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Flashcards in Neuro Deck (194):
1

Benign brain tumor that pushes on the brain tissue without invading it. seen parasaggital or at edges

Meningioma

2

"fried-egg appearance", can have calcifications

oligodendroglioma

3

perivascular rosettes, hydrocephalus, 4th ventricle

Ependymoma (ependymal cells line ventricles)

4

degeneration of anterior motor horn

Poliomyelitis or Werdnig Hoffman

5

Synringomyelia (anterior white commisure)

LMN sx i.e. weakness + loss of P/T from UE (because usually at c8-t1)

Can expand to hit Anterior motor horn, as well as lateral horn t1 (horners)

6

UMN and LMN signs

ALS

7

Hypertrophic cardiomyopathy + degen of several neural tracks

Friedreich ataxia

8

where do you do lumbar puncture

L4-L5. spinal cord stops at L2 but cauda equina til s2. subarachnoid space

9

most common cause of Subarachnoid Hemorrhage (bleed on bottom of the brain)

Rupture of berry aneurysm (anterior circle of willis --> ACom branch points)

10

why is a Berry aneurysm susceptible to rupture?

Lacks a media layer

11

whats the AFP level in neural tube defect

HIGH as a fuckin KITE

12

most common cause of hydrocephalus in new born

Cerebral aqueduct stenosis (blocks 3-->4)

13

Foramen of Monro

Lateral ventricles --> 3rd

14

4th ventricle through Foramen meagendie/luschka into:

subarachnoid space

15

Define dandy-walker formation

congenital failure of cerebrellar vermis --> presents with absent cerebrelleum and massively dilated 4th ventricle (posterior fossa)

16

massivelyd dilated 4th ventricle

Dandy walker formation

17

downward displacement of cerebellar vermis and tonsils through foramen magnum

Arnold Chiari (2)

18

name 3 common associations with Arnold-Chiari malformation (type 2)

(cerebellar herniation)
Hydrocephalus, Synringomyelia, Meningomyelocele

19

Cystic degeneration of the spinal cord

Syringomyelia

20

lose pain and temp in UE

Syringomyelia

21

Lateral horn of hypothalamospinal tract

Synringomyelia can expand and knock this out = horners (t1)

22

muscle atrophy and weakness in syringomyelia

expands to knock out Anterior Horn (LMNs)

23

Polio damages:

Anterior motor horn--> LMN signs

24

Floppy baby, autosomal recessive

Werdnig-Hoffman; degen of anterior motor horn

25

ALS: Degen of ________

UMN and LMN of Corticospinal tract

26

Corticospinal tract is damaged in

ALS

27

Enzyme mutation that can cause ALS

Superoxide dismutase

28

_____ increases survival in ALS pt by ______

Riluzole ("Lou gehrigs") increases survival by decreasing presynaptic glutamate release

29

Glutamate antagonist

Riluzole used to treat ALS (Lou Gehrigs)

30

What are the neural components of Friedreich Ataxia

Degenerative disorder of the cerebellum: ataxia

and Spinal cord: loss of MVP, deep tendon reflex, LE muscle strength

31

describe the frataxin gene (lost in freidreich)

Mitochondrial iron regulation...loss = iron buildup and thus free radical damage

32

first sign of friedreich ataxia

clumsyness

33

Neisseria menigitidis meningitis

through the NOSE nigga.

34

signs of meingitis

headache, nuchal rigidity, fever; Photophobia, vomiting, altered mental status.

35

where does lumbar puncture sample

Subarachnoid space

36

what ischemic neural effects can an Insulinoma have?

Repeated bouts of hypoglycemia --> global cerebral ischemia (brai needs glucose)

37

Pt has a stroke...whats the protocol for tx

give tPA--> have to do CT (noncontrast) to RULE OUT HEMORRHAGE!! tPA within 1st 4 hours

aspirin/clopidogrel can be given to reduce risk

38

does TIA register on MIA?

