Neurodegenerative Diseases Flashcards
Alzheimer
early memory and visuospatail probs
young onset: preselin 1 assoc
Needs BOTH plaques and tangles for definitive dx (biopsy or autopsy)
cerebral atrophy, cortical neuronal and synaptic loss
FTD
early behavioral probs (inappropriate) also executive and/or language probs
Tangles, ubiquitin inclusions, PICK bodies = intraneuronal inclusions
sometimes dementia LACKING distinct histol features AND without memory loss for years
Hippocampus spared until late
Parkinson’s
Tremor, rigidity, bradykinesia (lewy bodies)
Lewy Body
DIFFUSE lewy bodies, Early Parkinsonian probs
Psychosis, fluctuation consciousness
PSP (progressive supranuclear palsy)
Bradykinesia, rigidity, falls (earlier than Parkinson’s)
ABNORMAL VERTICAL EYE MOVEMENTS
ALS
weakness and atrophy, fasciculations, both UMN and LMN signs
apathy
Huntington’s
CAG repeat
dementia (stealing, cheating, substance abuse, driving probs - SOCIAL BEHAVIORAL CHANGES) depression, chorea (fleeting high velocity movements)
more characteristic GROSS changes in brain, marked caudate atrophy on CT/MRI
CJD
Rapid progressive dementia (months as opposed to several years)
Prion
55-65
Dementia with myoclonus (by definition faster than volitional movements)
Sporadic
vCJD
bovine to human CJD
younger presentation
slower progression of disease
Kuru
Prion
Early tremor and ataxia
Cannibalism
GSS (Gerstmann-Straussler-Scheinker)
Prion Autosomal dominant Cerebellar findings: clumsiness, incoordination, gait, ataxia NOT myoclonus usually Presentation may vary even with family
Fatal Familial Insomnia
Prion Onset 35-60 Autosomal Dominant Progressive insomnia Memory loss, confusion, hallucinations
Binswanger’s
due to uncontrolled HTN, white matter loss (low density lesions)
Normal Pressure Hydropcephalus
Potentially reversible
Triad: dementia, gait, incontinence
Gait most likely to improve with tx/sx
Multi-Infarct Dementia
Vascular, step-wise clinical progression
Prevent stroke!
