DSA 21 Disturbances of Sensation

Question 1

diminished pinprick, touch or vibration

Answer 1

hypesthesia

Question 2

increased or exaggerated painful sensation to a painful stimulus

Answer 2

allodynia

Question 3

affects a SINGLE muscle group

Answer 3

mononeuropathy

Question 4

What disorders are associated with mononeuropathies?

Answer 4

Diabetes, thyroid disease, RA, SLE (these are METABOLIC disease)

Question 5

lateral femoral cutaneous nerve neuropathy

Answer 5

Meralgia Paresthetica

Question 6

sensory disturbance in the distribution of >1 peripheral nerve; may have saturday night palsy and carpal tunnel syndrome

Answer 6

mononeuropathy multiplex

Question 7

sensory disturbance in the distribution of a nerve root or dermatome

Answer 7

radiculopathy

Question 8

What is a common physical finding of a person with radiculopathy?

Answer 8

pain at the site of the nerve root

Question 9

subacute/chronic radiculopathy

Answer 9

suggests degenerative or possibly inflammatory spine disease

Question 10

acute radiculopathy

Answer 10

traumatic, infectious, or vascular etiology

Question 11

weakness in the distribution of a single nerve root

Answer 11

myotome; present in radiculopathy

Question 12

positive straight leg raising

Answer 12

radiculopathy

Question 13

positive spurling sign

Answer 13

radiculopathy

Question 14

What if someone has negative imaging but they have symptoms of radiculopathy?

Answer 14

ischemic etiology; nerve root infarction

Question 15

acute polyneuropathy

Answer 15

GBS

Question 16

What is the onset of most polyneuropathies?

Answer 16

gradual or subacute

Question 17

Why does someone with a polyneuropathy have orthostatic hypotension?

Answer 17

polyneuropathy affects all types of peripheral nerves including AUTONOMIC and orthostatic hypotension is an autonomic dysfunction

Question 18

What are some causes of peripheral polyneuropathy?

Answer 18

diabetes, alcoholism, thyroid disease, rheumatologic diseases

Question 19

What conditions have pain at the level of the lesion?

Answer 19

radiculopathy, spinal cord lesion; so dn’t be tricked!

Question 20

sphincter dysfunction impairing bowel and or bladder dysfunction

Answer 20

spinal cord lesion

Question 21

spinal ataxia

Answer 21

inherited spinal cord disease that will be negative on imaging

Question 22

A patient is diagnosed with B12 deficiency spinal cord lesion. Is imaging a diagnostic factor?

Answer 22

will be negative on imaging

Question 23

what are some inflammatory spinal cord lesions

Answer 23

transverse myelitis, combined degeneration of the cord or MS; will either be negative or positive on imaging

Question 24

Brown-sequard syndrome

Answer 24

ipsilateral loss of proprioception, contralateral loss of pain and temp, ipsilateral UMN weakness

Question 25

onset of syringomyelia?

Answer 25

gradual

Question 26

identify: shawl-like distribution of decreased pain and sensory loss

Answer 26

syringomyelia

Question 27

what sensory loss is unaffected in syringomyelia?

Answer 27

light touch and proprioception

Question 28

LMN-type hand weakness and atrophy of the hands

Answer 28

syringomyelia

Question 29

etiology of syringomyelia

Answer 29

enlargement of the central canal of the spial cord

Question 30

subacute combined degeneration of the cord

Answer 30

B12 deficiency

Question 31

B12 deficiency symptoms

Answer 31

decreased vibration and position sense in the feet, positive Romberg, UMN weakness, gait disturbed

Question 32

What is frequently associated with a B_12 deficiency

Answer 32

macrocytic hyperchromic anemia

Question 33

What if there is a low normal of B_12?

Answer 33

check methylmalonic acid

Question 34

Crossed signs in which there is sensory loss on one side and cranial nerve findings on the other side

Answer 34

brainstem lesion

Question 35

acute brainstem lesion

Answer 35

vascular disease

Question 36

gradual brainstem lesion

Answer 36

neoplastic

Question 37

acute or subacute brainstem

Answer 37

demyelinating like MS

Question 38

Large vs small thalamic lesions

Answer 38

large will include corticospinal tract (UMN weakness)

Question 39

small thalamic lesion symptoms

Answer 39

contralateral numbness and tingling and contralateral pain

Question 40

diminished sensation on the entire left or right half of the body

Answer 40

thalamic lesion

Question 41

thalamic syndrome

Answer 41

contralateral numbness and pain

Question 42

What condition doesn't cause a thalamic lesion?

Answer 42

MS

Question 43

dominant hemisphere affected in a parietal lobe lesion

Answer 43

language disturbance along with sensory disturbance to any/all modalities

Question 44

asteriognosis

Answer 44

lack of the the mental perception of depth or three_dimensionality by the senses, usually in reference to the ability to perceive the form of solid objects by touch. associated with a parietal lesion

Question 45

Agraphesthesia

Answer 45

associated with a parietal lesion difficulty recognizing a written number or letter traced on the skin after parietal damage

Question 46

extinction with bilateral simultaneous stimulation

Answer 46

parietal lesion

Question 47

diminished 2 point discrimination

Answer 47

parietal lesion

Question 48

what if a parietal lesion doesn't involve the dominant hemisphere

Answer 48

may be spatial disturbance and DENIAL of illness

Question 49

non_dominant parietal lobe

Answer 49

important in visuo_spatial perceptions

Question 50

What condition does not affect the cerebral cortex?

Answer 50

MS

Question 51

patient presents with infarct of the nerve root. what do you expect to see on MRI?

Answer 51

nothing, MRI is frequently negative for infarct of the nerve root

Question 52

in radiculopathy of thoracic spine, more likely to result from ______ than _________.

Answer 52

nerve root infarction, disc herniation

Question 53

what is myelopathy?

Answer 53

disorder affecting the spinal cord. sensory/motor deficit will be below the level of the lesion

Question 54

what are complications of B12 deficiency?

Answer 54

combined degeneration of the spinal cord, dementia, and polyneuropathy

Question 55

what is the clinical manifestation of Wallenberg's syndrome (lower medulla)?

Answer 55

ipsilateral facial numbness, hoarseness and dysarthria, ipsilateral Horner's syndrome, ipsilateral arm and leg ataxia, diminished sensation in contralateral arm, leg, and torso

Question 56

what sensory disturbance is seen in thalamic lesions?

Answer 56

contralateral loss/decrease of all sensation, contralateral pain

Question 57

what sensory disturbance is seen in parietal lobe lesions?

Answer 57

decreased discriminative function on opposite side of the body. abnormal 2 point discrimination, graphesthesia, stereognosis, bilateral simultaneous stimulation