Nope, its a reversible thang less than 15 minutes of focal neuro dysf(x)

39

hypoxia and irreversible damage

irreversible damage after 5 minutes of hypoxia.

Hippocampus (pyramidal neurons/temporal lobe), Cerebral cortex (laminar necrosis layers 3 5 6)
Cerebellum (purkinje layer)

40

hyaline arteriolosclerosis (HTN) leads to what type of stroke?

Lacunar stroke

41

Describe lacunar stroke

involves lenticulostriate vessels = small lacunar infarcts (cystic areas)

Thalamus: pure sensory
Internal capsule: pure motor

42

earliest change in ischemic stroke

Liquefactive necrosis 1st sign = red neuron = eosinophilic change of neuron cytoplasm

43

which cells are responsible for gliosis post storke

astrocytes

44

in stroke, neutrophils are day 1-3, which cell is day 4-7?

Microglia (MQ of the brain)

45

what are the 2 aneurysms in the brain?

Berry aneurysm (subarachnoid space) and Charcot-Bouchard (parenchymal space)

46

Describe charcot-bouchard aneurysm

due to HYPERTENSION.

LENTICULOSTRIATE vessels going to BASAL GANGLIA (look in the center where the cord would attach)

intracerebral hemorrhage/bleeding into PARENCHYMA (so not lobar)

47

sudden headache + nuchal rigidity

subarachnoid hemorrhage

48

LP indicating SAH

Xanthochromia (yellow due to bilirubin)

49

what does yellowish LP indicate

Subarachnoid Hemorrhage.

Can be a bloody or yellowish tap = SAH

50

Berry aneurysm can cause

Bitemporal hemianopia by compressing optic chiasm
Subarachnoid hemorrhage
Hemorrhagic stroke

51

lens shaped lesion on CT

Epidural hematoma

52

lucid interval after bleed

Epidural hematoma

53

crescent shaped lesion on CT

subdural hematoma

54

Uncal herniation

1. CNIII: eye moves down and out + dilated pupil
2. PCA: contralat homonymous hemianopsia -- infarction of occipital lobe
3. Paramedian artery: Duret (brainstem) hem

55

deficiency of Arylsulfatase

Metachromatic Leukodystrophy (demyelination)
-->sulfatides accumulate in lysosomes. ataxia/dementia

56

defeciency of galactocerebrosidase

Krabbe (buildup of galactocerebrosidase and psychosine). demyelination. Peripheral neuropathy, optic atrophy, developmental delay

57

Leukodystrophies (inherited mutations fuck up myelin)

AR: Metachromatic leukodystrophy (arylsulfatase) and Krabbe (galactocerebrosidase)

X-linked: Adrenoleukodystrophy (long chain fatty acids--> brain and adrenals)

58

Clining features of MS

Blurred vision in one eye (optic nerve)
vertigo and scanning speech (brainstem)
internuclear opthalmoplegia (MLF)
Hemiparesis (periventricular white matter)
Bowel bladder and sexual dysfunction (ANS)

59

Lumbar puncture MS

Increased lymphocytes, increased Ig's with OLIGOCLONAL IgG bands on electrophoresis
Myelin basic protein (because destroyed myelin)

60

Astrocytes

Neuroectoderm
GFAP = astrocyte marker

61

Microglia vs macroglia

Microglia: phagocytes. mesodermal
Macroglia: astrocytes, oligo, ependymal. Neuroectoderm

62

Guillain Barre: injury to

schwann cells!!

