Term
| Do higher density objects show up light or dark on a CT scan? |
|
Definition
| Bright: Metal> Bone > Calcification > Contrast enhancement, Acute blood |
|
|
Term
| How do most nonhemorrhagic lesions show up on a CT scan |
|
Definition
| Slightly dark due to tissue edema, less dense |
|
|
Term
| How do things appear in T1-weighted images |
|
Definition
| CSF is dark, gray matter is gray and white matter is white |
|
|
Term
| How do things appear in T2-weighted images |
|
Definition
| Gray matter is relatively white, white matter is relatively gray, and CSF is white |
|
|
Term
| How do things appear on a FLAIR image |
|
Definition
| Gray matter is relatively white, white matter is relatively gray, and CSF is black |
|
|
Term
| What things are pretty much always dark on any type of MRI |
|
Definition
| Anything that has rapid fluid flow or sparse H atoms, i.e. blood, bone, plastic implants etc.. |
|
|
Term
| What is the most sensitive sequence for most nonhemorrhagic lesions. Do they appear light or dark? |
|
Definition
|
|
Term
| What is the most sensitive sequence for acute infarction |
|
Definition
| DWI (Diffusion weighted imaging) |
|
|
Term
| How do hemmorrhagic lesions appear on T1w and T2w |
|
Definition
| bright on T1w images or black on T2w images |
|
|
Term
| What is the most sensitive sequence for most hemorrhagic lesions |
|
Definition
| T2w gradient echo (T2w GRE.) The black appearance of hemorrhage “blooms.” |
|
|
Term
|
Definition
| Failure of optic fissure to close |
|
|
Term
|
Definition
| Rigidity of lens increases with age – . |
|
|
Term
| Pigment epithelium - outer layer optic cup. |
|
Definition
1. Absorbs light, decreases reflection.
2. Phagocytoses discs in outer segments of photoreceptors.
3. Resynthesizes photopigments.
4. Weak junction with retina is site of retinal detachment. |
|
|
Term
| supplies blood to inner layers of retina |
|
Definition
|
|
Term
| supply blood to outer segments of photoreceptors |
|
Definition
|
|
Term
| Discuss the Retina - inner layer of the optic cup. What cells make it up and what functions do they have? |
|
Definition
Closest to pigment epithelium are the rods and cones (color), this is the site of phototransduction. Signal is conducted to Bipolar cells which further conduct the signal to the ganglion cells of the optic nerve. The ganglion cells are where the impulses are generated. Also in the region of the bipolar cells are the horizontal and amacrine cells which are Lateral connections for contrast
enhancement. (Synapses located in outer and inner plexiform layers.) Glial Cells (in retina are called Müller Cells) - span the width of the retina. Play an important role in retinal homeostasis of ions and neurotransmitters |
|
|
Term
| Bulging optic disc vs. depressed (cupped) optic disc. |
|
Definition
Bulging = intracranial pressure (tumor)
Cupped/depresssed = Intraocular pressure (glaucoma) |
|
|
Term
|
Definition
an area of depressed vision within the visual field.
A scotoma can be physiological (blind spot) or pathological |
|
|
Term
| At what point do the axons of the optic nerve become myelinated |
|
Definition
| after they pierce the sclera at lamina cribrosa |
|
|
Term
|
Definition
The rods operate (dominate) in dim
light |
|
|
Term
|
Definition
| Cones operate/dominate in bright light |
|
|
Term
| Which Regenerates faster and which have higher sensitivity between the rods and cones |
|
Definition
| Cones regenerate faster, rods are more sensitive |
|
|
Term
| Age-related macular degeneration |
|
Definition
(1) Exudative (i.e., wet or neovascular) and (2) Non-exudative
(i.e., dry atrophic)The exudative or neovascular AMD is associated with
neovascularization of the subretinal choroidal membrane and detachment of the retinal pigment epithelium and subretinal hemorrhages. Dry or non-exudative AMD is much more prevalent and generally less severe than wet or exudative. Non-exudative AMD leads to clumps of pigments in the outer retina (Drusen) with focal atrophy of the retinal pigment epithelium, and gradual loss of central vision |
|
|
Term
|
Definition
| Mostly effects rods, peripheral retina degenerates causing tunnel vision and night blindness. Black pigment in the peripheral retins and thin blood vessels at the optic nerve head represent the basic pathological abnormalities |
