Presentation Day Yeah! Flashcards
Bell’s Palsy gen char
Def: acute lmn peripheral facial palsy
Causes: Inflammation, swelling, demyelination CN VII
HSV, Zoster, EBV
Prog: Most will regain full control of face
Bell’s Palsy clin
SS: sudden onset unilateral facial paralysis eyebrow sag droop of corner of mouth decreased taste sensation anterior 2/3 tongue
Eval: No test needed CT MRI EMG Serologic testing
Txt:
Artificial tears
prenisone
valacyclovir
Trigeminal Neuralgia gen char
Def: MC cause of facial shooting pain
Cause: compression of trigeminal nerve root by artery or vein or acoustic neuroma
- anything touching face can set it off
Trigeminal Neuralgia clin
SS: Recurrent brief, acute episodes of sharp, stabbing pain unilateral Not during sleep
Dgx: >= 3 attacks >= 1 division of nerve Pain -recurring - severe - shooting, stabbing - precipitated by innocuous stimuli to affected side of face
Eval:
CT
MRI
Txt:
Anti-epileptic (Carbamazepine)
Opiates
Surgery
Myasthenia Gravis gen char
Def: chronic progressive autoimmune neuromuscular dx with voluntary muscle weakness
Cause: antibodies attack/block receptors of Ach
Prog: managed but not cured
Myasthenia Gravis clin
SS: diplopia ptosis dysphagia asthesia muscle fatigue dyspnea
Eval: Acetylcholine Receptor Antibody Test Anti-MUSK antibody test Repetitive Nerve Stimulation Edrophonium Test Ice Pack Study CT thymus
Txt: acetylcholinesterase inhibitors steroids plasmapheresis thymectomy PT
Duchenne Muscular Dystrophy gen char
Def: x-linked recessive inherited dx
Cause: DMD gene cannot translate dystrophin protein
Prog: fatal by late 20s
Muscular Dystrophy clin
SS: frequent falls gower's sign not hitting major milestones while growing trouble clearing throat heart arhythmias intestinal pseudo-obstruction lower IQ
Eval: Muscle biopsy Serum Creatine Kinase ALT/AST Gene testing EKG
Txt: PT ventilation prednisone creatine ACEI or BB Immunizations
Lyme Dx gen char
Def: borrelia burgdorferi spirochete that causes rash, joints, heart, nervous system issues
Cause: deer tick passing spirochete over to human after 24-48 hrs
Prog: good with txt with facial nerve palsy, motor, sensory deficits
Lyme Dx clin
SS: Erythema migrans flu-like symptoms erythema/urticaria stiff neck myalgias arthralgias 1st degree heart block bell's palsy arthritis memory loss
Eval: CBC LFT ESR/CRP Monostat LP Serologic testing EKG CT/MRI
Txt:
Abx
ALS gen char
Def: sclerosis of umn and lmn involved with corticospinal tract
Cause: motor neurologic disorder
Prog: die 32 mths after symptoms show, die 19 mths after dgx
ALS clin
SS: muscle weakness sapsticity stiffness difficulty walking weird laughing/crying trouble swallowing
Eval:
labs
imaging
EMG
Txt:
Riluzole
supportive txt
Guillian Barre Syndrome gen char
Def: demyelination of axons in PNS after infection, usually campylobacter jejuni
Cause: macrophages attack myelin and denude axons
Prog: Great with txt
Guillian Barre Syndrome clin
SS: weakness, paraestheia, numbness in LE Bilateral, symmetrical weakness respiratory distress Ileus arrhythmia
Eval: CBC Metabolic Panel Glucose TSH UA CT LP EMG
Txt:
Intravenous immunoglobulin
OR
Plasmapheresis
Supportive (ventilator)
