Other Neurologic Disorders

Question 1

What condition is described below?

Also called benign intracranial hypertension
Commonly in overweight women 20-44
History of chronic OM or chronic mastoiditis

Answer 1

Pseudotumor Cerebri

Question 2

List some causes of Pseudotumor Cerebri?

Answer 2

Idiopathic
Transverse venous sinus thrombosis
Chronic pulmonary disease
Hypothyroidism
SLE
Hypoparathyroidism
Addison’s disease
Medications
Vitamin A toxicity
Withdrawal of corticosteroids after long-term use

Question 3

What are some signs and symptoms of Pseudotumor Cerebri?

Answer 3

Headache
Diplopia
Visual problems
Papilledema
Abducens nerve
Pulse synchronous tinnitus
Blind spot enlargement

Question 4

What type of monitoring is done in Pseudotumor cerebri?

Answer 4

Monitor with LP and eye exams

Question 5

What can result if Pseudotumor cerebri is left untreated?

Answer 5

Visual loss – second to optic atrophy

Question 6

What condition is described below?

Most commonly will see in alcoholics (May also occur in AIDs, surgery for obesity, hyperemesis gravidarum)
Secondary to a thiamine deficiency

Answer 6

Wernicke’s Encephalopathy

Question 7

Describe Korsakoff syndrome

Answer 7

Anterograde and retrograde amnesia and sometimes confabulation (Don’t remember anything before or after)

Question 8

What are some signs and symptoms of Wernicke’s Encephalopathy?

Answer 8

Confusion
Ataxia
Peripheral neuropathy
Korsakoff syndrome
Nystagmus
Ophthalmoplegia

Question 9

What is the treatment for Wernicke’s Encephalopathy?

Answer 9

IV Thiamine then glucose

Question 10

What is Thiamine given prior to glucose in the treatment of Wernicke’s Encephalopathy?

Answer 10

IV glucose given before IV -thiamine may worsen Korsakoff syndrome or even cause Wernicke’s

Question 11

What condition is described below?

A condition in which the autonomic nervous system (ANS) does not work properly

Manifested by a variety of symptoms that may occur alone or in combination (this may affect the functioning of the heart, bladder, intestines, sweat glands,
pupils, and blood vessels)

Central v. peripheral

Answer 11

Dysautonomias

Question 12

What is the most common symptom in dysautonomias?

Answer 12

postural hypotension

Question 13

List some signs/symptoms you can see in dysautonomias?

Answer 13

Blood pressure regulation (postural hypotension most common and disabling)
Thermoregulatory sweating
GI function
Sphincter control
Sexual dysfunction
Respiratory dysfunction
Acute urinary retention
Ocular dysfunction (dilated pupils)

Question 14

List some potential CNS causes of dysautonomias

Answer 14

Spinal cord transection

Myelopathies – tumor or syringomyelia
Above T6 level or from brainstem lesions - Syrnigobulbia and posterior fossa tumors
Below T6 may lead to sphincter and sexual dysfunctions

Pure autonomic failure

Mutisystem atrophy

Shy-Drager Syndrome

Question 15

What is Shy-Drager Syndrome?

Answer 15

Parkinsonian

Pyramidal symptoms

Cerebellar deficits

Question 16

List some potential PNS causes of dysautonomias

Answer 16

Seen in patients with GBS

Metabolic neuropathies (DM, amyloidotic, uremic)

Hereditary neuropathies

botulism

Question 17

List some signs/symptoms of PSN dysautonomias

Answer 17

Syncope
Hypotension
Paroxysmal hypertension
Tachycardia
Facial flushing
Hyper/hypo hidrosis
Abdominal distension
Urinary dysfunction
GI – V/D/C
Erectile dysfunction
Apneic episodes
Declining night vision

Question 18

What is the treatment for dysautonomias?

Answer 18

There is no treatment for underlying cause – treat the symptoms