63

Endoneural inflammation
endomysial inflammation

GBS
polymyositis

64

ADH and oxytocin synthesis

made in hypothalamus but stored in PP

65

Lateral hypothalamus

Lose lateral = lose weight

66

Ventromedial hypothalamus

Satiety. Lose ventromedial = verymuch hungry

67

Tau protein

Neurofibrillary tangle: Alzheimer
Round aggregates = pick bodies: Pick disease

68

Sx of Pick disease

Language (temporal) and behavior (frontal) deficits

69

Parkinsons, loss of ________ neurons in the _________ of the basal ganglia

dopaminergic
substantia nigra

70

Sx of Parkinsons

Tremor (pill rolling) at rest, disappears with movement
Rigidity (cogwheel) in extremities
Akinesia is slowing of voluntary movement
Postural instability/shuffling gait

71

Expressionless face and tremor that disappears with movement

Parkinsons: Akinesia = expressionless face. Pill rolling tremor.

72

dementia in Parkinsons vs Lewy body

Lewy body: early dementia
Parkinsons: late dementia

73

Subtantia nigra vs caudate nucleus disorder

SN: Parkinsons (dopaminergic)
CN: Huntington's (GABAergic. trinucleotide = anticipation)

74

When and why do you see Chorea (disorder)

See it in Huntingtons (loss of GABAergic neurons in caudate nucleus)

Normally, GABA from BG to Cortex has an inhibitory hold on neurons. loss of GABA = random firing/movement = chorea

75

Increased CSF = expanded/dilated ventrilces = sretching of the _________ fibers = Normal P Hydrocephalus

Corona radiata fibers

76

Sx of NPH

Wet, wobbly, wacky

77

Lumbar puncture improves Sx

NPH (because removes some csf)

78

intracellular vacuoles

Spongiform encephalopathy

79

Dementia + ataxia + startle myoclonus (involuntary contractions with mild stimuli)

Spongiform encephalopathy

80

layer of gray matter in between internal capsule and ventricle

Caudate --> lost in Huntington = hydrocephalus ex vacuo

81

striatum

Caudate + Putamen (internal capsule in between them)

82

name a tumor that can cross the corpus callosum

GBM "butterfly lesion"

83

pseudopalisading and GFAP +

GBM (also, endothelial cell prolif)

84

benign tumor of ARACHNOID Villi/Cells

Meningioma

85

psamomma bodies + may present as seizure/focal neuro deficits

Meningioma

86

spindle cells in a concentrically whorled pattern

Meningioma

87

loss of hearing, tinnitis, s-100 +

schwannoma = benign tumor of schwann cells

88

neurofibromatous 2 brain tumor

bilateral schwannomas

89

calcified tumor in white matter, usually frontal lobe, seizures

Oligodendroglioma

90

where do you see a Pilocytic astrocytoma

posterior fossa/cerebellum

91

Cystic and solid components to neural tumor

Pilocytic astrocytoma: cystic lesion + mural nodule

92

Eosinophilic fibers of astrocytes on brain tumor biopsy

Rosenthal fibers --> Pilocytic Astrocytoma

93

Primitive neuroectodermal tumor (PNET): Name + Histo

Medulloblastoma: small blue cells

94

Homer-wright rosettes vs perivascular pseudorosettes

Homer-wright: Medulloblastoma, Neuroblastoma (AM)
Perivascular: Ependymoma

95

high mitotic index child brain tumor (posterior fossa)

Medulloblastoma = highly malignant

96

neuroblastoma

tumor of adrenal medulla in kids
neural crest origin
homer wright rosettes

97

brain tumor from epithelial origin

epithelial remnants of Rathke's pouch = Craniopharyngioma

98

Bitemporal hemianopsia in a child vs adult

child: consider Craniopharyngioma
adults: Pituitary adenoma

99

how dos ectoderm become neuroectodorm = neural plate

Notochord (which becomes Nucleus polposus)

100

Neural plate gives rise to

Notochord and neural crest cells

101

Telencephalon and Diencephalon

Part of Forebrain (Football has TDs)

Telencephalon: cerebral hem/lateral ventricles
Diencephalon: thalamus/3rd ventricle

102

Midbrain/aqueduct come from which layer

Mesencephalon

103

AFP in spina bifida occulta

no structural herniation, just failure of bony spinal to close. intact dura. hair/skin simple.

