Which AED classically is associated with hirsutism (in women), gingival hyperplasia and facial deformities/changes.
How does this drug also case ataxia and dysmetria with long term use?
PHENYTOIN
Causes cerebellar shrinking, which can present with cerebellar signs.
“Saturday night palsy” or Radial nerve entrapment, occurs when there is prolonged arm pit entrapment. IE, a drunk falls asleep with arm hanging over something.
What is the classic TRIAD of symptoms?
- Weakness of extensors of wrist and fingers (wrist drop)
- Weakness of tricepts
- Problems with supination
Describe the deficit in the following mononeuropathies:
- Median Nerve
- Ulnar Nerve
- Radial Nerve
- Median N. = Pain/numbness/tingline of thumb and 2nd/3rd digits.
- Ulnar N. = Weakness of hand grip- due to…
- Weakness of flexor carpi ulnaris
- Weakness of intrinsic hand muscle
- Weakness of 4th and 5th digit flexors. - Radial N. = Weakness of extensors (hand, elbow) and problem with supination.
A patient is treated with an MAOI-A for depression and is diagnosed with Parkinsons Disease.
- Why is Levodopa/carbidopa contraindicated with MAOI-A use?
How long should the washout period be before starting Levodopa/Carbidopa?
- MAOIs are post synaptic enzymatic metabolizers of Dopamine.
Concurrent use of MAOI plus levodopa/carbidopa can decrease efficacy of Levodopa/Carbidopa and WORSEN PD symptoms.
- 2 week washout period.
Damage to these frontal lobe areas would cause:
- Orbitofrontal region
- Dorsolateral frontal region
- Medial frontal region
- Orbitofrontal region = personality change (disinhibition, mood lability, irritability, euphoria, poor judgment, distractibility)
- Dorsolateral frontal region= Executive function change
- Medial frontal region = Apathy syndrome
Which brain lesion is associated with MANIA and which with DEPRESSION?
Mania = R frontal
Depression = L frontal
Which area of the brain is the main site for serotonergic neuronal cell bodies?
Raphe Nuclei of brain stem, mostly in PONS.
What is the pathophysiology of Wilson’s disease?
Problem incorporating copper into Ceruloplasmin and diminished biliary excretion of Cu.
Leads to excessive Cu build up in organs. In the brain, especially in Basal Ganglia.
What is the genetic inheritance pattern of Wilson’s disease and what chromosome is the gene located in?
AUTOSOMAL RECESSIVE
CHROMOSOME 13.
Most common etiology of intracranial hemorrhage?
HTN.
