exam P2 Flashcards
- Disturbances of the Cerebrospinal Fluid Circulation. Hydrocephalus
Hydrocephalus is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the cavities (ventricles) of the brain. CSF is a clear, colorless fluid that surrounds the brain and spinal cord, providing cushioning and nutrition, as well as removing waste products.
Disturbances:
Overproduction: Rare, usually caused by choroid plexus papilloma.
Blocked Flow: Common causes include congenital malformations (e.g., aqueductal stenosis), tumors, cysts, or infections.
Impaired Absorption: Can result from conditions like meningitis or subarachnoid hemorrhage.
Hydrocephalus:
Types:
Communicating: CSF flows between ventricles but isn’t absorbed properly, often due to subarachnoid hemorrhage, meningitis, or congenital absence of arachnoid villi.
Non-communicating (Obstructive): Blockage prevents CSF from flowing through the ventricular system; common sites include the aqueduct of Sylvius and the foramen of Monro.
Symptoms:
Infants: Enlarged head, bulging fontanelle, irritability, poor feeding.
Adults/Older Children: Headache, nausea, vomiting, blurred vision, balance problems, cognitive difficulties.
Diagnosis:
Imaging: MRI, CT scan to visualize enlarged ventricles and identify blockages.
Other Tests: Lumbar puncture (with caution), CSF pressure monitoring.
Treatment:
Shunt Placement: Ventriculoperitoneal shunt to divert CSF from ventricles to the abdominal cavity.
Endoscopic Third Ventriculostomy (ETV): Creates an opening in the floor of the third ventricle to allow CSF to bypass obstruction.
- Idiopathic Facial Nerve Palsy (Bell Palsy)
-Definition: Sudden, unilateral facial muscle weakness or paralysis without a clear cause, presumed to be due to viral infection or inflammation of the facial nerve.
-Symptoms:
Sudden weakness or paralysis on one side of the face.
Drooping mouth, inability to close the eye, drooling.
Loss of taste on the anterior two-thirds of the tongue.
Hyperacusis (increased sensitivity to sound).
-Diagnosis:
Clinical Examination: Assessment of facial muscle strength and symmetry.
Exclusion of Other Causes: Imaging (MRI/CT) to rule out stroke, tumors, or infections; blood tests for Lyme disease, herpes zoster.
-Treatment:
Medications: Corticosteroids to reduce inflammation; antiviral drugs if a viral infection is suspected.
Eye Care: Artificial tears, eye patch to protect the cornea.
Physical Therapy: Exercises to improve facial muscle strength and coordination.
- Neurological Disorders Causing Hearing Loss: Ménière’s Disease
⦁ Definition: A chronic disorder of the inner ear characterized by episodes of vertigo, fluctuating hearing loss, tinnitus, and aural fullness.
⦁ Symptoms:
⦁ Vertigo: Episodes lasting minutes to hours, often associated with nausea and vomiting.
⦁ Hearing Loss: Sensorineural, fluctuating, and progressive, typically affecting one ear.
⦁ Tinnitus: Ringing or buzzing in the affected ear.
⦁ Aural Fullness: Sensation of pressure or fullness in the ear.
⦁ Diagnosis:
⦁ Clinical History: Recurrent episodes of vertigo with associated hearing loss.
⦁ Audiometry: Hearing tests to document sensorineural hearing loss.
⦁ Electrocochleography (ECoG): Measures electrical potentials in the inner ear.
⦁ MRI: To rule out other causes like vestibular schwannoma.
⦁ Treatment:
⦁ Lifestyle Modifications: Low-salt diet, avoidance of caffeine, alcohol, and tobacco.
⦁ Medications: Diuretics to reduce fluid buildup, antiemetics, vestibular suppressants (meclizine, diazepam), corticosteroids.
⦁ Surgical Options: Endolymphatic sac decompression, vestibular nerve section, labyrinthectomy in severe cases.
- Types of Vertigo
Peripheral Vertigo: Originates from the inner ear or vestibular nerve.
⦁
⦁ Examples:
⦁ Benign Paroxysmal Positional Vertigo (BPPV): Caused by dislodged otoliths in the semicircular canals.
⦁ Ménière’s Disease: Fluid imbalance in the inner ear.
⦁ Vestibular Neuritis: Inflammation of the vestibular nerve, often viral.
⦁ Labyrinthitis: Inflammation of the inner ear structures.
⦁ Symptoms: Sudden onset, severe spinning sensation, nausea, vomiting, balance issues, hearing loss (if labyrinthitis).
