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Flashcards in NB 2 CRAM Deck (117):
1

11⁄2 Syndrome

Cause: Lesion of PPRF & MLF on one side due to infarction ormultiple sclerosisSymptoms: Inability of ipsilater eye to perform horizonal eye movements & of contralateral eye to adduct normally (usually exhibiting nystagmus on terminal abduction)

2

Alcohol detoxification

Symptoms: Develop 3-8 hours after they are deprived from alcohol. Increased NorE (Hyperhidrosis, tachycardia, hypertension, tremor). Increased dopamine (psychotic symptoms). Increased glutamate (epileptic seizures). Withdrawal symptoms typically last 5-7 days. 5% develop delirium 2-3 days after they've stopped drinking & in some cases it can be fatal.

3

Alcoholic polyneuropathy

Cause: Due to toxic effect of alcohol or associated nutritional deficiency (e.g. B1 [thiamin] deficiency)Symptoms: Symmetric loss. Starts w/ sensory loss in distal foot & leg. Later motor loss in lower leg.

4

Alexia

Cause: Damage in splenium (posterior part of corpus callosum) causing a disconnection between visual & language systemSymptoms: Patient's can't read in left visual field b/c visual input can't get to language centers on left side of brain

5

Alzheimers disease

Cause: Loss of neurons (selective of dopamine, noradrenergic, & cholinergic), most notably in hippocampus, entorhinal cortex, association cortices, basal nucleus of MeynertSymptoms:Histological signs: (1) Neuritic Senile Plauqes: Extracellular deposits containing neuritic & glial processes w/ central core of amyloid beta protein (chromosome 21) due to additional cleavage of beta chain by beta-secretase & gamma-secretase (normally just alpha-secretase) (2) Neurofibrillary tangles: Intracellular paired helical fragments due to hyperphosphorylated Tau proteins (stabalize MAPs) that occurs during neuron degeneration (3) Granulovacular degeneration: Intracellular circular zones of cytoplasm

6

Amnesia (anterograde)

Inability to form new memories

7

Amnesia (retrograde)

Loss of old memories

8

Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease)

Cause: LMN (weakening & later destruction) with damage to parts of pyramidal tract & precentral gyrus laterSymptoms: Begins asLMN syndromein one or both hands.LMN syndromeprogresses all other motor neurons (e.g. arms, legs, bulbar motor nuclei)Prognosis: Death 3-5 years after diagnosis

9

Androgen Insensitivity Syndrome

Cause: X-linked recessive in which androgen receptor for testosterone is defectiveSymptoms: If XY testes develop but don't descend b/c testosterone produced has no effect. Normal female external genitalia, primary amenorrhea, sparse to absent development of pubic or axillary hair, female breasts & body shape, have female sexual identity

10

Anterior spinal artery syndrome

Cause: Blockage of anterior spinal artery. Resutls in lesioning of LMN in anterior horn (corticospinal tracts) & ALS.Symptoms:UMN syndrome, Loss of pain & temp, Urine retention, Sexual function impaired

11

Athetosis

Cause: May accompany ahemiplagiaSymptoms: Slow writhing abnormal movements of limbs, trunk, head, face, or tongue

12

Atonic bladder

Cause: Lesion of dorsal nerve roots of sacral segmentsSymptoms: Fullness sensation of bladder lost, incontinence, dribbline, no mictrition reflex

13

Automatic bladder

Cause: Transection of spinal cord w/ reovery of reflexes in sacral segmentsSymptoms: Bladder fills to threshold pressure & spontaneous reflex leads to emptying

14

Ballismus

Cause: Lesion of the subthalamic nucleus (so symptoms usually unilateral→hemiballismus). Dopamine receptor agonists can also cause ballismus due to overactivity of direct & underactivity of indirect pathways.Symptoms: Rapid, exaggerated, flinging, or abnormal rotation of limb on side contralateral to the lesion

