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Neuro > Spinal diseases, demyelinating myelophatyes, neuropathies > Flashcards

Spinal diseases, demyelinating myelophatyes, neuropathies Flashcards

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1
Q

C segments injury

A

tetraparesis/tetraplegia

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2
Q

Th to L segments injury

A

Paraparesis/paraplegia

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3
Q

Arnorld-Chiari syndrome

A

Meningomyelocele
Severe tonsilar herniation
Hydrocephalus

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4
Q

Neuromyelitis optica type of disease

A

Autoimmune disease

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5
Q

B12 deficiency leads to

A

Symmetrical sensory disturbances of lower limbs
Ataxia
Spasticity
Loss of reflexes
Loss of vibration and proprioception sense
Problem in posterior column

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6
Q

Spondylosis type of disease

A

Degenerative spine disease.

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7
Q

Spondylosis process

A

Dehydratation and disintegration of the nucleus pulpous–> decreased disc height–> spinal canal stenosis–> compression of the spinal cord

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7
Q

Spondylosis parts more often involved

A

Cervical and lumbar

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8
Q

Spondylosis. Clinical

A

Sciatica
Brachialgia

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9
Q

Cauda equina syndrome type of disease

A

degenerative disease

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10
Q

Cauda equina syndrome what happens

A

lumbar canal stenosis leads to compression of the cauda equina

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11
Q

Cauda equina syndrome. Clinical

A

Pain in back, legs
Weakness or paralisis
Urinary retention and urinary incontinence
Urinary retention, incontinence
Sexual disfunction
Anestesia in buttocks, anus, genitalis

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12
Q

Cauda equina treatment

A

Decompression surgery in 24h

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13
Q

Neuromyelitis optica treatment

A

inmunosupresors, corticoesteroids, anti-B therapy

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14
Q

Neuropathies. Clinical

A

Patient complains about weakness, sensory disturbance (numbness, pain), autonomic disturbance (diarrea, bladder dysfunction)
Exploration:
Pes cavas, ulceration, fasciculation
Nerve thickness, reduce muscle consistency

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15
Q

Axonopathy. Symptoms and signs

A

Burning, tingling and numb feet. Start distally and goes to proximally. Walking difficulties
Atrophy of small feet muscle
Weakness of toe and ankle dorsiflexion
Distal loss of touch and pinprick sensation
diminished/non-elicotable Achilles reflexes

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16
Q

Neuropathy with translation blocks

A

Asymmetric motor nerve impairment, usually starting in the hands
Positive anti-GM-1 antibodies
Good response to treatment with human immunoglobulins

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17
Q

Patient with a current sharp Knife.like” pain in her lower right jaw is likely to have