NORMAL AFP

104

maternal diabetes and messed up brain development

Anencephaly

105

Clinical findings of anencephaly

Polyhdramnios, increased AFP, no forebrain.

106

failure of L and R hemispheres to separate

Holoprosenchepaly

107

Conditions that cause Holoprosencephaly (failure R/L sep)

Patau, Fetal alcohol syndrome, Sonic hedgehog signaling pathway

108

Lumbosacral myelomeningocele

Arnold Chairi II (herniation through foramen magnum)

109

aquedecutal stenosis + hydrocephalus after cerebellar tonsillar herniation

Arnold Chiari II

110

cystic dilation of the 4th ventricle (posterior fossa)

Dandy walker

111

congenital hydrocephalus

structural: Aqueductal stenosis, Dandy walker, Chairi
infectious: CMV, toxoplasmosis, meningitis

112

Sx of infantile hydrocephalus

Macrocephaly
Poor feeding ("trouble latching while breast feeding")
Muscle hypertonicity
Hyperreflexia
Seizures/developmental delay

113

why does infantile hydrocephalus cause hyperreflexia and hypertonicity (muscular)

UMN damage --> stretching of the periventricular pyramidal tracts

114

sensation/taste anterior 2/3 tongue

1/2 branchial arches

Sensation: V
Taste: VII

115

sensation/taste posterior 1/3 tongue

3/4 branchial arches

IX (CN 9 = Glossopharyngeal)

116

role of Glossopharyngeal (CN9) and Hypoglossal (CN12) to tongue

9: taste and sensation of posterior 1/3
12 (Hypoglossal): Motor innervation to everything except for

palatoglossus (X; elevates posterior tongue during swallowing)

117

Locus ceruleus (pons)

Norepinephrine

Increased in anxiety
Decreased in depression

118

Ventral tegmentum and Substantia nigra pars compacts (midbrain)

Dopamine

119

Basal nucleus of Meynert

ACh

Increased in Parkinson
Decreased in Alzheimers (AD = low ACh)

120

GABA (Nucleus Accumbens) levels in
anxiety and hungtingtons

Decreased in both

121

Stress and panic

Locus Ceruleus (NE)

122

Nucleus accumbens

GABA. Reward/pleasure/addiction/fear

123

Thalamic fibers going to primary somatosensory cortex

VPL (pain temp, MVP)
VPM (face...sensation and taste)

Damage to either = complete contralateral sensory loss

dont be a peasant --> my impulse is "ventral" so has to be motor and not sensory

124

VPL nucleus of thalamus
(vs in hypothalamus its like "ventromedial area")

Spinothalamic tract: Pain and temp

DC/ML: MVP (proprioception, touch, vibration, pressure)

125

Patient has unsteady gait/difficulty walking. which track/nucleus of thalamus

VPL --> DC/ML = MVP = lost proprioception

126

VPM nucleus of thalamus

VPM --> Makeup goes on the Face

Face sensation and taste

127

LGN and MGN of thalamus

LGN: "Light" = vision
MGN: "Music" = hearing

128

VL nucleus of thalamus

Motor to Basal ganglia/cerebellum

129

The famous 5 F's = Limbic system

Feeding, Fleeing, Fighting, Feeling, Fucking

(emotion, long term memory, behavior, ANS)

130

structures of Limbic System

Hippocampus
Amygdala
Mammillary Body
Fornix
Cingulate Gyrus

131

Acute paralysis, dysarthria, dysphagia, diplopia, loss of consciousness

Osmotic demyelination syndrome aka central pontine myelinolysis

132

Cerebral edema/herniation related to Sodium

High to low, your brain will blow

133

Romberg

+: Ataxia is sensory = DC-ML fucked up
-: Ataxia is cerebellar

134

alpha synuclen intracellular eosinophilic inclusions

Lewy bodies --> Parkinsons and Lewy body dementia

135

resting tremor, shuffling gait

Parkinsons

136

Angry man with choreo (dancing movements), wheres the damage?

