Degeneration

Question 1

What is the difference is symptoms between upper and lower motor neurone symptoms?

Answer 1

Lower: (prevent excessive muscle movement)
- muscle atrophy, fasciculations, decreased reflexes, decreased tone, negative Babinsky sign, and flaccid paralysis

Upper: (responsible for muscle movement)
- Increase in muscle tone. increased muscle stretch reflex, clonus, or involuntary and rhythmic muscle contractions

Question 2

What is motor neurone disease?

Answer 2

Month-by-month progressive weakness caused by degeneration of nerves

Doesn’t affect sensory

Die 2-3 years after diagnosis

Question 3

What causes fasciculations?

Answer 3

Wasting of the muscle

Can be caused by deficiencies in vitamin D, vitamin B, Calcium

Question 4

How is MND diagnosed?

Answer 4

Nerve conduction test

Examination: fasciculations with no reflexes

Question 5

What are some symptoms of Parkinsons?

Answer 5

(Asymmetrical symptoms)

Depression/ Anxiety
Visual hallucinations
Fluctuating alertness
REM sleep behaviour disorder
Bradykinesia
Rigidity
Tremor
Constipation

Question 6

What is REM sleep behaviour disorder?

Answer 6

Dream enactment during REM sleep

Associated with Parkinson’s disease

Question 7

What are some symptoms of Alzheimer’s disease?

Answer 7

Early:
- Forget Recent conversations/ events
- Forget names of places and objects
- Can’t thing of right word
- Poor judgement

Late:
- Difficulty swallowing
- Small handwriting

Question 8

What are Parkinson’s+ syndromes?

Answer 8

Symmetrical symptoms associated with Parkinson’s syndromes

Question 9

How is Parkinson’s disease managed?

Answer 9

Levodopa
Treat symptoms
Physio

Question 10

How is motor neurone disease managed?

Answer 10

Riluzole: slows progression
Treat symptoms
Feeding tubes
Diet
Sleep

Question 11

How is Alzheimer’s disease managed?

Answer 11

Donepezil, rivastigmine, memantine (acetylcholine inhibitors that manage symptoms)
Physio
Diet
Sleep

Some drugs newly developed can slow progression by destroying the b-amyloid. Not available yet

Question 12

What are some causes of limb weakness?

Answer 12

• Focal stroke
• Cancer/ tumour
• Upper/motor neurone lesion
• Myalgia
• Myasthenia gravis

Question 13

What are cortical signs vs subcortical signs?

Answer 13

Cortical: higher level functions like visual loss, speech difficulties

Subcortical: lower level functions deeper in the brain so affects primitive actions like movement