15

Binuclear Ophthalmoplegia

Cause: Bilateral MLF lesionSymptoms: Inability to adduct either eye upon horizontal gaze (convergence intact b/c center responsible for that is usually intact)

16

Bipolar disorder

Cause: Likely polygenetic with a psychodynamic aspectSymptoms: Severe cyclic mood changes (severe highs followed by lows). If maniac periods aren't treated in time they may develop into psychosis.Brain activity: Area in prefrontal cortex below genu in corpus callosum has reduced activity during depressive phase & increased during manic phase.Treatment: Mood stabalizers, pyschotherapy, antidepressants

17

Bell's palsy

Same asFacial palsy.

18

Brain death

Characterized by: Not responsive to stimuli, No spontaneous respiration, pupils dilated & unreactive to light, No vestibulo-ocular reflex, No corneal reflex, Isoelectric EEG

19

Broca's aphasia

Cause: Lesion of Broca's area [44-pars opercularis, 45-pars triangularis]Symptoms: Speech & writing are difficult with missed syllables. Repetition & naming are abnormal but better than spontaneous speech. Comprehension is only slightly affected.

20

Brown Sequard Syndrome

Cause: Hemisection of spinal cordSymptoms: IpsilateralLMN syndrome@ level of lesion &UMN syndromebelow level of lesion. Contralateral loss of pain & temp. Ipsilateral loss of touch, vibration, & propioreception.

21

Carpal Tunnel Syndrome

Cause: Compression of median nerve in carpal tunnel (tendon of flexor pollicis longus, flexor digitorume longus & brevis)Symptoms: Pain or tingnling sensation in hands radiating up arm, Weakness & wasting of innervated muscles,Population: Women more likely

22

Cataplexy (parasomnia)

Symptoms: Partial or complete sleep paralysis of skeletal muscle (flaccid w/ areflexia) @ start or end of sleep. Awareness preserved. Most last few seconds.Population: Common in narcolepsy. Mostly in children.

23

Central medullary syndrome

Cause: Usually pathological cyst that usually develops ventrally & usually in the cervical cord that increases pressure on vetral horns & the anterior white commisureSymptoms:LMN syndrome& loss of pain & temp at level of cyst, stiffness, headaches, & possibley ANS disfunction

24

Cerebellar lesions (alcohol)

Cause: Loss of neurons (particullarly Purkinje cells) in cerebellar cortex of anterior lobe of & some parts of vermis & gliosis, most likely due to malnutritionSymptoms: Dysmetria of legs, truncal ataxia, lurching gait, intention tremor of trung & legs (NOT arms). Nystagmus, dysarthria, & hypotonia NOT common.Treatment: Alcohol abstinence, improved nutrition. There is improvement but recovery is incomplete.

25

Cerebellar lesions (cerebro- cerebellum)

Cause: Lesion of cerebro cerebellum (plans & times movement, important in learning sequents movements [e.g. piano])Symptoms: Ipsilateral hypotonia, dysdiadochokinesia, rebound phenomenon, dysmetria, intention tremor. Ataxia, decomposition of movement, dysarthria.

26

Cerebellar lesions (spino- cerebellum)

Cause: Lesion of spino cerebellum (organizes posture & limb movement)Symptoms: Imbalance (fall to side of lesion), Gait ataxia, Arm ataxia

27

Cerebellar lesions (vestibulo-cerebellum)

Cause: Lesion of vestibulo cerebellum (balance, head & eye movement organization)Symptoms: Truncal ataxia, wide based stance, can't walk heel-to-toe, Nystagmus, Titubation (head nodding), Head tilt.

28

Cerebellar Stroke

Cause: Usually one sided so symptoms occur on ipsilateral side of lesionSymptoms: Limb & truncal ataxia, dysarthria, intention tremor, limb dysmetria, dysdiadochokinesia, rebound phenomenon.Other symptoms (due to damage in region of infarct): Ipsilateral facial weakness & sensory loss.