Caudate nucleus --> huntingtons

137

Neuronal death via NMDA-R binding and glutamate toxicity

Huntingstons: NMDA - Hunt with Glutamatate gun (NRA)

138

CAG Repeats and loss of ACh and GABA

Caudate loses ACh and GABA = Hungtingtons

139

No ifs, ands or buts (can't repeat)

Conduction Aphasia: damage to Arcuate Fasciculus. (poor repetition)

140

Disinhibited behavior: Hyperphagia, hypersexuality

Kluver-bucy --> amygdala lesion
Frontal lobe damage (R side = disinhibited behavior)

141

Reemergence of primitive reflex, difficulty concentration, poor judgement

Frontal lobe damage

142

Eye looks toward side of lesion

FEF

143

Eye looks away from lesion

PPRF

144

Stroke: Motor/Sensory to Upper Limb and Face

MCA

145

temporal lobe (wernicke) and frontal lobe (Broca) stroke

MCA

146

Lower limb motor and sensory loss

ACA

147

after stroke, can't walk

ACA (lower limb sensorimotor)

148

dysphagia, hoaseness, woming, decreased pain and temp from ipsilat face and cl body

PICA: lateral medulla (wallenberg)

149

Paralysis of face

AICA: Facial droop means AICAs pooped

150

intracranial hemorrhage that can cross suture lines

Subdural hematoma
i.e. shaken baby, alcoholics, blunt trauma/whiplash

151

intracranial hemorrhage that cross falx/tentorium

epidural hematoma

152

hemorrhagic stroke/intracerebral hemorrhage

Basal ganglia

153

lateral corticospinal tract (UMN)

voluntary movement of contralateral limbs

154

positive Romberg, absence of deep tendon reflexes, Latent bacteria

Tabes dorsalis

155

Tracts affected by vit b12 def

Subacute combined degeneration:
DC-ML (lose mvp)
Lateral corticospinal tract (UMN signs)
Spinocerebellar tract

Ataxic gait, parestheia, impaired position and vibration

156

KYPHOSCOLIOSIS, HCM, Staggering gait, frequent falling, PES CAVUS (high plantar arches)

Friedreich ataxia (trinucleotide repeat GAA)
-->death by cardiomyopathy

157

Brown Sequard syndrome

hemisection of spinal cord
CL pain and temp loss
Ipsilateral loss of MVP, and UMN signs
Ipsilateral loss of all sensation at level of lesion

158

UMN vs LMN face lesion

UMN: CL lower face paralysis
LMN: ipsilat paralysis of upper and lower face

159

Neuroleptic Malignant Syndrome (after antipsychotic overdose)

diffuse muscle rigitidity
high fever/ANS instability
High Creatine kinase (rhabdomyolysis)

Tx = Dantrolene (block Ca rel from RyR of SR) or Bromocriptine (dopamine agonist)

160

2 most common causes of intellectual disability

Down syndrome (most common overall)
Fragile X (most common inherited)

161

CNIII is motor/sensory/both?

Pure MOTOR

Some Say Marry Money But My Brother Says Big Boobs Matter Most

162

Radial Nerve Damage (include vs spare triceps reflex)

In Axilla (crutches/saturday night palsy) = Proximal injury = lose finger extensors, get wrist drop, absent triceps reflex

Injury to proximal radial nerve as it crosses posterior humerus (MIDSHAFT HUMERUS) spares triceps reflex, lose extensors of hand.

Finger/thumb drop (loss of extension) without wrist or tricep deficits = damage in supinator canal, i.e. mechanic doing lots of screwdriving

163

B12 deficiency rxns

MMA ---MMA CoA mutase --> Succinyl-CoA (not succinylcholine)

Homocysteine --Methionine synthase/THF-->Methionine

164

rxn in PKU

lose PH or its cofactors tetrahydroBiopterin (BH4)
Phenylalanine--Phenylalanine Hydroxylase (PH) -->Tyrosine

165

Cerebellar lesions are different from cerebral because:

the cerebellum double crosses you! so ends up being ipsilateral.

