Western-D.O. of the Nervous System

Question 1

Alzheimer’s Disease

Answer 1

The most common cause is dementia; brain cells degenerate reducing responsiveness.

Question 2

Alzheimer’s Disease

Sx & Dx

Answer 2

Sx: Begins slow & worsens over time: personality changes, poor memory, inability to recognize people/places

Dx: cholinergic enhancers (Aricept-donepezil), tricyclic antidepressant (Remeron-mirtazapine), Provigil, NSAID’s, Gingko Biloba

Question 3

Parkinson’s Disease

Answer 3

A progressively slow degenerative disorder of the CNS nerve tissue & neurotransmitter production.

Question 4

Parkinson’s Disease

Sx & Tx

Answer 4

Sx: tremors at rest, sluggish initiation of movements, “shuffling gait”, mask-like face, staring, (damages both sides of the body)

Tx: Levodopa (dopamine precursor), anticholinergics

Question 5

Stroke (CVA)

Answer 5

Cerebrovascular attack: permanent damage to brain tissue d/t ischemia (lack of blood/oxygen leading to death of tissue) in excess of 4 minutes. (Can be caused by aneurism, trauma or vascular malformation “wet stroke” or by blood clot: thrombus or embolus “dry stroke.” Most common artery involved:
Middle Cerebral Artery (Forehead does wrinkle)

Question 6

Stroke (CVA)

Sx & Tx

Answer 6

Sx: ipsilateral facial paralysis, contralateral hemiparesis, loss of extensor control, visual blurring, pupil asymmetry, difficulty speaking, aphasia, dizziness, HA, possible loss of consciousness

Tx: (wet stroke) Keep BP low.
(Dry stroke) Coumadin, aspirin

Question 7

Transcient Ischemic Attack (TIA)

Answer 7

A temporary deficiency in the brain’s blood supply d/t emblus, thrombus or arterial stenosis. Most commonly affected: internal carotid, middle cerebral or vertebrobasilar arteries.

Question 8

Transcient Ischemic Attack (TIA)

Sx & Tx

Answer 8

Sx: same as stroke, but transient; sudden onset may include ipsilateral blindness or contralateral hemiparesis, dizziness, double vision, general weakness, loss of sensation, slurred speech, imbalace, falling. (Symptoms are temporary & reversible).

Tx: First try antiplatelets, then anticoagulants; severe cases: arterial bypass

Question 9

Trigeminal Neuralgia

Answer 9

(Tic Douloureux) Disorder of CN V along one or more sensory divisions, esp. maxillary

Question 10

Trigeminal Neuralgia

Sx & Tx

Answer 10

Sx: successive excruciating pain lasting seconds–2 minutes, aggravated by touch & activity.

Tx: carbamazepine, phenytoin, amitriptyline; severe cases: craniectomy of CN V.

Question 11

Bell’s Palsy

Answer 11

Unilateral facial motor weakness/paralysis d/t acquired dysfunction of CN VII.

Question 12

Bell’s Palsy

Sx & Tx

Answer 12

Sx: unilateral facial motor weakness/paralysis, inability to close affected eye, increased salivation & lacrimation, altered taste (Forehead does not wrinkle).

Tx: corticosteroids (oral prednisone) during acute stage

Question 13

Glaucoma

Answer 13

Increased intraocular pressure resulting in atrophy of the retina and optic nerve. Possible blindness.

Question 14

Cataract

Answer 14

Clouding of the lenses which causes decreased vision. Etiology unknown, maybe age related.

Question 15

Detached Retina

Answer 15

Usually happens d/t trauma of the head. Any distorted vision, flashes of light or vision loss, get medical attention ASAP. This could require surgical reattachment.

Question 16

Meniere’s Syndrome

Answer 16

Vertigo, hearing loss, nausea & tinnitus, leading to progressive deafness. Caused by rapid, violent firing of the fibers of the auditory nerves. If the organ of Corti occurs progressive deafness is the result.