⦁ Diagnosis: Clinical examination, Dix-Hallpike maneuver for BPPV, audiometry, vestibular tests (e.g., caloric testing).
⦁ Treatment: Repositioning maneuvers (Epley for BPPV), medications (antihistamines, benzodiazepines, antiemetics), vestibular rehabilitation.
⦁
Central Vertigo: Originates from the brain or brainstem.
⦁
⦁ Examples:
⦁ Stroke: Particularly in the cerebellum or brainstem.
⦁ Multiple Sclerosis: Demyelinating lesions in the brain.
⦁ Migraine-Associated Vertigo: Vertigo associated with migraine headaches.
⦁ Tumors: Brainstem or cerebellar tumors.
⦁ Symptoms: Gradual onset, may be less severe but more persistent, often accompanied by other neurological symptoms (e.g., double vision, weakness).
⦁ Diagnosis: MRI or CT scan, neurological examination, vestibular tests.
⦁ Treatment: Treat underlying condition (e.g., antiplatelet therapy for stroke, disease-modifying therapies for MS, migraine prophylaxis).
- Peripheral Vestibular Lesions: Vestibular Neuropathy
⦁ Definition: Inflammation of the vestibular nerve, usually caused by a viral infection, leading to sudden onset of vertigo.
⦁ Symptoms:
⦁ Sudden, severe vertigo.
⦁ Nausea, vomiting.
⦁ Imbalance, difficulty walking.
⦁ No hearing loss (distinguishes from labyrinthitis).
⦁ Diagnosis:
⦁ Clinical History: Sudden onset vertigo without hearing loss.
⦁ Vestibular Testing: Caloric test showing unilateral hypofunction, head impulse test.
⦁ Exclusion of Other Causes: MRI to rule out central causes.
⦁ Treatment:
⦁ Medications: Vestibular suppressants (meclizine, diazepam) for acute symptoms, corticosteroids.
⦁ Antiviral Therapy: If a viral etiology is strongly suspected.
⦁ Vestibular Rehabilitation: Exercises to improve balance and compensate for vestibular loss.
- Peripheral Vestibular Lesions: Benign Paroxysmal Positional Vertigo (BPPV)
⦁ Definition: A common cause of vertigo resulting from dislodged otoliths (calcium carbonate crystals) within the semicircular canals of the inner ear.
⦁ Symptoms:
⦁ Brief episodes of vertigo, typically lasting less than a minute.
⦁ Triggered by specific head movements (e.g., rolling over in bed, looking up).
⦁ Nausea, sometimes vomiting.
⦁ Diagnosis:
⦁ Dix-Hallpike Maneuver: Elicits vertigo and characteristic nystagmus.
⦁ Other Positional Tests: Supine roll test for horizontal canal BPPV.
⦁ Treatment:
⦁ Repositioning Maneuvers: Epley maneuver (for posterior canal BPPV), Semont maneuver, Brandt-Daroff exercises.
⦁ Medications: Vestibular suppressants for acute episodes, not recommended long-term.
- Peripheral Vestibular Lesions: Acoustic Neuroma
⦁ Definition: A benign tumor arising from the Schwann cells of the vestibulocochlear nerve (cranial nerve VIII), also known as vestibular schwannoma.
⦁ Symptoms:
⦁ Progressive, unilateral sensorineural hearing loss.
⦁ Tinnitus (ringing in the ear).
⦁ Balance disturbances.
⦁ Facial numbness or weakness (if tumor compresses facial nerve).
⦁ Diagnosis:
⦁ Audiometry: To assess hearing loss.
⦁ MRI with Contrast: To visualize the tumor.
⦁ Brainstem Auditory Evoked Potentials (BAEPs): To evaluate nerve function.
⦁ Treatment:
⦁ Observation: Small, asymptomatic tumors.
⦁ Surgery: Microsurgical removal, especially for larger tumors.
⦁ Radiotherapy: Stereotactic radiosurgery (e.g., Gamma Knife) for medium-sized tumors.
- Glossopharyngeal Neuralgia
⦁ Definition: A rare condition characterized by severe, episodic pain in the areas innervated by the glossopharyngeal nerve (throat, tongue, ear).
⦁ Symptoms:
⦁ Sudden, sharp, stabbing pain lasting seconds to minutes.
⦁ Triggered by swallowing, chewing, talking, coughing, or yawning.
⦁ Pain typically affects one side.
