Tremor + Multiple Sclerosis Flashcards
Parkinsonian tremor features?
Worse at rest
Gets better on movement
What type of tremor is defined by absence at rest and worse on movement?
Intention tremor
What is usually associated with psychogenic tremor?
Psychological abnormality on history
Examination findings are likely unreliably reproducible and inconsistent with anatomical lesions
How is psychogenic neurology diagnosed and who should it be considered in early on in the differential?
Diagnosis of exclusion after many investigations
- worth considering early on in certain patients who may start to deny the possibility of a non-organic cause (i.e. “I’m not crazy etc”)
Which 2 neurologically-presenting conditions may be preceded by infection?
Guillain-Barré (peripheral NS affected)
ADEM - acute disseminated encephalomyelitis (central NS affected)
Out of sensory and muscular symptoms, which predominates in Guillain-Barré?
Muscular symptoms
- weakness normally predominates and at least some will be demonstrable on exam if not predominant
Difference between ADEM and MS?
ADEM = monophasic MS = relapsing/remitting course, often with complete recovery in-between relapses
Who does MS most commonly affect?
Young women
What is MS?
Autoimmune demyelinating condition affecting the brain and nerves
- auto-antibodies attack myelin sheaths around nerves which causes inflammation and destruction of the sheaths
Common presentations of MS?
Tiredness Vision problems (particularly relevant) Problems walking/with balance Weakness Intention tremor
What vision problems are most common to MS and may sometimes be ignored if mild?
Optic neuritis - episode of visual blurring and pain
- pain gets worse on eye movement as inflamed sheath gets stretched
Which types of vision are most commonly affected by MS and why?
Colour and central vision
- these come from the cone cells, the axons conducting messages from the cone cells are myelinated, where as the rod cell (dark/peripheral vision) axons are not
