neuro 18 Flashcards
(32 cards)
cardinal feature of toxic-metabolic encephalopathy
waxing and waning level of arousal; asterixis is a frequent finding
most common presentation of neurosarcoidosis
cranial neuropathy due to chronic basal meningitis, with facial and optic nerves most freq affected
pathology for neurosarcoidosis
noncaseating granuloma
treatment for neurosarcoidosis
steroids
neuropathy in DM
distal symmetric sensory polynuropathy; predilection for involvement of small myelinated and unmyelinated fibers; loss of temp and pinprick sensation
autonomic neuropathy in DM
gustatory sweating, orthostatic hypotension, diarrhea, and impotence
Whipple disease
dementia, seizures, myoclonus, ataxia, supranuc ophthalmoplegia, oculomasticatory myorhthmia
Wernicke’s encephalopathy triad
opthalmoplegia, truncal ataxia, and confusion; developing over a period of days to weeks
opthalmoplegia
weakness or paralysis of extraocular muscles
other manifestations of Wernicke’s encephalopathy
impaired pupillary light response; hypothermia; postural hypotension; and other evidence of nutritional def
what causes wernicke’s enceph
deficiency in thiamine
treatment for wernicke enceph
IV thiamine; ocular signs can resolve within hours and the confusion over days to weeks; the gait ataxia may persist
Korsakoff’s syndrome
isolated memory deficits that persist after Wernicke’s enceph; patients have confabulation
what causes subacute combined degernation of the spinal cord?
vit B12 def; degeneration of posterior (dorsal columns) and lateral white matter tracts of the SC
presentation of vit B12 def
insidious onset of paresthesias in the hands and feet; with time, weakness and spasticity develop in the legs;
what is elevated when B12 is deficient?
homocysteine and methylmalonic acid, the precursors of B12
folate def
may cause the same def as in B12 but typically you see the heme def without the neuro
characteristics of antiphospholipid syndrome
venous or arterial thrombosis; recurrent fetal loss; and thrombocytopena; this disease is assoc with elevated titers of antibodies directed against phosppholipids
anti-phospholipid antibodies
in vitro prolongation of the PTT (lupus anticoagulant); can occur in isolation or in assoc with underlying immune disorder
when to do a work up for anti-phospholipid antibody
young patients with stoke or in those with otherwise unexplained stroke; dx requires demonstration of high titer IgG antiphospholipid antibodies on two occasions
treatment of anti-phospholipid antibody syndrome
warfarin to achieve INR between 3 and 4
antiphospholipid antibody refers to what
it’s a general term that encompasses the lupus anti-coagulant, anticardiolipin antibodies, and antibodies against a mixture of various phospholipids
nervous system is more commonly affected by hypo or hyperthyroidism
hypothyroidism
central pontine myelinosis
rare demyelinating disorder that occurs most often in alcholics and may be precipitated b too-rapid correction of hyponatremia