29

Cerebellar Tumor (midline)

Cause: Tumor (astrocytoma) in cerebellar midlineSymptoms: Increased ICP (headache, vomiting, papilledema, hydrocephalus). Wide based stance, truncal ataxia, hypotonia (enequal on two sides). Balance disorder (can't tandem walk-heel to toe). Nystagmus.Population: Most commen in children (occuring in 1st decade)

30

Coma

Characterized by: Deep state of unconsciousness. Person is alive but not able to move or respond to environmental stimuli.Glasgow coma scale: Score 3-15. 90% <=8 are in coma & 50% likely to die in 6-8hr. 9-11 moderate severity. >12 minor.Eye Response: (1) No eye opening (2) Eye opening to pain (3) Eye open to verbal command (4) Eye open spontaneousVerbal Response: (1) No verbal response (2) Incomprehensible sound (3) Inapproriate words (4) Confused (5) OrientedMotor Response: (1) No motor response (2) Extension to pain (3) Flexion to pain (4) Withdrawal from pain (5) Localizing pain (6) Obeys commands

31

Complex Regional Pain Syndrome (CRPS)

Cause: Injury resulting persistent pain even after healing either by persistent sypathetic activity or sensitization of noiceptors to norepinephrineSymptoms: Persistent pain, increased sweating

32

Conduction aphasia

Cause: Damage to arcuate fasciculus (connects Wernicke's [22] & Broca's areas [44, 45]).Symptoms: Patient can understand what is said but can't repeat it. When the patient is talking they will recognize mistakes but in their attempts to correct them will only make more.

33

Corticobulbar fiber damage

Cause: E.g. Posterior limb of internal capsule infaractionSymptoms: Contralateral tongue deviation, Deviation of eyes towards side of lesion, Contralateral lower facial muscle paralysis (patient is still able to wrinkle forhead on both sides)

34

Creutzfeld-Jacob disease

Cause: Prion disease resulting in spongiform appearance of cortex

35

Decerebrate posturing

Cause: Lesion below the red nucleus (rostral midbrain)Symptoms: Painful stimulus results in extension of arms & legs

36

Decorticate posturing

Cause: Lesion above the red nucleus (rostral midbrain)Symptoms: Painful stimulus results in flexion of arms & extension of legs

37

Dementia pugilistica

Cause: Repetitive head trauma

38

Diabetes Insipidus (central)

Cause: Lesion of supraoptic or paraventricular nuclei (e.g. head injury) resulting in reduced ADH secretionSymptoms: Excessive thrist, large urine volume

39

Diabetes Mellitus

Cause: Insulin deficiency causes hyperglycemia, which can cause peripheral neuropathiesSymptoms: Sensory (pain & temp) loss (usually symmetric & begins in legs b/c small unmyelinated DRG cells vulnerable to hyperglycemia), Motor disfunction (usually asymmetric), ANS neuropathy.

40

Drug-induced Dyskinesia (Chorea)

Cause: Side effect of L-Dopa, Some anticonvulsangs or antispychotic drugs, which ehance dopaminergic transmission in basal gangliaSymptoms: Ususally choreic movement, Sometimes dysonias (e.g. facial grimacing or eye closure)

41

Drug-induced Parkinsonism

Cause: Drugs that block dopamine receptors or dopamine release.Symptoms: Parkinson's disease like sypmtoms that resolve after withdrawal of the drugs

42

Dyslexia

Cause: Can be inherent or aquired (damage to left lobe). Have smaller cells in magnocellular layers of lateral geniculate nucleus (depth & motion)NEUROSCIENCE: Diseases Symptoms: Problems with print to sound translation, tendency to read words backword, inability to process transient sensory input quickly

43

Dysthmyia

Symptoms:Less severe when compared to major depression. Non-disabling long-term symptoms that result in the patient not function or feeling well.