A

Trigeminal neuralgia

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18
Q

Polyneuropathy that affects nails

A

arsenic poisoning

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19
Q

Antibodies in Miller-Fisher syndrome

A

anti-ganglioside

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20
Q

Charcot-Marie tooth. Clinical

A

Feet deformation
Foot drop because of distal weakness
Atrophies
Sensory symptoms

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21
Q

Type of Charcot-Marie tooth that is demyelinating

A

type 1

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22
Q

Type of Charcot-Marie tooth that is axonal

A

type 2

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23
Q

Fibers that are more affected in Sjogren’s neuropathy

A

Sensory fiber

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24
Gunyon's canal syndrome
Pinched ulnar nerve in the wrist
25
Nerve that is biopsies in polyneuropathy
Suralis
26
Best treatment for trigéminas neuralgia
Carbamazepine
27
Hallmark of the meralgia of paresthetics is
Hypesthesia lateral to the thigh
28
Nerve affected in meralgia paresthetica
cutaneous femurs lateralis
29
The contraction of the biceps when the doctor elicited the styloradial reflex is due to
myelopathy
30
Diabetic neuropathy. Clinical
Painful CN III defect Numbness of the toes Inability to flex at the hip and extend at the knee Unilateral flank pain along the rib arch Painful paresis Glove and stocking sensory loss
31
Subacute combined degeneration of the spinal cord. Clinical
Spastic weakness in the legs Paresthesia in extremities Loss of vibration and position sense Cognitive impairment Optic atrophy Extensor plantar responses and absent ankle jerks
32
Subacute combined degeneration of the spinal cord is
Progressive degeneration of the spinal cord due to B12 deficiency
33
Neuromyelitis optica type of disease
Chronic autoimmune disease which affects atrocities. Antibodies against acquaporines. Necrotic lesion
34
Neuromyelitis optica. Clinica
Bilateral paraparesis o tetraparesis Relapses Long cervical cord lesion Nausea and vomiting Brain lesions Blindness
35
Neuromyelitis optica treatment
Anti-B theraphy, inmunosupresor, corticoesteroids
35
Acute disseminated encephalomyelitis age
children and young adults
36
Acute disseminated encephalomyelitis
Infection or vaccination precedes the disease. Brain is infiltrated by LT Fever Headache Nausea Epileptic seizures Encephalopathy: disartria, dysphonia, foggy vision, ataxia, tetraparesis Coma
37
Acute disseminated encephalomyelitis treatment
Corticosteroids or plasmaforesis
38
Charcot-marie-tooth type of illness
Hereditary motor and sensory polyneuropathy
39
Charcot-marie-tooth. Clinical
Feet deformation (pes cause) Foot drop because of distal weakness Atrophies Sensory symptoms
40
Guillain-Barré syndrome. Type of disease
Acute inflammatory demyelinating polyneuropathy
41
Guillain-Barré syndrome. Antibodies
Antibodies antigangliosides
42
Guillain-Barré syndrome. Clinical
Parestesia in the lower limbs that ascendents to the upper limbs Reflexes attenuate or disappear in few days of onset Nistagmus Pain Respiratory failure Postural hypotension, arritmias, urinary retention, constipation, diarrea Facial disparesis Pupillary paralysis Propioception is more affected than pain and temperature sensation EMG: prolonge wave F Antigangliosides antibodies Lumbar puncture: more proteins with normal cell count
43
Guillain-Barré syndrome. Treatment
Immunotherapy. If there is no response, plasmapheresis
44
Progressive multifocal encephalopathy. Clinical
Subacute cortical disfunction: aphasia, mental changes, visual problems
45
Types of Multiple sclerosis
Relapsing remitting: most common, stable between relapses characterized by attacks of neurological dysfunction Secondary progressive: evolve from relapsing remitting type. Disability progression independent of relapses. Consequence of secondary degeneration Primary progressive: Slowly progressive symptoms or infrequent relapses. Disease onset after 40 years. Worse prognosis Benign: Retrospecting diagnosis. Non accumulation of disability along time
46
Multiple Sclerosis. Clinical
- Visual problems: optic neuritis (pain, central scotoma, color vision disturbance). Vertical gaze palsy - Paresis, paraplegia - Parestesia Iof the trunk or legs. Lhermitt's sign: electrical sensation that runs through the back and limbs, elicited by bending the head forward. In advanced stages: - Cerebellar: incoordination, unbalance - Picturing and sexual disfunction - Fatigue - Cognitive disorders, mood disorders - Pain - Brainstem signs and symptoms: nystagmus, internuclear ophthalmoplegia - Paroximal symptoms: tonic spasms, trigeminal neuralgia, paroxymal dysarthria, ataxia, paroxysmal sensory and pain symptoms, double vision, akinesia, proximal paresis
47
What do you see in MRI of Multiple Sclerosis
Lesions in brain, in spinal cord. Brain atrophy, bigger ventricles
48
Multiple sclerosis treatment
Symptomatic Treatment of relapses: corticosteroids, metilprednisolone Modifying therapies: INF beta (not for symptoms), glatiramer acetat, Dimetil fumaram, teriflunomid, Natalizumab
49
% of ALS familiar
5%
50
Patient with muscle atrophy, fasciculation and plantar response extension is likely to have
ALS
51
Riluzole works by
Glutamate receptors
52
Amiotrofic lateral sclerosis (ALS) what neurones involves
Upper and lower motor neuron
53
ALS clinical features
Hypo/hypereflexia Disartria, disfagia Spasticity Amiotrofic Babinski
54
Mutation of SOD1
ALS
55
Primary lateral sclerosis
A form of ALS in which only the corticospinal tract is affected
56
Reflex in a patient with ALS that is a sign of pseudobulbar impairments
Clonic masseter reflex
57
Incidence of ALS
2/100000 per year
58
Motor neuron damage that involves only the upper motor neuron
Primary lateral sclerosis Pseudobulbar palsy Monomelic amyotrophy Spastic familiar paraparesis
59
Motor neuron damage that involves only the lower motor neuron
Progressive muscular atrophy
60
Lumbar puncture in multiple sclerosis
Oligoclonal bands, positive in CSF, negative in serum
61
Multiple sclerosis antopato
plaques of demyelination in the withe matter Perivascular mononuclear infiltrate in the CNS Axon collapse in the CNS
62
Treatment progressive multiple sclerosis
cystostatics
63
70 years old ataxia, forget things, hyperreflexia of the upper and lower limbs, positional sensitivity disturbed
Subacute combined degeneration of the spinal cord
64
Drug hyperexcitable bladder in MS
Anticholinergics (oxybutynin, imipramine, toterodine)
65
What do black holes on MRI in MS mean
Axonal collapse
66
Treatment for fatigue in MS
Amantadine
67
Treatment to reduce incidence of seizures in MS
Natalizumab
68
Azathioprine is used for
Liver damage
69
ADM-specific test
Extensive symmetrical changes on the head MRI in both hemispheres Meningitic fluid Negative oligoclonal bands in the lymphocyte after remission of the disease
70
Best test for multiple sclerosis
MRI
71
Form of MS that shouldn't be treated with interferon beta
Primary progressive
72
Patient with Ms no responding to IFN beta what to give
Natalizumab
73
Optic neuritic a year ago now has spasticity is likely to have
MS
74
Patient with primmary progressive multiple sclerosis can be treated with interferons)
No
75
How do demyelinating lesions look in MRI sequences
flair-weighted
76
How do demyelinating lesions look in CT T2
increased signal T2
77
Treatment for spasticity in MS
Baclofen Benzodiazepine Tizanidine Botulinum
78
Antibodies in a patient that lost her sight months ago and is paretic
anti-NMO
79
Vitamin deficiency associated with multiple sclerosis
Vitamin D

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