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Anti Hu antibody

Small cel lung ca

Encephalomyelitis, sensory neuropathy

1

Anti-Ri antibody

Breast and small cell lung ca in adults, neuroblastoma in children

Opsoclonus-myoclonus, retinal degeneration

2

Anti-Ta antibody

Brain and testicular tumors

Limbic and brainstem encephalitis

3

Anti-Tr antibody

Hodgkin's disease

Subacute cerebellar disorder with dysarthria and nystagmus (against purkinje cells)

4

Anti-VGCC antibody

Lambert-eaton syndrome, associated with oat cell/small cell lung ca

Neuromuscular disorder, ab against presynaptic voltage-gated calcium channels

5

Anti-Yo antibody

Ovarian, uterine, breast cancer

Cerebellar disorder, brainstem encephalitis

6

Glutamic acid decarboxylase

Stiff man syndrome, involuntary muscle spasms and rigidity

7

Anti-Ma antibody

Testicular or lung ca

Limbic encephalitis, b/l hyper intense lesions on T2 in medial temporal cingulate and insula, memory impairment And AMS

Path- peri vascular mononuclear infiltrates, no viral inclusions

8

West syndrome

Infantile spasms, repeated flexion or extension spasms of head, trunk and limbs 10-30sec, 4-8mo

Eeg: hypsarrhythmia

Tx: corticotropin (acth), prednisone, vigabatrin, ketogenic diet

9

Juvenile myoclonic epilepsy

Myoclonic jerks usually in morning, normal IQ, 12-16yo, autosomal dominant

Eeg: 4-6hz spike waves and poly spike discharges

Tx: valproate

10

Petit mak seizure

Absence sz, blank staring spells

Eeg: 3hz spike wave discharges

Tx: ethosuximide, valproate

11

Lennox-gestaut

MR, uncontrolled seizures in 80%, 2-6yo, associated with encephalopathy and malformations, proceeded by infantile spasms

Tx: valproate, lamotrigine, topamax

12

Ia sensory fibers

alpha-type A

Annulospiral endings of muscle spindles

Largest (17um) and fastest (120m/s)

13

Type Ib sensory fibers

Alpha-type A

Golgi tendon organs

16um diameter

14

Type II sensory fibers

Beta and gamma type A

Flower spray endings of muscle spindles and cutaneous tactile receptors

8um diameter

15

Type III sensory fibers

Delta type A

Temperature, crude touch, and pricking pain

3um diameter

16

Type IV sensory fibers

Type C

U myelinated fibers relaying pain, itch, temperature, and crude touch

0.5-2um diameter

17

Skeletal muscle motor fibers

Alpha type A

Myelinated, fastest motor fibers

18

Muscle spindle motor fibers

Gamma type A

Myelinated

19

Sympathetic motor nerve fibers

Type C

unmyelinated, slowest

20

Meissner corpuscles

Touch, vibration (80cycles per sec), also some spatial resolution but not as good as merkel
Small receptor fields, signal transmitted via large myelinated beta-type A fibers
Rapidly adapting, superficial in no hair skin, esp soles of feet and palms
Allow people to distinguish between two pointed structures placed together on skin
Consist of stack of flattened Schwann cells

21

Merkel disks

Touch and pressure, spatial pattern (sharpest of all sensory endings in skin)
Small receptive fields, slowly adapting
Group together to fill a single Iggo dome receptor, which is innervated by single beta type A fiber
Superficial in dermal papillae of hairy and no hair skin, at center of papillary ridge

22

Pacinian corpuscle

Vibration (high freq stim- 30-800 cycles per sec)
Superficial and deep, rapidly adapting
Beta type A fibers
Largest sensory receptor

23

Ruffini end organs

Heavy touch and pressure
Slow adaptive, large receptive fields
Deep layers (sub q and joint capsules)

24

Hair end organs

Touch
Rapid adapting
Base of hair follicles

25

Free nerve endings

Touch- delta type A fibers 5-30m/s
Tickle/itch - C fibers 62m/s, unmyelinated
Pain- C fibers