44

Dystonia

Symptoms: Muscle spasm or sustained posture that are usually segmental resulting in hypertrophy

45

Emotions (Frontal lobe damage)

Symptoms: Indulgence, Irreverence, Impatient

46

Emotions (Temporal lobe damage)

Symptoms: Taming, Flattening of emotion, Increased sexual behavior, Loss of some learned fear response

47

Epilepsy

Primary: No clear cause, no aura, no focal symptomsSecondary: Seizure originates from a focal group: (1) Partial-no consciousness alteration (2) Secondary generalized-consciousness alteration (3) Primary generalized. There is usually an aura preceding onset of parial seizures.Treatment: Reduce Na+ channels [Phenytoin,carbamazepine], Enhance GABA [benzodiazapine,barbituates]

48

Epilepsy (Psychomotor)

Cause: Seizures originating in temporal lobeSymptoms: Olfactory or gustatory hallucinations, followed by mood change, & lapse into dreamy state. Finally a motor phase. After recovery patients can't recall the experince.

49

Facial palsy

Cause: Lesion of corticobulbar tract, facial nuclues, or facial nerveSymptoms: (1) Corticobulbar tract: Contralateral lower face paralysis (2)

50

Fatal familial insomnia

Cause: Prion disease. Selective atrophy of some thalamic nuclei, malfunction of ANS (↑Sympathetics).Symptoms: Progressive untreatable insomnia. Also has motor signs, memory & attention deficit.

51

Friedreich's ataxia

Cause: Spincerebellar degradationSymptoms: Onset in 1st or 2nd decade. Progressive limb & gait ataxia. Absent deep tendon reflexes & sensory axonal neuropathy.Histological signs: Atrophy of dorsal columns, corticospinal tracts, & spinocerebellar tracts

52

Frohlich Syndrome

Cause: Ventromedial hypothalamic syndrome due to damageSymptoms: Disorder of caloric balance charaterized by obesity (besides other symptoms)

53

Gerstmann syndrome

Cause: Lesion of angular gyrus (Area 39), which translates visual patters into meaningful informationSymptoms: Reading & writing very abnormal while Naming is often abnormal

54

Global aphasia

Symptoms: Can't produce or understand language in any form

55

Grand Mal Seizure

Symptoms: A primary generalized seizure (1) Tonic phase-30s (2) Clonic phase-1-2min jerking (3) Postictal phase-sleepy disoriented, headache, muscle soreness,

56

Guillain-Barre

Cause: Autoimmune disorder following viral respiratory or GI infections resulting in demylenation of PNSSymptoms: Progressive muscle weakness & paralysis. Usually have good recovery.Population: Males more commonDiagnosis: Protein in CSF (100-300mg/dL), NCV (nerve conduction velocity), EMG (electromyography), Plasma exchangeTreatment: Immune globulin

57

Hemiplegia

Symptoms: Gait in which one arm held flexed & ipsilateral leg is extended so arm does not swing & leg is swung around to clear ground. May have athetosis.

58

Hirschsprung's Disease

Cause: Reduced motility in distal colon due to parasympathetic dysfunctionSymptoms: Feces gets trapped causing abnormal dilation (megacolon)

59

Horner's Syndrome

Cause: Reduced ipsiliataral sympathetic activity (1) Lesion of hyothalamospinal pathway (2) Compession of sympathetic chain [e.g. apical lung tumor] (3) Postganglion lesion [e.g. tumor in cavernous sinus]Symptoms: Ipsilateral miosis, ptosis, ahydrosis

60

Huntington's Disease

Cause: Bilateral degeneration of striatal neurons with D2 receptors resulting in underactivity of indirect pathway due to excessive # of CAG repeats on chromosme 4 (autosomal dominant)Symptoms: Bilateral dyskinesia, involuntary movement of head, arms, & legs, hypotonia, depressionHistological signs: Striatel atrophy w/ preferential loss of spiny neurons w/ D2 receptors. There is also a reduction in GABA & glutamate decarboxylase.Treatment: (1) Antidepressants to manage depression associated w/ HD. (2) Haloperidol [D2 anatgonist] will increase indirect pathway activity but may lead to difficulty swallowing, speaking, and walking.