|
|
Term
|
Definition
Neovascularization, cottonwool spots. This arises as a result of pathological changes in blood vessels
whose circulation becomes compromised. The abnormal vessels multiply (i.e., angiogenesis) in an uncontrolled manner causing blindness. Present treatment involves use of lasers to stop proliferation of the blood vessels and leakage of fluid into the retina |
|
|
Term
|
Definition
(“nearsightedness”), people can see well up close, but have difficulty
seeing far away because the focal point is in front of the retina |
|
|
Term
|
Definition
the cornea has a radius of curvature that is different in one axis
relative to the other. Therefore, light is focused on more than one point which
leads to blurred vision near or at a distance |
|
|
Term
|
Definition
(“farsightedness”), people have trouble seeing up close because
the focal point is behind the retina. The cause is a cornea that is flatter than normal, or an eye that is shorter |
|
|
Term
| Where do most of the axons from the eye go to? |
|
Definition
| Lateral Geniculate Nucleus of the Thalamus. In the LGN there are 6 layers, 3 from each eye. |
|
|
Term
| Where do the fibers of the optic radiation for lower and upper field course? |
|
Definition
| Both course lateral to the lateral ventricles. Upper field loop over the temporal horn of the lateral ventricle and course along the temporal lobe terminating below the calcarine fissure. Inferior field fibers take a more direct posterior course through the deep parietal white matter and terminate above the calcarine fissure |
|
|
Term
| Vascular supply of ganglion cells, bipolars, inner part of receptors. Sole supply of retina inner surface |
|
Definition
|
|
Term
| Vascular supply of outer segments of photoreceptors |
|
Definition
|
|
Term
| Vascular supply to optic tract and LGN |
|
Definition
| Anterior choroidal artery - a branch of the Internal Carotid Artery |
|
|
Term
vascularize optic radiation in
parietal lobe |
|
Definition
| Middle cerebral artery - deep branches |
|
|
Term
| Vascular supply to part of LGN and back to calcarine fissure |
|
Definition
Posterior cerebral artery (PCA) branches and forms calcarine artery. The PCA is easily compressed during herniation of the medial temporal lobe
over the free edge of the tentorium |
|
|
Term
| Non dominant lesion of Angular and supramarginal gyri of occipitaoparietal area will produce what? |
|
Definition
Lesions result in hemispatial
neglect but do not disturb visual sensation. |
|
|
Term
| Fusiform or occipitotemporal gyrus lesions produce what symptoms |
|
Definition
| These areas identify objects, symbols, colors (“what” pathway). Lesions in this area result in visual agnosia and alexia (on left side) and prosopagnosia (on right side). |
|
|
Term
|
Definition
| loss of the ability to read |
|
|
Term
|
Definition
| loss of ability to recognize objects, persons, sounds, shapes, or smells |
|
|
Term
|
Definition
| ability to recognize faces is impaired |
|
|
Term
|
Definition
i. Severity: least severe
ii. Anatomy: nerve structure remains intact
iii. Etiology: ischemia
iv. Recovery: days to weeks (average 6-7 weeks)
v. Electrically:
1. no degeneration of the nerve, and hence there is no regeneration
2. interruption of conduction impulse down the nerve |
|
|
Term
|
Definition
i. Severity: more severe injury than neurapraxia
ii. Anatomy: external structure of the nerve and the internal connective tissue sheaths remain intact (epineurium and perineurium are preserved)
1. axons and myelin continuity is lost
2. affects motor, sensory, autonomic nerves
3. axon loss = Wallerian degeneration
a. EMG = denervation potentials and fibrillations
iii. Etiology:
1. nerve crush injuries
2. nerve stretch injuries
iv. Recovery: full recovery can occur through regeneration of axons
1. slow process: regeneration occurs over weeks to years
2. there is an element of retrograde proximal degeneration of the axon
3. regeneration fibers must cross the injury site and regeneration through the proximal or retrograde area of degeneration may require several weeks