-->dysdiadochokinesia (loss of rapidly alt movements)
-->limb dysmetria (over/undershoot)
-->intention tremor (tremor during movement)

166

2 CAN pneumonics

Whipples: Cardiac, Arthralgia, Neuro sx
Wernicke: Confusion, Ataxia, Nystagmus

(this is wernicke encephalopathy, not aphasia; and nystagmus interhcangable with opthalmoplegia. due to Thiamine b1 def)

Note: Thiamine def = periph neuropathy, high-output cardiac failure, and Wernickes (ataxia, confusion, nystagmus)

167

Dx of Thiamine deficiency

(periph neuropathy + cardiac failure aka wet beri beri DCM + Wernicke encephalopathy aka confusion ataxia nystagmus)

Increased rbc TRANSKETOLASE activity after giving thiamine

168

Synaptophysin vs GFAP

GFAP = Astrocytes (NeuroGlia-->hence responsible for reactive GLIOSIS)
-->Gliomas (non-neuronal tissue) =
Astrocytoma, Ependymoma, Oligodendroglioma
(still part of brain so still all neuroectoderm)

Synaptophysin = neurons, neuroectodermal cells, neuroendocrine

169

Von Hippel Lindau (4)

1. Hemangioblastoma of cerebellum/retina (vascular)
2. Renal Cell Carcinoma (bilateral)
3. Pheochromocytomas
4. Angiomatosis (Cavernous hemangiomas all over)

170

difficulty removing hand from handshake

Myotonia (seen in myotonic dystrophy)

171

Frontal balding, cataracts, myotonia, testicular atrophy, arrythmia

Myotonic Dystrophy (type 1 fibers. auto dom trinuc rpt)

172

AICA vs PICA

Both: Ips P/T Face, CL P/T Body. Vomit/vertigo/nystag

AICA: Lateral Pons. Facial paralysis. Taste ant 2/3 tongue
(Facial droop means AICA pooped)

PICA: Lateral Medulla. Dysphagia/hoarseness
(dont pica horse that can't eat)

173

Locked-in syndrome

1. Osmotic Demyelination (central pontine myelinolysis)
-->correct hyponatremia (low to high pons will die) rapid
2. Basilar artery stroke

Osmotic demyelination more likely to present with loss of consciousness

174

ACom or PCom: CNIII palsy

PCom.

Both can cause visual defects.
Both sites are more likely to be aneurysm than stroke. Both sites = Berry (saccular) aneyrums, with ACom #1

175

Motor and PNS component of CNIII

Motor in Middle: Affected by ischemia/ vascular dx (DM)
-->Ptosis, Down-and-out gaze, Horizontal/vert diplopia

PNS outside: Affected by compression (PCA aneurysm)
-->dec Pupillary light reflex, Blown pupil with down/out

176

Vertical diplopia (can't go down the stairs)
"With Cranial Nerve _____ its hard to walk down to the bottom floor"

CN IV (Trochlear = SO4)
head tilts toward side of lesion, can compensatory tilt in other direction while going down stairs

177

Kid has MVP, autism, and intellectual disability. He has a problem in gene ________

Methylation ( Fragile X)

178

Kid has ASD, duodenal atresia, palmar crease, sandal gap. His b-HCG is ________, and his condition is a result of ______ _______

bHCG INCREASED in Down (dec in 18 and 13)

Meiotic Nondisjunction

179

Elderly patient comes in with insomnia, can we give him Benzo?