⦁ Diagnosis:
⦁ Clinical History: Description of characteristic pain and triggers.
⦁ Exclusion of Other Causes: MRI or CT scan to rule out tumors, vascular anomalies.
⦁ Treatment:
⦁ Medications: Anticonvulsants (carbamazepine, gabapentin), antidepressants (amitriptyline).
⦁ Nerve Blocks: Local anesthetics or steroids.
⦁ Surgery: Microvascular decompression, radiofrequency ablation, or nerve sectioning in refractory cases.
- Headache and Facial Pain: Classification, Red Flags, Treatment
⦁ Classification:
⦁ Primary Headaches:
⦁ Migraine: Pulsatile, often unilateral, associated with nausea, photophobia, phonophobia, and sometimes aura.
⦁ Tension-Type Headache: Bilateral, non-pulsatile, pressure or tightness, mild to moderate intensity.
⦁ Cluster Headache: Severe, unilateral, periorbital pain, associated with autonomic symptoms (tearing, nasal congestion).
⦁ Secondary Headaches: Caused by an underlying condition (e.g., infection, tumor, vascular disorder, trauma).
⦁ Red Flags(“SNOOP”):
⦁ S: Systemic symptoms (fever, weight loss) or secondary risk factors (HIV, cancer).
⦁ N: Neurological symptoms (confusion, weakness, vision changes).
⦁ O: Onset (sudden, “thunderclap” headache).
⦁ O: Older age (>50 years) at onset.
⦁ P: Previous headache history (new or different headache).
⦁ Treatment:
⦁ Primary Headaches:
⦁ Migraine: Acute (triptans, NSAIDs), preventive (beta-blockers, antiepileptics, CGRP inhibitors).
⦁ Tension-Type: NSAIDs, muscle relaxants, stress management, physical therapy.
⦁ Cluster: Acute (oxygen, sumatriptan), preventive (verapamil, corticosteroids).
⦁ Secondary Headaches: Treat underlying cause (e.g., antibiotics for infection, surgery for tumors).
- Involuntary Movements: Types of Dyskinesias
⦁ Types:
⦁ Tremor: Rhythmic, oscillatory movements (e.g., Parkinson’s disease, essential tremor).
⦁ Chorea: Irregular, dance-like movements (e.g., Huntington’s disease, Sydenham’s chorea).
⦁ Athetosis: Slow, writhing movements (e.g., cerebral palsy).
⦁ Dystonia: Sustained muscle contractions causing twisting and repetitive movements (e.g., cervical dystonia, writer’s cramp).
⦁ Myoclonus: Sudden, brief, shock-like contractions (e.g., myoclonic epilepsy, Creutzfeldt-Jakob disease).
⦁ Tics: Sudden, repetitive movements or sounds (e.g., Tourette’s syndrome).
⦁ Diagnosis and Treatment:
⦁ Clinical Examination: Observation of movement patterns, neurological examination.
⦁ Imaging and Laboratory Tests: MRI, genetic testing, blood tests to identify underlying causes.
⦁ Medications: Dopamine antagonists for tics, anticonvulsants for myoclonus, botulinum toxin for dystonia.
⦁ Physical and Occupational Therapy: To improve function and manage symptoms.
- Acute Stroke: Symptoms of Ischemic Stroke, The National Institutes of Health Stroke Scale (NIHSS)
⦁ Symptoms of Ischemic Stroke:
⦁ Sudden numbness or weakness, especially on one side of the body.
⦁ Sudden confusion, trouble speaking, or understanding speech.
⦁ Sudden trouble seeing in one or both eyes.
⦁ Sudden trouble walking, dizziness, loss of balance or coordination.
⦁ Sudden severe headache with no known cause.
⦁ NIHSS:
⦁ Purpose: Quantify the severity of stroke-related neurological deficits.
⦁ Components: Level of consciousness, gaze, visual fields, facial palsy, motor arm and leg function, limb ataxia, sensory loss, language, speech, and extinction/inattention.
⦁ Scoring: Higher scores indicate greater severity of deficits, used to guide treatment decisions and predict outcomes.
- Acute Stroke: Risk Factors, Diagnosis, Treatment
⦁ Risk Factors:
⦁ Modifiable: Hypertension, diabetes, smoking, hyperlipidemia, atrial fibrillation, obesity, physical inactivity, excessive alcohol use.
⦁ Non-Modifiable: Age, gender (higher in men), race (higher in African Americans), family history, prior stroke or TIA.
