonly occurs in _______________.
young women
Blurry vision and ______________ are suggestive of optic neuritis.
painful movements of the eye
What tests can help diagnose MS?
- MRI showing periventricular white matter plaques
- LP showing oligoclonal bands
- Evoked potentials showing demyelination
Acute MS flares are treated with ____________.
steroids
Chronic MS treatment should be with ______________.
a number of MS-specific drugs like interferon beta, fingolimod, or glatiramer
MS presents with what urinary symptoms?
Either incontinence or retention (so treat with amitriptyline or bethanechol)
What drug is commonly used to treat MS spasms?
Baclofen
What drug is used to treat neuropathic pain in MS?
Gabapentin
Those with Guillain-Barré often have _______-reflexia.
hypo
How can Guillain-Barré be definitively diagnosed?
With an LP looking for protein without cells
How does IV IG work?
It binds the body’s native immunoglobulin and effectively removes it.
True or false: give steroids to treat Guillain-Barré.
False. Never give steroids to those with Guillain-Barré. Treat with IV IG and intubation (if the diaphragm is affected).
What three muscle groups are usually most affected in myasthenia gravis?
- Eyes and eyelids
- Throat
- Hands
Each of these groups moves frequently, which depletes the acetylcholine reserves.
An EMG of someone with myasthenia gravis will show ____________________.
initially normal amplitude waves that taper off
How can you diagnose myasthenia gravis?
- Acetylcholine receptor antibodies
- EMG
- CT looking for thymoma
Why should you carefully monitor myasthenia gravis patients after giving physostigmine?
They might be having trouble swallowing already, and when you give them cholinesterase inhibitors you will cause them to have increased secretions.
List four treatments for myasthenia gravis.
- Steroids
- IV IG
- Thymectomy
- Cholinesterase inhibitors
Why are the proximal muscles more affected in Lambert-Eaton myasthenic syndrome?
In LEMS, muscle use improves with increased use. The proximal muscles generally get used the least (particularly if you’re sitting most of the day).
What three diagnostic tests should you order in a suspected LEMS case?
- Antibodies (diagnostic)
- EMG showing increased amplitude with use (the opposite of myasthenia gravis)
- CT looking for small cell lung carcinoma
Differentiate the presentations of upper- and lower-motor neuron injuries.
- UMN: weakness and hyperreflexia
* LMN: weakness, hyporeflexia, and fasciculations
______________ can add a couple months of life to those with amyotropic lateral sclerosis.
Riluzole
