toxic metabolic

Question 1

CO poisoning

Answer 1

predilection for globes pallidus (as due cyanide and manganese). hippocampal and cerebellar injury and diffuse cerebral edema.
mild- N, HA, fatigue
severe- apahty, ridigity, bradykinesia, dystonia.
delayed deterioration wks after initial insult- depression, memory loss, psychosis.
tx-100% O2 or hyperbaric O2

Question 2

cyclosporin

Answer 2

immunosuppresant in renal transplant. cause WM changes in occipital lobes (mainly) - seizure, cortical blindness, HA, encephalopathy

Question 3

calcification of BG

Answer 3

often idiopathic. associated with hypoPTH, abn of phosphate and ca. after infection with neurocystercosis or TB.

Question 4

familial cerebrovascular ferrocalcinosis (Fahr’s disease)

Answer 4

bilateral, symmetric calcification of BG, thalamus, dentate nuc. mvt disorder and psychiatric impairment

Question 5

heaptic encephalopathy

Answer 5

imaging- bilateral, symmetric hyper intensity of globes pallidus extending to cerebral peduncle wo mass effect in pt with liver failure on unenhanced T1. due to impaired meta of metals like manganese and copper. asterixis,

Question 6

central pontine myelinolysis (CPM)

Answer 6

rapid correction of longstanding hyponatremia - change in osmolarity and shifts of free water. in alf and chronically malnouisehd, medically ill pt.
sx range from parkinsonism to coma, quadriparxsis, locked in syndrome, bulbar dysfunc.
prog is poor
MRI- central area of hyperintesnity in pons with sprain got corticopsinal tract - trident sign