NO!! Drugs to avoid in elderly:
Benzo's: cognitive impairment/delirium/falls

TCAs (amytriptyline) and antihistamines (Diphenhydramine) due to strong anticholinergic effects and delirium/falls

180

Temporal lobe herniation =

Uncal aka transtentorial herniation! Uncus = medial temporal lobe;

181

Uncal Herniation Manifestations

1.Ipsilateral CNIII = Ipsilat blown pupil/downandout
2.Ipsilateral PCA = contralat homonymous hemianopia
3.Compress CL Peduncle = CL Corticospinal tract = IPSILAT HEMIPARESIS
4.Duret hemorrhages: brainstem (pons/midbrain) due to stretching of Paramedian Basilar Artery (fatal)

182

Recurrent Lobar Hemorrhages in Elderly

Cerebral AMYLOID angiopathy

183

Endomysial inflammatory infiltrate
Endoneural hyaline arteriolization
Endoneural inflammatory infiltrate

Polymyositis (proximal mm weakness)
Diabetic neuropathy
GBS

184

Headache that gets worse with Valsalva (they will say its worse when he coughs or bears down during MM)

Suggests increased ICP aka tumor (and NOT a migraine)

185

contralateral Hemiparesis loss

contralateral Hemisensory loss

Corticospinal tract lesion (cortical/brainstem)

Ascending somatosensory = DC-ML and Anterolateral

186

Posterior Communicating Artery (PCom)
Posterior Cerebral Artery (visual/occipital cortex)
PICA (Lateral medulla)

PCom: saccular Aneurysm = COMPRESSES CNIII so see ipsilateral down and out + ptosis and myDRiasis

PCA: Contralateral homonymous hemianopia w/macular sparing

PICA: Dec P/T ipsilateral face and CL body; dysphagia, hoarseness, ipsilateral Horner; vomiting/vertigo/nystagmus

187

Parasympathetics vs Sympathetics eye

CNIII has PNS fibers on outside....so damage = MYDRIASIS
(seen with compression= PCA aneurysm/Uncal herniation...won't really be seen with diabetic/vascular/ischemic damage unless severe)

Horners = SNS damage = MIOSIS, ptosis, anhydrosis ------->any lesion above T1 i.e. Syringomyelia (c8-t1), Pancoast tumor, Brown-Sequard (hemisection resulting in CL P/T and Ipsi

PICA: involves ipsilateral Horner (b/c knocks out SNS fibers)

188

Cerebellum Peduncles

Input:
Inferior - ipsilateral info
Middle - contralateral cortex info

Output:
Superior - Sends info to contral cortex to modulate movement (via output fibers = Purkinje fibers)

189

Lateral vs Medial Cerebellar Lesion (Romberg is - b/c cerebellar)

Lateral: Limb dysmetria (fall to ipsilat side)
Medial: Truncal ataxia/nystagmus

lose Rapid alt movements = dysdiadochokinesia
also lose tandem walking in cerebellar lesion

190

Lesion location :
Chorea (sudden, jerky movements. Huntington)
Hemiballismus (sudden flailing of 1 arm, +/- Ipsi leg)
Intention Tremor (zigzag when extending to target. MS)

Chorea: Basal Ganglia

Hemiballismus: Contralat Subthalamic (Basal Ganglia -->Lacunar STROKE)

Intention Tremor: Cerebellum

191

-Sudden uncontrolled muscle contraction(hiccups/jerks)
-Sustained, involuntary muscle contraction (writer cramp)
-High freq tremor w/sustained posture (outstretchedarm)
-Tremor alleviated by intentional movement

Myoclonus
Dystonia (also the eyelid thing. can manual suppress)
Essential Tremor (relieve with EtOH)
Resting tremor (parkinson)

192

Essential tremor tx

"Extremely tiring to keep my arm up"
Have some EToH, bETa - blocker
-pt self medicates with EtOH
-Tx with Beta blocker or primidone

193

Dementia and visual hallucinations, followed by parkinsonian features

Lewy body dementia (Halewycinations) --> alpha-synuclein defect

194

Autoimmune myelin destruction (demyelinating)

Guillain Barre (PNS)
Multiple Sclerosis (CNS). Can feel fatigue after hot shower