4. neuritis tip progresses down the distal site, such as the wrist or hand
5. repair rate: as fast as 2 to 3 mm per day and as slowly as 1.5 mm per day
v. Electrically: denervation changes
1. complete loss of voluntary motor units
2. regeneration of motor end plates will occur |
|
|
Term
|
Definition
i. Severity: most severe
ii. Anatomy:
1. axons and all surrounding structures are interrupted
2. nerve is no longer in continuity
3. (the most extreme form is transaction of nerve)
4. (most neurotmetic injuries do not produce gross loss of continuity of the nerve but rather internal disruption of the architecture of the nerve sufficient to involve perineurium and endoneurium as well as axons and their covering)
iii. Etiology:
1. tearing of nerve
2. sharp transaction of nerve
3. local anesthetic toxicity
iv. Recovery:
1. surgical procedure is needed to restore nerve integrity
2. prognosis is uncertain
v. Electrically:
1. denervation changes are the same as seen in axonotmesis lesions:
a. complete loss of voluntary motor units
b. regeneration of motor end plates will occur
2. complete loss of motor, sensory, and autonomic function
3. axonal regeneration may cause a neuroma to form at the proximal stump |
|
|
Term
| Lesions of PPRF result in horizontal gaze paralysis of both eyes to which side? |
|
Definition
| Side of the PPRF lesion!!! |
|
|
Term
| How does a hemorrhagic lesion show up on a CT scan |
|
Definition
|
|
Term
| An ICA aneurysm pushing on the lateral part of the optic chiasm would cause what visual field defect |
|
Definition
| partial, nasal hemianopsia |
|
|
Term
|
Definition
| Spiral Ganglion, ventral or dorsal cochlear nuclei. Then S.L.I.M. - Superior Olivary nucleus, lateral lemniscus, Inferior colliculus, Medial Geniculate nucleus of the thalamus. Then auditory radiations to the transverse gyri of Heschl in the lateral fissure. |
|
|
Term
| When someone presents with dermatomyositus, you should look for what? |
|
Definition
|
|
Term
| What Cancer is associated with Myasthenia gravis? |
|
Definition
|
|
Term
| What Cancer is associated with LEMS? |
|
Definition
|
|
Term
| Symptomatic treatment of acute migraine attack |
|
Definition
1. Non-specific treatment of migraine: aspirin, acetominophen, non-steroidal antiinflammatories
(e.g. naproxen sodium; diclofenac).
2. Specific: * isometheptene (Midrin [isometheptene, dichloralphenazone, acetaminophen]):
should be taken with the very first symptoms of headache.effective in patients who
do not tolerate ergots; also effective in tension headache. 3. Specific: Ergot alkaloids: Dihydroergotamine, can cause nausea, over use headaches and gangrene from vasoconstriction(ergotism) do NOT use in pregnancy. 4.Triptans - Sumatriptan, *Naratriptan, don't use within 24 hours of using ergotamines |
|
|
Term
|
Definition
| Treat to comorbidity. Blood pressure meds: Propranolol, Nadolol, Timolol, Verapamil(Ca channel blocker) NSAIDS: Ibuprofen. Tricyclics: Amitriptyline (Elavil): especially good for the patient who also has tension headaches. Anticonvulsants: Divalproex Sodium (Depakoate), Topiramate, gabapentin. Anti-depressants are also used if depression is present |
|
|
Term
| CLUSTER HEADACHE TREATMENT |
|
Definition
1. Prevention:
a. *Verapamil (calcium channel blocker)
b. *Lithium
c. Anticonvulsants (Topiramate, valproate)
2. Acute treatment:
a. Oxygen
b. Sumatriptan SQ
c. Dihydroergotamine IV/IM |
|
|
Term
| What beta blockers can be used for prevention of headache and what mechanism do they work by and what contraindications do they have |
|
Definition
| Inderal, Timolol. Also lower blood pressure. Mech: Membrane stabilization. Contraindication: asthma, bradycardia |
|
|
Term
| Which Ca channel blockers could be used for prevention of migraine and What contraindications do they have? |
|
Definition
| Verapamil, Nifedipine. contraindications: low blood pressure; heart block |
|
|
Term
| Contraindication of NSAIDS in prevention of migraine? |
|
Definition
| GI; Reye’s syndrome in children |
|
|
Term
| Tricyclics used for prevention and contraindications. |
|
Definition
| Amitriptyline, Nortriptyline. Esp good for lack of sleep and tension headaches. Contraindications: too many other drugs that effect serotonin levels, weight gain. |