61

Hyperthermia

Cause: Lesion of anterior hypothalamusSymptoms: Increase in metabolism, shivering, peripheral vasoconstriction (reduce heat loss)

62

Hypnagogic hallucinations

Symptoms: Pre-sleep dreams.Population: Common innarcolepsy.

63

Hypothermia

Cause: Lesion of posterior hypothalamusSymptoms: Decrease in metabolism & motor activity, peripheral vasodilation (increase heat loss)

64

Internuclear Ophthalmoplegia (MLF

Cause: Lesion of MLFSymptoms: Inability to adduct eye on ipsilateral side of the lesion during horizontal gaze (convergence maintained)

65

Jet lag

Cause: Sudden change of light dark cylce different from internal clockSymptoms: Night time insomnia, daytime sleepiness (since clock is slow flights east are harder to recover from)Treatment: 1-3mg melatonin in evening one hour before going to bed

66

Kluver-Bucy Syndrome

Sames asEmotions (Temporal lobe damage)

67

Kuru

Symptoms: Prion disease

68

Lambert Eaton Syndrome

Cause: Autoimmune (x-linking) Vgated Ca2+ channels in motor neuron terminals (often in small [oat] cell lung cancer)Symptoms: Muscle weakness that improves with activity, Reflexes usually decreasedTreatment:4-aminopyridine,Calcium gluconate, Plasma exchange, Tumor removal

69

Lead poisoning

Cause: Lead in system via lungs, skin, or gutSymptoms (adult): Focal weakness of extensors of fingers, wrist & arms. Bilateral arm weakness & wasting in chronic cases. Virtually no sensory symptoms. Memory & concentration problems.Symptoms (children <6yo): Encephalopathy, Reduced IQ, ADD, Learning disability. High levels can cause mental retardation, como, or death.Symptoms (infants): Encephalopathy

70

Leprocy (Hansen's Disease)

Cause: Infection w/ mycobacterium leprae preferentially proliferate in interior of unmyelinated axons causing nerve compression & ischemiaSymptoms: Skin lesions, Profound sensory lossTransfer: Prolonged contact w/ infected individual. Enters through skin lesion.

71

LMN syndrome

Cause: Any disease process that can damage a LMN (e.g. Amoyotrophic lateral sclerosis, peripheral nerve damage, ect.)Symptoms: Hyporeflexia/areflexia, Flaccid paralysis, Muscle wasting, Fasciculations (sponataneous twitches), Fibrillations (EMG recordings of fasciculations)

72

Locked in Syndrome

Cause: Usually develops after blockage of basilar artery resulting in enormous pontine infarctionSymtpoms: Complete paralysis of voluntary muslces in all parts of body except for those that control verticle eye movements (mesencephalic reticular formation in midbrain organizes verticle eye movements), Fully aware & able to think

73

Louis-Bar Syndrome

Cause: Autosomal recessive disorder on chromosome 11 that causes massive loss of Purkinje cells in cerebellar cortexSymptoms (motor): Ataxia at first walking, dysarthria, facial weakness, oculomotor weakness, delayed motor developmentSymptoms (other): Growth & sexual development retardation, Immune deficiency, Death within 3 decades

74

Major Depression

Symptoms: Inability to work, focus, eat, sleep, & enjoy pleasurable activities

75

Mid-Pontine syndrome

Cause: Reduced blood flow to anteromediallateral pons due to (1) Short circumferential branches of basilar arterySymptoms: (1) Hemiataxia (ipsilateral) (2) Heimplegia (contralateral) (3) Hemianesthesia of face (ipsilateral) (4) Hemiplegia of muscle of mastication (ipsilateral)

