Spinal Cord, sleep disorders, movement disorders Flashcards
(70 cards)
where is artery of adamkiewicz?
at T10 major source for lower cord
do polyneuropathies have a truncal sensory level?
no that’s what makes spinal lesions different
what is lhermitte sign?
electric like sensation extending down back and into arms with neck flexion
(seen with focal cevical lesions most notably demyelinating)
what important dysfunction is very prominent in spinal cord lesions?
urinary urgency/incontinence
kernig vs. brudinski?
kernig- painful knee extension/resistance with hips and knees flexed
brudinski- involuntary lifting of legs with neck flexion in spine position
what is- initial flaccid paraplegia or quadriplegia depending on location of artery occlusion followed by the flaccidity converting to spasticity with increased reflexes and Babinski signs. Sensory loss is dissociated with loss of pain and temperature and sparing of vibration, position sense, and partially touch. Bladder and bowel function are impaired.
anterior spinal artery syndrome
is anterior spinal artery syndrome or posterior spinal artery syndrome more common?
anterior spinal artery
Classically, presents with pain and temperature loss in cape distribution, weakness/atrophy in arms, and, ultimately, corticospinal and dorsal column dysfunction below lesion?
syringomyelia- cavity within the cord, sometimes with chiari 1
what is progressive involvement of corticospinal tracts and dorsal columns with increased reflexes, Babinski signs, and loss of position and vibration? what are the 3 most common causes?
subacute degeneration
- vitamin B12- anemia post gastric surgery
- copper deficiency- post gastric surgery or zinc toxicity
- Vitamin E deficiency- post gastric, CF, abetalipoproteinemia
what is hereditary spacstic paraparesis? autosomal dominant or recessive or x-linked
degeneration of distal corticospinal axons and dorsal column degeneration and manifested primarily by slowly progressive spastic paraparesis
what do patients with hereditary spastic paraparesis?
spasticity, hyperactive reflexes and babinski signs
What are key points of friedreich ataxia?
autosomal recessive, degeneration of the most of the parts of the spinal cord, childhood onset
-ataxia, sensory loss, dysarthria, areflexia, and babinski
what associated clinical findings can be found with ALS?
frontotemporal dementia and parkinson disease
what is progressive spastic paraparesis due to the transmission of a type C oncovirus by semen, blood, breast milk and shared needles. It is endemic in the Caribbean and South America?
HTLV-1 myelopathy
what occurs late in the course of theAIDS systemic illness. Major symptoms are spastic paraparesis, weakness, painless vibratory and position sense loss and sensory ataxia?
AIDS associated vacuolar myelopathy
where does polio attack? what characterizes it?
anterior horns
-flaccid weakness,
primary/idiopathic movement disorders may start unilaterally, but?
usually become bilateral overtime
acute onset unilateral movements are frequently secondary and should prompt brain imaging
T of F- the tardive syndromes can persist for many years after the offending drug has been discontinued?
true
substania nigra inclusion bodies are called what in parkonsins?
lewy bodies
sensory ataxia usually comes from what? how do you tel difference?
dysfunction of large-fiber sensory nerves and/or posterior columns in the spinal cord
patients will not have position or vibration senses
patients with sensory ataxia should be assessed for what?
B12
where does CO poisoning attack
globu pallidus .parkinsonism
primary or idiopathic movement disorders have what type of onset?
slow and progressive
lack of progression of a syndrome with an acute onset is suspicsious of what?
secondary structural lesion
