2012 Flashcards
MS disease progression types
# relapsing remitting form (85% of cases)- progression does not occur between attacks # secondary progressive form (80% of cases after 25 years) - a gradually progressive course after an initial relapsing-remitting pattern; # primary progressive form (10% of cases), -gradual progression of disability from clinical onset. # progressive-relapsing form occurs rarely, with acute relapses being superimposed on a primary progressive course.
Marcus Gunn pupil
RAPD
the swinging-flashlight test- whereupon the patient’s pupils constrict less
MS - Examination in advanced cases commonly reveals…
optic atrophy, nystagmus, dysarthria, and upper motor neuron, sensory, or cerebellar deficits in some or all of the limbs
CEREBELLOPONTINE ANGLE TUMOR
most common tumor
acoustic neuroma (schwannoma,)
Neurofibromatosis 1
common AD - gene: neurofibromin 1 (NF1),
associated with
# unilateral acoustic neuromas,
# skin: café-au-lait spots on the skin, cutaneous neurofibromas, axillary or inguinal freckles,
# optic gliomas,
# iris hamartomas,
# dysplastic bony lesions.
Neurofibromatosis 2
rare AD gene: neurofibromin 2 (NF2), # bilateral acoustic neuromas, # central or peripheral nervous system tumors, including neurofibromas, meningiomas, gliomas, and schwannomas.
what is the disease? festination (rapid shuffling steps and a forward-flexed posture when walking) voice disorders mask-like face expression small handwriting
parkinson
conditions associated with CVA
vascular - atherosclerosis inflamatory: giant cell arthritis, SLE, polyartritis nodosa, CNS primary angitis, syphilis, AIDS fibromuscular dysplasia dissection lucunar infarct moyamoya migrane Venous or sinus thrombosis
aca stroke presantation
- contralateral paralysis and sensory loss affecting the leg.
- Volun`tary control of micturition impared
causes for mononuclear CSF
meningitis - viral, TB, parzits, fungul. GBS - only very very mild MPN metastasis - none or very mild SAH - non or PMN lysteria - non or MPN treated bacterail meningitis - mpn untreated bacterial meningitis - pmn
CHRONIC INFLAMMATORY DEMYELINATING
POLYNEUROPATHY (CIDP)
similar to Guillain-Barré syndrome except that it
follows a chronic progressive course.
#Weakness, hyporeflexia, or areflexia & sensory - distal upper or lower extermitis. - less but common - proximal. # paraesthesia upper extermity
steroid, IVIG
guillain barre causes
- follow minor infective illnesses,
2, inoculations, - surgical procedures
- without obvious precipitants
Trigeminal neuralgia (tic douloureux) gander? pathophisiology pain triggers sensory involvment DD
women
trigeminal (V) nerve roots are close to a vascular structure, and microvascular compression followed by demyelination of the nerve is believed to cause the disorder.
Stimulation of trigger zones about the cheek, nose, or mouth by touch, cold, wind, talking, or chewing
no sensory envolvment
no trigeminal abnormal reflexes (corneal, jaw jerk)
similar pain may occur in
multiple sclerosis or brainstem tumors, which should be
considered in young patients
long-term spontaneous remission is rare
anti musk
seronegatic MG
15%
Eosinophilia–myalgia syndrome (EMS) cause clinical signs lab EMG treatment
incurable, sometimes fatal flu-like neurological condition increases with larger doses of dietry tryptophan and increasing age.
muscle pain and weakness associated with inflammation of skin
lab - liver enzymes, leukocytosis, eosinophilia.
EMG - neuropathy, myopathy
treatment - steroids, NSIAD