|
|
Term
|
Definition
| Depakote. Anti-convulsant used to prevent migraines. Mechanism: Inhibits repetitive firing; affect on channels. weight gain, GI, tremor. AVOID in pregnancy! |
|
|
Term
|
Definition
| Topomax. Anti-convulsant used to prevent migraines. Mechanism: Inhibits repetitive firing; affect on channels. Weight loss. Avoid in pregnancy! |
|
|
Term
| Antidepressants used to prevent migraines |
|
Definition
– Fluoxetine (Prozac)
– Sertraline (Zoloft)
– Paroxetine (Paxil)
– Citalopram (Celexa)
– Dufluoxetine (Cymbalta |
|
|
Term
|
Definition
| Autosomal Dominant. CTG repeat. Use genetics, clinical features and EMG to diagnose. Treatment: Pacemaker for widening p-r interval. Ritalin and caffeine for hypersomnolence. |
|
|
Term
| Facioscapulohumeral muscular dystrophy |
|
Definition
| Diagnosis: DNA analyis for linkage to Chromosome 4 |
|
|
Term
|
Definition
| Shows signs of both Upper and lower motor neuron disease. Not a demyelinating disease, so EMG shows decreased AP amplitude due to dying axons but conduction velocity remains unchanged. Needle EMG active ongoing denervation of muscles. MRI should be normal. Rule out other diseases, MG, MS, RA, Syphilis. Spreads from one side to the other. |
|
|
Term
| Deep tendon refelx levels |
|
Definition
• biceps brachii/deltoid C5
• brachioradialis C6
• triceps C7
• patellar L4
• achilles S1 |
|
|
Term
|
Definition
• 5/5 normal strength for bulk and age
• 4/5 weak but able to give resistance
• 3/5 able to flex against gravity
• 2/5 able to flex with gravity eliminated
• 1/5 muscle contracts without joint mvmt
• 0/0 no muscle or joint movement |
|
|
Term
|
Definition
• 4/4 clonus
• 3/4 (normal) with spread
• 2/4 normal
• 1/4 only with reinforcement
• 0/4 no reflex can be elicited |
|
|
Term
| peripheral nerve strength testing |
|
Definition
| Ulnar - finger abduction. Radial - finger extension. Median - Grip strength. |
|
|
Term
| How do you test the C8 myotome |
|
Definition
| Palmaris longus/ wrist flexion. Try to uncurl their flexed wrist. |
|
|
Term
| How do you test the T1 myotome |
|
Definition
| Thumb opposition. They put their thumb to their pinky and you try to pull your index finger through it. |
|
|
Term
| Differences between MG and LEMS |
|
Definition
LEMS: spares the ocular and bulbar muscles. Repetitive contraction can result intransient improvement in strength. EMG reveals a progressive increment in the amplitude of multiple compound motor
action potentials attained with repetitive stimulation of a nerve (vs. in MG,
where there is a decrement in amplitude). TEnsilon test using edrophonium is postitive for both conditions. |
|
|
Term
| Three questions to diagnose migraine with 93% sensitivity. |
|
Definition
| 1. Moderate to severe pain 2. Nausea 3. Photophobia |
|
|
Term
| Pupillary light reflex pathway |
|
Definition
| Optic nerve, Chiasm, tract, do NOT synapse in LGB rather enters brainstem via brachium of the superior colliculus. Synapse in pre-tectum, Bilateral edinger westphal nuclei, CN III |
|
|
Term
|
Definition
| Goes through the hypothalamus down the hypothalamospinal tract? Sympathetic chain, SCG, follows Carotid, joins V-1, long ciliary nerve, to eye muscles for dilation and for raising eyelid (mullers muscle, not levator palpabrae) |
|
|
Term
|
Definition
| condition characterized by an unequal size of the pupils. |
|
|
Term
| Cocaine and hydroxyamphetamine tests |
|
Definition
| Cocaine doesn't dilate eye = defect somewhere in sympathetic pathway, non-localizable. If Hydroxyamphetamine dilates the eye, the lesion is before the Superior cervical ganglion, failure to dilate = proximal to Superior cervical ganglion |
|
|
Term
| List some causes of preganglionic horner's syndrome |
|
Definition
| Central: Stroke, VA dissection w brain stem. Pre-ganglionic: Apex of lung mass, cervical spine abnormality, or neuroblastoma in children |
|
|
Term
| List some causes of post ganglionic horner's syndrome |
|
Definition
| Dissection of Carotid artery, cluster headache |
|
|
Term
|
Definition
ipsilateral hearing loss with or without tinnitus as
well as a range of labyrinthine, brainstem, and cerebellar symptoms
and signs. Other manifestations include ipsilateral Horner syndrome