76

Multiple sclerosis

Description: Autoimmune (Type IV Hypersensitivity[delayed type], may be due tomolecular mimicry)Symptoms: Vision loss [CN II only CN affected], Diplopia [Processes affecting conjugate eye movements affected], Muscle weakness [Corticospinal tract], Poor coordination, balance, & speech [Cerebellum], Altered sensation [Lesions in spinal cord]Treatment: Symptoms reduce in colder temperatures due to improved conductionDefect: Oligoclonal expansion ofTh1memory cells against a variety of nerve associated phospholipids/glycolipidsResult: Nerve cell death results in release of MBP (myelin basic protein) & other CNS proteins resulting in antibodies against them, further exacerbating problem through attraction of phagocytes & complement activationDiagnosis: Oligoclonal immunoglobulin in CSF (anti-MBP, etc.)Population: Female:Male (2:1)Susceptibility: Increased with HLA-DR2

77

Muscular dystrophy (Duchenne)

Cause: X-linked recessive disorder resulting in absence of muscle protein dystrophinSymptoms: Progressive weakness & muscle degeneration. Onset (3-5) years, Inability to walk (10-15) years, Inability to breath 20 years.

78

Myasthenia

Cause: Any disease of the synaptic cleft (e.g. breif nAChR opening times, abnormal ACh to nAChR binding)

79

Myasthenia Gravis

Cause: Autoimmune (x-linking) of nAChR channels in NMJ resulting in endocytosis. Sometimes associated w/ tymic tumors.Symptoms: Voluntary muscle weakness that increases w/ activity. Eye muscles often affected first (ptosis, double vision). Swallowing difficulty (frequent chocking), Breathing difficultyTreatment:Neostigmine,Pyridostigmine,Prednisone,Cortisone,Azathioprine,Cyclosporine, Plasma exhange, Thymectomy

80

Myotonia

Cause: Any defect in transmission of electrical impulses in the muscleNEUROSCIENCE: Diseases

81

Myotonia congenita

Cause: Autosomal dominant disease where there is reduction of Cl- channels in muscle membrane resulting in slow muscle relaxation b/c Cl- channels are essential in keeping membrane potential near Ecl- during AP recovery when K+ ions are accumulating in transvers tubule systemSymptoms: Increased excitability, K+ accumulation in transverse tubule system can lead to depolarization & spontaneous firing after the end of nerve stimulation, Muscle stiffness, Atrophy

82

Narcolepsy

Symptoms: Frequent day-time sleep attacks, REM within 10 minutes of sleep onset,Cataplexy&hypnagogic hallucinationscommon, Day-time sleepiness can causesleep apneawhich can reduce latency to sleep 2min [5min normal].

83

Nightmares (parasomnia)

Symptoms: Usually awakenings from REM w/ detailed recall of dreamPopulation: Mostly in children

84

Opiate detoxification

Cold: GI flu symptoms, Tachycarida, Hypertension, 2nd & 3rd days are worst, Not longer than 5-7 days, Hyposomnia can continue for weeksWarm:Methadoneused to replace opiates & dose reduced over 3 weeks, High chance of break off, Hypertension, Tachycardia

85

Panic disorder

Cause: Characterized by reducedbenzodiazapinebinding sits in frontal lobe than in normal brains

86

Paraplegia

Cause: Bilateral spinal cord injurySymptoms:LMN syndrome@ level of lesion &UMN syndromebelow. Urine retention. After several months flexor spasms decrease w/ development of stage of paraplegia in flexion. Loss of ALL somatosensory perception below the lesion.

