Neuro Disorders

Question 1

What is Parkinson’s dz?

Answer 1

Degenerative disorder of CNS assoc w/ Lewy bodies & loss of dopaminergic neurons of the substantia nigra pars compacta

Question 2

What are Lewy bodies composed of?

Answer 2

Alpha-synuclein intracellular inclusion

Question 3

What are the sx of Parkinson’s dz?

Answer 3

• Tremor
• Cogwheel
• Rigidity
• Akinesia
• Postural instability

Question 4

What is Huntington’s dz?

Answer 4

AD CAG trinucleotide repeat disorder

Question 5

What is Huntington’s dz char by?

Answer 5

• Chorea
• Aggression
• Depression
• Dementia

Question 6

What causes neuronal death in Huntington’s dz?

Answer 6

NMDA-R binding & glutamate toxicity

Question 7

What will be seen on imaging with Huntington’s dz?

Answer 7

Atrophy of striatal nuclei (main inhibitors of movement)

Question 8

How does Hemiallismus present?

Answer 8

Sudden, wild flailing of 1 arm +/- ipsilateral leg

Question 9

What is the char lesion of Hemiballismus?

Answer 9

Contralateral subthalamc nucleus

Question 10

What is the presentation of Chorea?

Answer 10

Sudden, jerky, purposeless movements

Question 11

What is the characteristic lesion of Chorea?

Answer 11

Basal ganglia

(Huntington’s)

Question 12

What is the presentation of Athetosis?

Answer 12

Slow, writhing movements esp seen in fingers

Question 13

What is the characteristic lesion of Athetosis?

Answer 13

Basal ganglia

(Huntington’s)

Question 14

What is the presentation of Myoclonus?

Answer 14

Sudden, brief, uncontrolled muscle contraction

Jerks, hiccups, common in metabolic ABN such as renal & liver failure

Question 15

What is the presentation of Dystonia?

Answer 15

Sustained, involuntary muscle contractions

Writer’s cramp, blepharospasm (sustained eyelid twitch)

Question 16

What is the presentation of Essential tremor (postural tremor)?

Answer 16

Action tremor; exacerbated by holding posture/limb position

Question 17

What causes Essential tremors?

Answer 17

Genetic predisposition

Question 18

What do pt w/ essential tremors self medicate w/?

Answer 18

Alcohol

Question 19

What is the tx for essential tremors?

Answer 19

Beta blockers or Primidone

Question 20

What is the presentation of a Resting tremor?

Answer 20

Uncontrolled movement of distal appendages (Most nocticable in hands)

Tremor alleviated by intentional movement

Question 21

What is the characteristic lesion of a Resting tremor?

Answer 21

Parkinson’s dz

Question 22

What is the presentation of an Intention tremor?

Answer 22

Slow, zigzag motion when pointing/extending toward a target

Question 23

What is the characteristic lesion of an Intention tremor?

Answer 23

Cerebellar dysfunction

Question 24

What is the consequence of a bilateral Amygdala lesion?

Answer 24

Klüver-Bucy syndrome–hyperolrality, hypersexuality, disinhibited behavior

Question 25

What is Amygdala lesion assoc w/?

Answer 25

HSV-1

Question 26

What is the consequence of a Frontal lobe lesion?

Answer 26

Disinhibition & deficits in concentration, orientation & judgement May have reemergence of primitive reflexes

Question 27

What is the consequence of a Right Parietal lobe lesion?

Answer 27

Spatial neglect synd (Agnosia of the contralateral side of the world)

Question 28

What is the consequence of a Reticular activating system (midbrain) lesion?

Answer 28

Reduced levels of arousal & wakefulness

Question 29

What is the consequence of a bilateral Mammillary body lesion?

Answer 29

Wernicke-Korsakoff synd

Question 30

What is Wernick-Korsakoff synd?

Answer 30

Confusion, opthalmoplegia, ataxia, confabulation, personality chagnes, memory loss (anterograde & retrograde amneisa)

Question 31

What is Wernicke-Korsakoff synd assoc w/?

Answer 31

Thiamine (B1) def & excessive alcohol use

Question 32

What can Wernicke-Korsacoff synd be precipiated by?

Answer 32

Giving glucose w/o B1 to a B1-def pt

Question 33

What is the consequence of a Basal ganglia lesion?

Answer 33

May result in tremor at rest, chorea or athetosis (Parkinson's dz)

Question 34

What is the consequence of a Cerebellar hemisphere lesion?

Answer 34

Intention tremor, limb ataxia, loss of balance & fall toward side of lesion

Question 35

What is the consequence of a Cerebellar vermis lesion?

Answer 35

Truncal ataxia & dysarthria

Question 36

What is the consequence of a Subthalamic nucleus lesion?

Answer 36

Contralateral hemiballismus

Question 37

What is the consequence of a Hippocampus lesion?

Answer 37

Anterograde amnesia--inability to make new memories

Question 38

What is the consequence of a Paramedian pontine reticular formation (PPRF) lesion?

Answer 38

Eyes look away from side of lesion

Question 39

What is the consequence of a Frontal eye field lesion?

Answer 39

Eyes look toward lesion

Question 40

What is Central pontine myelinolysis?

Answer 40

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

Question 41

What can Central pontine myelinolysis cause?

Answer 41

"Locked in syndrome"

Question 42

What causes Central pontine myelinolysis?

Answer 42

Commonly iatrogenic, caused by overly rapid correction of Na+ levels (hyponatremia)→ massive axonal demyelination in pontine white matter

Question 43

What is Aphasia?

Answer 43

Higher-order inability to speak (language deficit)

Question 44

What is Dysarthria?

Answer 44

Motor inability to speak (movement deficit)

Question 45

What is Broac's aphasia?

Answer 45

Nonfluent aphasia w/ intact comprehension

Question 46

What is Broca's area?

Answer 46

Inferior frontal gyrus of frontal lobe

Question 47

What is Wernicke's aphasia?

Answer 47

Fluent aphasia w/ impaired comprehension

Question 48

What is Wernicke's area?

Answer 48

Superior temporal gyrus of temporal lobe

Question 49

What is Global aphasia?

Answer 49

Nonfluent aphasia w/ impaired comprehension Both Broca's & Wernicke's areas affected

Question 50

What is Conduction aphasia?

Answer 50

Poor repetition but fluent speech, intact comprehension

Question 51

What causes Conduction aphasia?

Answer 51

Arcuate fasiculus