⦁ Diagnosis:
⦁ Clinical Examination: Assessment of neurological deficits.
⦁ Imaging:
⦁ CT Scan: Initial imaging to rule out hemorrhage.
⦁ MRI: Detailed imaging to identify ischemic areas.
⦁ Other Tests: Carotid ultrasound, echocardiogram, blood tests (glucose, coagulation profile).
⦁ Treatment:
⦁ Ischemic Stroke:
⦁ Acute: Thrombolytics (e.g., tPA within 4.5 hours of onset), mechanical thrombectomy (for large vessel occlusions).
⦁ Secondary Prevention: Antiplatelet agents (aspirin, clopidogrel), anticoagulants (for atrial fibrillation), statins, blood pressure control, lifestyle modifications.
⦁ Hemorrhagic Stroke:
- Acute Stroke: Symptoms of Intracerebral Hemorrhage
⦁ Symptoms:
⦁ Sudden severe headache.
⦁ Nausea and vomiting.
⦁ Sudden loss of consciousness or decreased level of consciousness.
⦁ Neurological deficits (similar to ischemic stroke): Weakness, numbness, difficulty speaking, vision changes.
⦁ Seizures (in some cases).
⦁ Diagnosis:
⦁ CT Scan: Quickly identifies bleeding and its location.
⦁ MRI: Provides detailed images, especially for smaller or more complex hemorrhages.
⦁ Angiography: To identify underlying vascular abnormalities (e.g., aneurysms, arteriovenous malformations).
- Subarachnoid Hemorrhage. The Hunt-Hess Scale for Aneurysmal Subarachnoid Hemorrhage
⦁ Definition: Bleeding into the subarachnoid space, often due to ruptured aneurysm.
⦁ Symptoms:
⦁ Sudden, severe headache (“thunderclap headache”).
⦁ Nausea and vomiting.
⦁ Stiff neck.
⦁ Loss of consciousness.
⦁ Focal neurological deficits.
⦁ Hunt-Hess Scale:
⦁ Grade I: Asymptomatic or mild headache, slight nuchal rigidity.
⦁ Grade II: Moderate to severe headache, nuchal rigidity, no neurological deficit other than cranial nerve palsy.
⦁ Grade III: Drowsiness, confusion, mild focal neurological deficit.
⦁ Grade IV: Stupor, moderate to severe hemiparesis.
⦁ Grade V: Coma, decerebrate posturing.
- Subarachnoid Hemorrhage: Diagnosis, Treatment
⦁ Diagnosis:
⦁ Clinical Examination: Sudden severe headache, neurological deficits.
⦁ Imaging:
⦁ CT Scan: Initial imaging to detect subarachnoid blood.
⦁ Lumbar Puncture: If CT is negative but clinical suspicion remains high, to detect blood or xanthochromia in CSF.
⦁ Angiography: To identify and locate aneurysm or other vascular abnormalities.
⦁ Treatment:
⦁ Initial Management: Stabilization, blood pressure control, pain management, antiemetics.
⦁ Surgical:
⦁ Aneurysm Clipping: Surgical clipping of the aneurysm to prevent rebleeding.
⦁ Endovascular Coiling: Minimally invasive procedure to occlude the aneurysm.
⦁ Supportive Care: Intensive monitoring, prevention of complications (e.g., vasospasm, hydrocephalus), rehabilitation.
- Traumatic Brain Injury (TBI): Subdural and Epidural Hematoma. Differential Diagnosis, Diagnosis, Treatment
⦁ Definitions:
⦁ Subdural Hematoma: Blood collection between the dura and arachnoid mater, often due to tearing of bridging veins.
⦁ Epidural Hematoma: Blood collection between the dura mater and the skull, typically caused by arterial bleeding (e.g., middle meningeal artery) following a skull fracture.
⦁ Symptoms:
⦁ Subdural Hematoma: Gradual onset of headache, confusion, drowsiness, weakness, seizures.
⦁ Epidural Hematoma: Loss of consciousness followed by a lucid interval, then rapid deterioration (headache, vomiting, confusion, hemiparesis).
⦁ Diagnosis:
⦁ Imaging: CT scan to visualize hematoma and assess severity.
⦁ Differential Diagnosis: Rule out other causes of altered mental status or focal neurological deficits (e.g., stroke, encephalitis).
⦁ Treatment:
⦁ Subdural Hematoma:
⦁ Small/Chronic: Observation, repeat imaging, medical management.