87

Parkinson's

Cause: Degeneration of dopaminergic neurons in SNc. Lesions also in locus ceruleus, raphe nuclei, basal nucleus of Meynert, cerebral cortex, central & peripheral ANS.Symptoms: Resting tremor (5Hz) that is suppressed during voluntary movement, Poor postural reflexes, Rigidity, Stooped posture, Slow shuffling gait, Poor arm swinging, Glabellar reflex, Impaired speech, DementiaStages: (1) Unilateral (2) Bilateral w/ postural reflexes (3) Bliateral w/o postural reflexes (4) Severe disability w/ some movement (5) AkinesiaHistological signs: Absence of neuromelanin in SNc (loss of black pigmentation), Selective loss of some noradrenergic & cholinergic neurons, Lewy bodies (granules containing protein) in degenerating cellsTreatment:L-dopa&Carbidopa(Sinemet),Bromocriptine,Pergolide,Amantadine,Selegiline,Entacapone,Tolcapone,Benztropine. Surgically lesion subthalamic nucleus, Gpi, Thalamus. Deep brain stimulation.

88

Periodic Limb Movements in Sleep (PLMS)

Symptoms: Periodic movements (30s interval) during NREM.

89

Persistent vegetative state

Characterized by: Sometimes develops after coma. Lost ability to think & are not aware of environment [no higher brain function] but still able to perform NON-cognitive function. Unable to respond to meaningful environmental stimuli.

90

Petit Mal Seizure

Symptoms: Absence seizure of children, 10s cessation of all motor activity, loss of consciousness, no postictal period

91

Pfiesteria piscicida (dinoflagellate) toxin

Symtpoms: Toxin upon skin contact or inhalation causes severe nuerological symptoms including, confusion, disorientation, severe memory loss, & poor concentration

92

Pick's disease

Symptoms: Dementia that is clinically difficult to distinguish from AD at onset. Death within 10 years. Behavioural disturbances & aphasia.Histological signs: (1) Cortical atrophy localized in frontal or temporal lobe (usually unilateral) (2) Astrogliosis w/ many residual neurons containing Pick's bodies composed of densely packed neurofilaments (3) Depletion of cholinergic neurons (particularly in basal nucleus of Meynert)Population: Women are more at risk

93

Poliomyelitis

Cause: Viral infection that affects mostly motor neurons in ventral hornsSymptoms: Muscle weakenss, in severe cases permanent paralysis & deathTransfer: Contact with infected secretions

94

Progeria

Cause: Genetic defect in protein that normally holds the nucleus & cells togetherSymptoms: Acclerated aging evident at about 2 years after birth & children die between 8-21 years of heart disease

95

REM Behaviour Disorder

Symptoms: Abnormal muscle activity during REM (e.g. chin & arms, NOT legs). Suffer vivid dream enactment.

96

Restless Legs Syndrome (RLS)

Symptoms: Urge to move legs when sitting or lying delaying sleep onset.

97

Schizophrenia

Cause: Likely polygenetic with a psychodynamic aspectSymptoms: Cognitive disfunction, Social/occupational dysfunction, Disorganized speech, Grossly disorganized or catatonic behaviorPrognosis: Generally poor with pateints with negative symptoms (loss of function) having a poorer progonis than those with positive ones (gain of function)Treatment:Haloperidol,Perphenazine,Clozapine,Olazapine

98

Seasonal Affective Disorder (SAD)

Symptoms: Depression during seasons of reduced light

99

Sleep apnea

Types: (1) Obstructive (2) Central: Disruption of respiratory centers in pons (3) Mixed: Central & Obstructive (4) Hypnograms. Mean latency to sleep 3min [5min normal].

100

Sleep Terrors (parasomnia)

Symptoms: Partial arousals from NREM. Often associated w/sleep walking.Population: Most commen in children.

101

Sleep walking (parasomnia)

Symptoms: Occurs in first 1-2 hours of sleep. Usually NREM-4.

