NEURO 3: CNS DISORDERS Flashcards

1
Q

Explain the development of a seizure disorder

A

Alteration in membrane potential in a small area (epileptogenic focus)

Neurons become hyperactive & hypersensitive

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2
Q

What are 2 classifications of seizure disorders based on brain involvement?

A
  1. Generalized onset: both hemispheres affected
  2. Focal onset: only one hemisphere affected
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3
Q

What are 2 kinds of generalized onset seizures?

A
  1. Motor seizures
  2. Nonmotor (absence) seizures
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4
Q

What are 4 types of motor seizures based on symptoms?

A
  1. Tonic: Loss of consciousness, muscle rigidity (stop breathing)
  2. Clonic: Involuntary rhythmic muscle contractions
  3. Myoclonic: Muscle twitching
  4. Atonic: Loss of muscle tone
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5
Q

What are 2 kinds of nonmotor absence seizures based on symptoms?

A
  1. Typical: staring spells in children
  2. Atypical: similar to typical but with some muscle involvement
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6
Q

What are 2 kinds of focal onset seizures based on LOC?

A
  1. Aware: no change in LOC (just a funny feeling)
  2. Unaware: altered LOC, automatisms
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7
Q

What is the term for the 5-30 minutes period after a seizure where the person may feel drowsy, confused, or weak?

A

Postictal state

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8
Q

What is the term for a prolonged seizure episode or continuing series of seizures without a period of recovery between episodes?

A

Status epilepticus

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9
Q

What are 3 priorities during a seizure episode?

A
  1. Maintain airway
  2. Protect from injury
  3. Document
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10
Q

What are 3 types of medications that can help control epilepsy?

A
  1. Sodium channel blockers
  2. GABA stimulation
  3. Glutamate receptor antagonists
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11
Q

What is the purpose of GABA?

A

Opens chloride channels, making cell membrane more negative and less likely to depolarize

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12
Q

What is the pathogenesis of cerebral palsy?

A

Damage in upper motor neurons that control voluntary and involuntary muscle movement

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13
Q

What is the term for brain damage due to accumulation of bilirubin in a baby’s blood?

A

Kernicterus

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14
Q

What determines the types of symptoms a person with cerebral palsy will experience?

A

Symptoms depend on function of damaged upper motor neuron

If neuron had inhibitory function, muscle relaxation becomes more difficult > rigidity

If neuron had excitatory function, muscle contraction becomes more difficult > ataxia

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15
Q

What is the term for rigidity due to continuous muscle contractions?

A

Spasticity

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16
Q

What is the term for uncoordinated movements and instability associated with cerebral palsy?

A

Ataxia

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17
Q

What is the term for abnormal involuntary movements associated with cerebral palsy?

A

Dyskinesia

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18
Q
A
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19
Q

What are 3 steps in the pathogenesis of multiple sclerosis?

A
  1. T and B cells damage myelin and oligodendrocytes (the cells that make myelin)
  2. Slowing or halting of nerve conduction
  3. Damage to underlying axons
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20
Q

What does it mean when they say that diagnosis of MS requires the disease to be “disseminated in space and time?”

A

Lesions must be present in at least 2 separate regions of the brain

Patient must experience at least 2 separate episodes of clinical symptoms

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21
Q

Around what age does the onset of MS occur, and how long do patients survive after diagnosis?

A

Onset: 30 yrs

Survival: 20-30 years

22
Q

What happens in amyotrophic lateral sclerosis?

A

Diffusely affects upper and lower motor neurons of cerebral cortex, brainstem, spinal cord

23
Q

In patients with ALS, what are 3 potential causes of death?

A
  1. Aspiration pneumonia
  2. Malnutrition
  3. Respiratory failure
24
Q

Which 2 medications are used in patients with ALS, and what are their functions?

A
  1. Riluzole: inhibits glutamate release
  2. Edaravone: free-radical scavenger
25
Q

Around what age does the onset of ALS occur, and how long do patients survive after diagnosis?