⦁ Large/Acute: Surgical evacuation (burr hole, craniotomy).
⦁ Epidural Hematoma:
⦁ Small/Stable: Observation, serial imaging.
⦁ Large/Rapidly Expanding: Emergency craniotomy and hematoma evacuation.
- Arteriovenous Vascular Malformations: Clinical Features, Diagnosis, Treatment
⦁ Definition: Abnormal tangle of blood vessels connecting arteries and veins, bypassing capillary beds, prone to bleeding.
⦁ Clinical Features:
⦁ Seizures.
⦁ Headache.
⦁ Focal neurological deficits.
⦁ Intracranial hemorrhage (sudden onset of severe symptoms).
⦁ Diagnosis:
⦁ Imaging:
⦁ MRI/MRA: Detailed visualization of vascular malformation.
⦁ CT Scan: To detect bleeding.
⦁ Angiography: Gold standard for detailed assessment of AVM architecture.
⦁ Treatment:
⦁ Observation: For small, asymptomatic AVMs.
⦁ Surgical Resection: For accessible AVMs with a high risk of bleeding.
⦁ Endovascular Embolization: Minimally invasive procedure to reduce blood flow to the AVM.
⦁ Radiosurgery: Focused radiation to induce gradual obliteration of the AVM.
- Speech Disorders: Types of Aphasia
⦁ Types:
⦁ Broca’s Aphasia: Non-fluent, expressive aphasia. Patients have difficulty speaking and writing but understand spoken and written language relatively well.
⦁ Wernicke’s Aphasia: Fluent, receptive aphasia. Patients speak in long sentences that have no meaning, add unnecessary words, and create new words. They have severe comprehension difficulties.
⦁ Global Aphasia: Severe form involving both expressive and receptive difficulties. Patients can neither speak nor understand spoken language.
⦁ Conduction Aphasia: Fluent speech with good comprehension but poor repetition and frequent errors in word choice.
⦁ Anomic Aphasia: Difficulty in naming objects and finding words, with relatively preserved speech and comprehension.
⦁ Diagnosis:
⦁ Clinical Evaluation: Speech and language assessment by a speech-language pathologist.
⦁ Imaging: MRI or CT scan to identify brain lesions causing aphasia.
⦁ Treatment:
⦁ Speech and Language Therapy: Tailored exercises to improve communication skills.
⦁ Supportive Communication Strategies: Using alternative communication methods, family education.
⦁ Medication: Potential use of medications to enhance language recovery (research ongoing).
- Coma: Glasgow Coma Scale, Diagnostic Tests, Treatment
⦁ Glasgow Coma Scale (GCS):
⦁ Components:
⦁ Eye Opening(4 points): Spontaneous, to speech, to pain, none.
⦁ Verbal Response(5 points): Oriented, confused, inappropriate words, incomprehensible sounds, none.
⦁ Motor Response(6 points): Obeys commands, localizes pain, withdraws from pain, flexion (decorticate), extension (decerebrate), none.
⦁ Scoring: Total score ranges from 3 to 15; lower scores indicate deeper levels of coma.
⦁ Diagnostic Tests:
⦁ Initial Assessment: ABCs (airway, breathing, circulation), GCS.
⦁ Imaging: CT scan, MRI to identify structural causes (e.g., hemorrhage, stroke, tumor).
⦁ Laboratory Tests: Blood tests (glucose, electrolytes, liver and kidney function, toxicology screen), lumbar puncture (if infection suspected).
⦁ EEG: To assess for seizure activity.
⦁ Treatment:
⦁ Stabilization: Airway management, ventilation, circulatory support.
⦁ Treat Underlying Cause: Addressing infections, controlling seizures, managing intracranial pressure (ICP).
⦁ Supportive Care: Preventing complications (e.g., pressure sores, infections), nutritional support, rehabilitation.
- Parkinson Disease: Clinical Features, Diagnosis, Treatment
⦁ Clinical Features:
⦁ Resting tremor (pill-rolling tremor).
⦁ Bradykinesia (slowness of movement).
⦁ Rigidity (muscle stiffness).
⦁ Postural instability (balance problems).
⦁ Other Symptoms: Mask-like facial expression, shuffling gait, micrographia, non-motor symptoms (depression, sleep disturbances, cognitive impairment).
⦁ Diagnosis:
⦁ Clinical Examination: Based on cardinal motor symptoms.
⦁ Response to Dopaminergic Medication: Improvement with levodopa confirms diagnosis.