102

Slow channel syndrome

Cause: Inherited rare condition that results in prolonged opening of nAChR when ACh binds causing a depolarizing blockSymptoms: Muscle weakness, Rapid fatigue, Progressive atrophy

103

Spasmodic torticollis

Symptoms: Dystonia of the neck (e.g. SCM muscle)

104

Spinal shock

Cause: Initial stage of UMN syndrome, resulting in flaccid paralysis (mechanism is not well understood)

105

Sydenham's chorea

Cause: Autoimmune disease that is a significant feature of rheumatic fever causing basal ganglion inflammationSymptoms: Onset between 5-15yo & a few month after infection. Choreic movements may be unilateral & recovery is good for nearly all patients.Population: Female:Male (3:1)

106

Tardive Dyskinesia

Cause: Some antipsychotic drugs (e.g.Haloperidol,Perphenazine)Symptoms: Commonly stereotypic movements of jaw, lips, & tonguePopulation: Older patients at more risk of disorder even after drugs are discontinued

107

Tic syndromes

Symptoms: Sterotyped movements that are usually transient & coordinated

108

Tongue deviation on protrusion

UMN damage: Deveiation towards contralateral side (e.g. posterior limb of internal capsule infaraction)LMN damage (CN XII): Deviation towards side of lesion

109

Tourette's syndrome

Cause: Autosomal dominant diseaseSymptoms: Onset @ 7yo. Multifocal tics & may have hyperactivity disorderPopulation: Female:Male (1:9)

110

Transcortical motor aphasia

Cause: Lesion in cortex superior to Broca's area (44 & 45)Symptoms: Same as Broca's aphasia but less severe & repitition is preserved. Usually much better at naming compared with spontaneous speech.

111

Transcortical sensory aphasia

Cause: Lesion in secondary association cortex (perisylvian area)Symptoms: Fluent speech w/ impaired comprehension, Naming proglems, Normal repetition, Semantic retrieval deficit, Normal syntax and phonetics. Inability to speak spontaneously.

112

Transient global amnesia

Cause: TIA, many othersSymptoms: Brief phase of retrograde amnesia associated w/ a sudden anterograde amnesia lasting minutes to days.

113

UMN syndrome

Cause: Damage to motor cortex or axonsSymptoms: Initial period of flaccidity (spinal shock). Followed by hyperreflexia, Extensor plantar response (Babiski reflex), No muscle wasting, Urine retention, Sexual disfunction. Symptoms are ipsilateral if below pyramidal dessucation (in medulla) & contralateral if above.

114

Wallenberg's syndrome

Cause: Reduced blood flow to posterolateral medulla due to (1) Posterior Inferior Cerebellar Artery (PICA) occlusion (2) Vertebral Artery occlusionSymptoms: (1) Difficulties swallowing, hoarseness (2) Dizziness, nausea & vomiting (3) Nystagmus, problems w/ balance & gait (4) Loss of pain & temp on one side of face & opposite side of body (5) Uncontrollable hiccups (sometimes)

115

Weber's syndrome

Cause: Reduced blood flow to anteromedial midbrain due to occlusion of short penetrating branches off of (1) Basilar artery (2) Posterior communicating arterySymptoms: (1) Parkinsonism (contralateral) (2) Hemiplegia (contralateral) (3) Facial & hypoglossal paralysis (contralateral) (4) Oculomotor paralysis w/ wide fixed pupils (ipsilateral)

116

Wernicke's aphasia

Cause: Damage to posterior section of left auditory cortex (Area 22-Wernicke's area)Symptoms: Speech is fluent but nonsensical. Repetition abnormal. Poor comprehension (reading better than writing). Good penmenship but misspelling & inaccuracies. Wrong names.

117

Wernicke-Korsakoff Syndrome

Cause: Vitamin B1 (Thiamin) deficiency due to malnutrition, generally as a result of alcoholism resulting in bilateral loss of cells in dorsomedial thalamus & mammilary bodiesSymptoms: (1) Acute phase [Wernike]: Confusion, Confabulation, Stupor, Ataxia (2) Chronic phase [Korsakoff]: Memory impairment, may show anterograde amnesia [probably b/c of damage to thalamus & hippocampus] & severe retrograde amnesia