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Metabolic Encephalopathies and Vitamin Deficiencies
Neuro Assessment 10
27
Anatomy
Graduate
12/13/2011

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Cards

Term
What are the systemic complications related to diabetes?
Definition
Small vessel disease in the brain w/ lacunar infarctions
Argyll Robertson pupil - preserved accommodation reflex, absent light reflex
Neuropathy - hypo/areflexia, atonic bladder, mononeuritis multiplex, Charcot's joints
Amyotrophy
Copressive nerve syndromes
Term
What can both hypo and hyperglycemia cause?
Definition
Encephalopathies
Term
What are the symptoms of hypoglycemia?
Definition
Confusion/Coma
Seizures
pupils dilated
Reflexes Brisk
Babinskis extensor
Blood sugar Low
IV glucose response
Term
What is diabetic encephalopathy associated with?
Definition
Confusion/Coma
Seizures +/-
Pupils Small
Reflexes Decreased
Babinskis flexor
Blood Sugar High
Acetone +/-
No Response to IV glucose
Term
How does sensory neuropathy present in Diabetic Neuropathy?
Definition
Symmetrical
Painful
Lower Limbs > upper limbs
disturbing the night sleep
Term
How does Autonomic neuropathy present in Diabetic patients?
Definition
atonic bladder
Term
How Does Diabetic ophthalmoplegia develop and present?
Definition
From infarction of nerve w/ vascular insufficiency
Causes:
diplopia
pain
ocular muscle weakness
Term
What are the 2 common nerves affected by Diabetic ophthalmoplegia?
Definition
CN 3 & 6
Term
What is caused by simultaneous infarction and ischemia of different peripheral nerves?
Definition
Mononeuritis Multiplex
Term
What causes amyotrophy?
Definition
involvement of roots
Term
What are the 6 Diabetic Neuropathies?
Definition
Sensory Polyneuropathy
Autonomic Neuropathy
Diabetic Ophthalmoplegia
Diabetic Mononeuritis
Mononeuritis Multiplex
Diabetic Amyotrophy
Term
What parts of the Brain does Hypoxic Encephalopathy affect most?
Definition
Hippocampus
Watershed areas btw vascular territories of major arteries
Deep folia of the cerebellum
Term
What are the Clinical Features of Hypoxic encephalopathy?
Definition
Drowsiness --> Coma
EEG Slow
Seizures
Myoclonus
Amnesia after Recovery
Term
Why is there amnesia after recovery from Hypoxic Encephalopathy?
Definition
Hippocampal involvement
Term
What are 4 Causes of Hypoxia?
Definition
1. Cardiac Arrest
2. CO poisoning
3. High altitude sickness
4. COPD/CO2 narcosis
Term
What kind of Encephalopathy might a patient have if they have a cherry red color in the skin with cyanotic hue?
Definition
Hypoxic Encephalopathy
Due to CO poisoning
Term
What are the symptoms of Posthypoxic Syndrome?
Definition
1. Persistent Coma/Vegetative
2. Dementia/Amnesia
3. Parkinson's Syndrome
4. Myoclonus
Term
What can result form basal ganglia involvement of hypoxic encephalopathy?
Definition
Parkinson's like state
Term
What can result with Diffuse cortical ischemia from hypoxic encephalopathy?
Definition
myoclonus
Term
What are they Systemic complications of Uremia & Neurotoxicity?
Definition
Seizures, myoclonus
Dysequilibrium Syndrome
Dementia
Confusion
Slow EEG
Subdural hematoma
Asterexis
Myopathy
Peripheral Neuropathy
Term
How are the reflexes in hepatic encephalopathy compared to uremic encephalopathy?
Definition
Hepatic - Brisk Reflexes
Uremic - Decreased Reflexes
Term
What symptoms are associated with Hepatic and not Uremic Encephalopathy?
Definition
Apraxia
Brisk Reflexes
EEG - Triphasic waves
Term
What can acute hepatic encephalopathy with hepatic failure be caused by>
Definition
1. Drug intoxications/acetaminophen overdose
2. Chronic cirrhosis/infections and metabolic
3. Elevated ammonia levels
Term
What are the clinical features of Encephalopathy caused by Electrolyte Distrubances?
Definition
1. Drowsiness/stupor/coma
2. Acute confusional state
3. Seizure
Term
What electrolyte is low if there is tetany?
Definition
Ca
(also seen in low Mg)
Term
What does SIADH cause?
Definition
Hyponatremia
Term
What can Diabetic insipidus and nonketotic diabetic coma be caused by?
Definition
Hypernatremia
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