A

Onset: 60-75 yrs

Survival: 3-5 yrs

26
Q

What causes Huntington’s disease?

A

Autosomal dominant mutation in gene for huntingtin protein

27
Q

Name 4 steps in the pathogenesis of Huntington’s disease

A
  1. Accumulation of mutant huntingtin protein in neurons
  2. Damage to GABA inhibitory causes decreased ACH activity in corpus striatum
  3. Striatal atrophy
  4. Excessive dopamine activity in corpus striatum
28
Q

What are 2 types of motor hyperkinesis seen in Huntington’s disease?

A
  1. Chorea: jerky involuntary movements
  2. Athetosis: slow writhing movements of hands and feet
29
Q

What is the term for impairment of willpower seen in Huntington’s disease?

A

Abulia

30
Q

What type of medication inhibits dopamine release to treat Huntington’s disease?

A

VMAT2 inhibitors

31
Q

Around what age does the onset of Huntington’s occur, and how long do patients survive after diagnosis?

A

Onset: 40-50 years

Survival: About 15 years

32
Q

What happens in Parkinson’s disease?

A

Loss of dopamine-releasing neurons in the substantia nigra (area of midbrain that modulates motor movement)

33
Q

What is the result of dopamine depletion in Parkinson’s disease?

A

Causes imbalance between direct & indirect motor pathways, which results in difficulty initiating/controlling movements

34
Q

What is the surgical treatment used to treat Parkinson’s?

A

Deep brain stimulation

35
Q

What is the purpose of levodopa in treating Parkinson’s?

A

Penetrates blood-brain barrier and then converted into dopamine

36
Q

Why is carbidopa combined with levodopa in treating Parkinson’s?

A

Prevents conversion of levodopa until after it crosses the BBB

37
Q

Other than levodopa-carbidopa, what are 2 other types of medications used in treating Parkinson’s?

A
  1. Dopamine receptor agonists
  2. MAO inhibitors
38
Q

What forms the intracellular neurofibrillary tangles in Alzheimer’s disease?

A

Hyperphosphorylated tau protein

39
Q

What forms the plaques in Alzheimer’s disease?

A

Amyloid beta protein

40
Q

What are 3 kinds of medications used to treat Alzheimer’s disease?

A
  1. Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine)
  2. NMDA receptor antagonists (memantine)
  3. Monoclonal antibody against amyloid beta protein (aducanumab)
41
Q

What do MAO inhibitors do?

A

Inhibit breakdown of serotonin, norepinephrine, dopamine

42
Q

What do tricyclic antidepressants do?

A

Inhibit reuptake of serotonin, norepinephrine, dopamine

43
Q

What is the term for the theory that neurotransmitter imbalance is the cause of depression?

A

Monoamine hypothesis

44
Q

Which hormone imbalance may lead to depression?

A

Increased cortisol causing neuronal atrophy

45
Q

What is the difference between mania and hypomania?

A

Mania lasts at least one week
Hypomania lasts at least 4 days

46
Q

What does lithium do in treating bipolar disorder?

A

Increases serotonin activity

Decreases norepinephrine and dopamine activity

Inhibits adrenergic and cholinergic receptor signaling

47
Q

What does valproic acid do in treating bipolar disorder?

A

Increases activity of GABA

48
Q

What is the term for rigidity due to continuous muscle contractions associated with cerebral palsy?

A

Spasticity

48
Q

What is the term for abnormal involuntary movements associated with cerebral palsy?

A

Dyskinesia

48
Q

Which 2 medications are used in patients with ALS, and what are their functions?

A
  1. Riluzole: inhibits glutamate release
  2. Edaravone: free-radical scavenger
48
Q

What is the action of carbamazepine?

A

Sodium channel blocker

48
Q

What is the term for uncoordinated movements and instability associated with cerebral palsy?

A

Ataxia