⦁ Imaging: DaTscan (dopamine transporter scan) to support diagnosis.
⦁ Treatment:
⦁ Medications:
⦁ Levodopa/Carbidopa: Mainstay of treatment.
⦁ Dopamine Agonists: Ropinirole, pramipexole.
⦁ MAO-B Inhibitors: Selegiline, rasagiline.
⦁ COMT Inhibitors: Entacapone, tolcapone.
⦁ Surgical: Deep brain stimulation (DBS) for advanced cases.
⦁ Supportive Therapies: Physical therapy, occupational therapy, speech therapy.
- Multiple Sclerosis: Clinical Features, Diagnosis, Treatment
⦁ Clinical Features:
⦁ Relapsing-Remitting MS (most common): Episodes of neurological dysfunction followed by periods of remission.
⦁ Symptoms: Optic neuritis, motor weakness, sensory disturbances, ataxia, spasticity, bladder/bowel dysfunction, cognitive impairment.
⦁ Diagnosis:
⦁ Clinical History and Examination: Based on relapses and remissions of neurological symptoms.
⦁ MRI: Lesions in the brain and spinal cord.
⦁ Lumbar Puncture: Oligoclonal bands in CSF.
⦁ Evoked Potentials: Slowed conduction in visual or somatosensory pathways.
⦁ Treatment:
⦁ Acute Relapses: Corticosteroids (methylprednisolone).
⦁ Disease-Modifying Therapies: Interferons, glatiramer acetate, natalizumab, fingolimod, ocrelizumab.
⦁ Symptomatic Treatment: Medications for spasticity, pain, fatigue, bladder dysfunction.
- Cerebral Sinus Thrombosis: Clinical Features, Diagnosis, Treatment
⦁ Clinical Features:
⦁ Headache (often severe).
⦁ Visual disturbances.
⦁ Seizures.
⦁ Focal neurological deficits (e.g., weakness, numbness).
⦁ Altered mental status.
⦁ Diagnosis:
⦁ Imaging:
⦁ MRI/MRV: Magnetic resonance venography to visualize thrombosis.
⦁ CT/CTV: Computed tomography venography.
⦁ Laboratory Tests: Coagulation profile, tests for thrombophilia, infection markers.
⦁ Treatment:
⦁ Anticoagulation: Heparin, followed by oral anticoagulants (warfarin).
⦁ Thrombolysis: In selected severe cases.
⦁ Management of Intracranial Hypertension: Measures to reduce intracranial pressure.
⦁ Treatment of Underlying Conditions: Infections, hypercoagulable states.
- Myasthenia Gravis: Clinical Features, Diagnosis, Treatment
⦁ Clinical Features:
⦁ Fluctuating muscle weakness, worsening with activity.
⦁ Ptosis (drooping eyelids), diplopia (double vision).
⦁ Bulbar symptoms: Dysphagia (difficulty swallowing), dysarthria (difficulty speaking).
⦁ Generalized weakness affecting limbs.
⦁ Diagnosis:
⦁ Clinical Examination: Fatigability of muscles, ice pack test for ptosis.
⦁ Antibody Tests: Acetylcholine receptor antibodies, MuSK antibodies.
⦁ Electrophysiology: Repetitive nerve stimulation, single-fiber EMG.
⦁ Imaging: Chest CT to detect thymoma.
⦁ Treatment:
⦁ Acetylcholinesterase Inhibitors: Pyridostigmine.
⦁ Immunosuppressive Therapy: Corticosteroids, azathioprine, mycophenolate mofetil.
⦁ Thymectomy: Surgical removal of thymus gland.
⦁ Plasmapheresis/IVIG: For myasthenic crisis or severe exacerbations.
- Brain Tumors: Clinical Features, Diagnosis, Treatment
⦁ Clinical Features:
⦁ Headache, often worse in the morning.
⦁ Seizures.
⦁ Focal neurological deficits (e.g., weakness, sensory changes).
⦁ Cognitive or personality changes.
⦁ Nausea and vomiting.
⦁ Diagnosis:
⦁ Imaging: MRI with contrast, CT scan.
⦁ Biopsy: Histopathological examination to determine tumor type.
⦁ Additional Tests: Functional MRI, PET scan for metabolic activity.
⦁ Treatment:
⦁ Surgery: Resection of the tumor.
⦁ Radiation Therapy: External beam radiation, stereotactic radiosurgery.
⦁ Chemotherapy: Temozolomide, other agents depending on tumor type
