Paralysis Flashcards
botulism caused by what?
exotoxin, old cans, IVDA
paralysis in botulism?
descending paralysis
paralysis with CN palsy and dilated non reactive pupils?
botulism
diagnosis of botulism?
EMG with progressively increased muscle fiber contraction
weakness of GBS?
symmetric ascending weakness, loss of DTR
other symptoms of GBS?
autonomic and sensory issues
weakness with normal nerve conduction velocity? with decremental motor response to nerve stim
MG
MG pupillary effects?
none
treatment for MG?
pharesis removes the ach receptor ab, high dose steroids, pyridostigmine
causes of critical illness myopathy? sx?
steroids/flaccid quadriparesis
cause of critical illness polyneuropathy? sx?
sepsis/weakness, absent DTR, loss of distal sensation
tx of CIM and CIP?
tight glucose contral, prevent secondary issues
PE sign in spinal cord compression?
positive straight leg raise
central cord syndrome limbs?
upper limbs worse than lower
anterior cord syndrome location of injury
ASA occlusion
b/l spastic paralysis with loss of temp and pain distal to lesion?
anterior cord syndrome
loss of vibratory sense and proprioception, urinary retention?
posterior spinal cord
causes of posterior spinal cord syndrome?
vertebral srtery dissection, MS
ipsilateral weakness and loss of proprioception
contralateral loss of temp and pain
brown sequard syndrome- later half of the cord
Miller fisher variant of GBS?
oculoparesis, ptosis, ataxia, areflexia
tx of GBS?
IVIG or pharesis
ticke borne paralysis sx?
tick needs to fed for 7 days first, also ascending paralysis
MG sx? diagnosis?
ach receptor ab, proximal muscle weakness
anti NMDA encephalitis association?
ovarian and testicular teratoma
presentation of anti NMDA encephalitis?
young patient with paranoia or psychosis who deescalates to encephalopathy and seziures
ascending paralysis complicated by areflexia and proprioception loss?
AIDP
tx for AIDP?
plasmapharesis or IVIG
tx for GBS?
IVIG or pharesis
complications of IVIG?
anaphylaxis, aseptic meningitis, renal failure, fluid overload
central cord syndrome cause? sx?
likely in setting of arthritis in older patients, loss of motor and sensory in arms and legs
reversal of nondeploarizing NMB like cisatracurium?
neostigmine
combat muscarinic effects of neostigmine?
glycopyrolate
how does suggamadex work?
encapsulates NMBA in plasma and then creates a concentration gradiest to pull more out of muslce and eliminated via kidneys
nutritional deficiency that can mimic GBS?
thiamine deficiecny- beriberi
wernicke encephalopathy presentation?
vomiting, horizontal nystagmus, palsies of eye movement, fever, ataxia
MIP and NIF threshold for MG?
> -20 NIF is bad, <40 on MIP bad, VC <15 cc/kg
poor indicator for VC on MG assessment?
<20 cc/kg
ice pack test for what?
improvement in ocular movement and proptosis, assessing for MG
concern for excess pyridostigmine when treating MG?
cholinergic crisis
treatment for MG
IVIG or pharesis for 5 days
weakness with progressive decrement of action potentials with repetitive motion on electrophysiological studies?
MG
weakness that will show electrophysiological with acute inflammatory demyelinating polyneuropathy
GBS
cholingergic crisis in which of the weaknesses?
MG
sx of cholingergic crisis in MG?
urinary retention, bradycardia, inc oral secretions, SLUDGE
tx of cholingergic crisis in MG?
Supportive use atropine
syringobulbia?
cysts in brainstem with gradual onset of motor, sensory, and autonomic sx
when is it ok to use BIPAP in myasthenia crisis?
before the patient develops hypercapnia
