Patterns of Neurological Dysfunction Flashcards
Where do extrapyramidal signs come from?
basal ganglia
Where do pyramidal signs come from?
Corticospinal /
pyramidal tract
What are the two types of extrapyramidal sings?
hyperkinetic hypokinetic
Signs of hyperkinetic (extrapyramidal) movement disorders?
Dystonia, Tics, Myoclonus Chorea (Tremor)
What is the term for spasmodic jerky contraction of groups of muscles?
myoclonus
Signs of hypokinetic movement disorders?
rigidity, bradykinesia
Parkinsonism
Name a hypokinetic movement disorder.
Parkinson’s disease
What is ataxia and what part of the brain does it come from?
loss of full control of bodily movements
cerebellum
What is a pyramidal lesion the same as?
upper motor neuron lesion
In which, upper or motor neuron lesions, are there decreased or absent reflexes?
lower
Symptoms of muscle disease?
wasting (usually proximal), decreased tone, decreased or absent tendon reflexes
Symptoms of neuromuscular junction disease?
fatiguable weakness, normal or decreased tone, normal tendon reflexes. No sensory symptoms
Symptoms of functional weakness?
no wasting, normal tone, normal reflexes, erratic power, non-anatomical loss
What occurs with acute stroke syndromes, space occupying lesions, and spinal cord problems ?
UPPER motor neuron lesions
What type of lesion is suggested by a contralateral pyramidal weakness in face, arm, leg?
hemispheric upper motor neuron
What occurs with Parasagittal frontal lobe lesion?
paraparesis
In a spinal cord upper motor neuron lesion, where does weakness occur?
pyramidal weakness below the level of the lesion
cervical: arms and legs
Thoracolumbar: legs
What disease pattern occurs with motor neuron disease, spinal muscular atrophy, (lead poisoning, poliomyelitis,…)?
LOWER - anterior horn cells
How does peripheral nerve involvement with lower motor neurons present?
Symmetrical (often length dependent) polyneuropathy with weakness and sensory symptoms: frequent complication of diabetes. Other aetiologies include a variety of toxic (alcohol) or metabolic insults as well as heritable disorders (often young onset and skeletal deformities)
Mononeuropathy as a result of nerve compression (carpal or tarsal tunnel syndrome, ulnar neuropathy, radial neuropathy) or mononeuritis multiplex (asymmetric polyneuropathy), which occurs in the context of diabetes or vasculitis
What type of sensory loss does stocking (and later glove) imply?
dependent neuropathy
What does sensory level loss imply?
spinal cord lesion
Haemianaestheisa suggests what?
contralateral cerebral lesion, or with no other signs a non-organic disorder
Disscociated sensory loss with lost spinothalamic (temperature / pain) but preserved dorsal column (vibration, light touch, proprioception) suggests what?
hemicord damage (anterior spinal artery syndrome, Brown-Sequard syndrome, syringomyelia)
What is Dysdiadochokinesis?
clumsy, fast, alternating movements
Intention tremor / ataxia is assessed by what in the arms?
finger nose test
Intention tremor / ataxia is assessed by what in the legs?
knee heel testing
Which part of the brain enables self-criticism and trying again?
frontal lobe
Why may anosmia occur with frontal lobe dysfunction?
olfactory pathway is beneath frontal lobe
What type of memory dysfunction is particularly common in temporal lobe dysfunction?
episodic memory loss
What is the treatment protocol for Parkinson’s?
Symptomatic treatment with Levodopa replacement or dopamine agonist
Multidisciplinary team management including Speech and language, OT, PT, exercise
For selected patients deep brain stimulation (subthalamic nucleus, globus pallidus int)