(rare), skew deviation (rare), nystagmus, ipsilateral facial numbness,
ipsilateral facial paresis, vertigo, dysarthria, vomiting, unsteadiness,
ipsilateral hemiataxia, and contralateral loss of pain and temperature
sensation on the limbs and body. |
|
|
Term
| SCA Infarction: (superior cerebellar artery syndrome) |
|
Definition
ipsilateral
Horner syndrome, ipsilateral limb ataxia, contralateral sensorineural
hearing loss (due to involvement of the lateral lemniscus carrying
decussated ascending auditory information), contralateral superficial
sensory loss, vertigo, nystagmus, nausea, and vomiting. |
|
|
Term
| VBI: (vertebrobasilar insufficiency) |
|
Definition
Hearing loss occurs in about
one fifth of patients with this entity. Deafness associated with
vertebrobasilar insufficiency mainly involves the cochlea, rather than
central auditory pathways. Tinnitus and vertigo are frequent
accompaniments, as are a wide a range of brainstem and cerebellar
symptoms and signs. |
|
|
Term
| Ramsay-Hunt syndrome (Herpes zoster oticus) |
|
Definition
vesicles in the external
auditory canal, burning pain in the ear, unilateral Bell palsy, unilateral
hearing loss, tinnitus, vertigo, and transient spontaneous nystagmus |
|
|
Term
|
Definition
may be part of a systemic viral illness or it may be
an isolated viral infection of the labyrinth and eighth nerve.
a. upper respiratory illness within 1 week or 2 weeks prior to the onset
b. symptoms are unilateral, and may include clinically evident aural or
vestibular symptoms, or both.
c. hearing loss: usually most severe at high frequencies. |
|
|
Term
|
Definition
a. fluctuating sensorineural hearing loss (low frequency)
b. subjective tinnitus
c. aural fullness
d. episodic vertigo
e. horizontal or horizontal-rotatory nystagmus
f. onset: fairly suddenly over seconds, or it may develop over minutes
or hours
g. duration of hearing loss is variable among patients with some
patients having this symptom for hours, others for days or weeks, and
others permanently.
h. natural history: progressive hearing loss. Involvement is typically
unilateral at onset, but may become bilateral. |
|
|
Term
In viral neurolabyrinthitis, autoimmune hearing loss, and Ménière syndrome, the clinical
manifestations are primarily... |
|
Definition
otologic, whereas hearing loss, tinnitus, vertigo, and spontaneous
nystagmus are the predominant manifestations. No neurologic manifestations are present, apart
from those attributable to the labyrinth and eighth nerve |
|
|
Term
| During a Weber test on a patient with conductive hearing loss, where will sound be percieved as louder? |
|
Definition
|
|
Term
| Differentiate between a peripheral and central lesion causing an abnormal Dix-Hallpike test |
|
Definition
o peripheral lesions: lag time in nystagmus and vertigo,
extinguishes with repeated attempts
o central lesions: immediate nystagmus and vertigo, does not
extinguish with repeated attempts
o normal: no nystagmus, no symptoms |
|
|
Term
| Firing in the circular canals increases with what direction of head movement and with what temperature of water? |
|
Definition
| Toward side of head moevement and with warm water. |
|
|
Term
|
Definition
ipsilateral third nerve paresis with
contralateral hemiparesis; caused by a lesion involving the III N
and the cerebral peduncles |
|
|
Term
|
Definition
ipsilateral third nerve paresis and
contralateral hemitremor caused by a lesion involving the III N
and the red nucleus |
|
|
Term
|
Definition
Cervical medullary
junction--e.g. Chiari I malformation |
|
|
Term
|
Definition
| brainstem disorders or medullary tumors such as medulloblastoma. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| horizontal gaze lies in the |
|
Definition
|
|
Term
| INO is named by the side of the |
|
Definition
MLF lesion or the side of the
adduction deficit. |
|
|
Term
| Most common cause of an INO |
|
Definition
|
|
Term
|
Definition
1) A lesion of the PPRF
2) Causes: Horizontal Gaze palsy and INO
3) e.g. A right PPRF gives a right gaze palsy
(the one) and a right INO (the one-half) |
|
|
Term
| Characteristic findings in dorsal midbrain syndrome |
|
Definition
1) up-gaze paralysis
2) lid-retraction
3) light-near pupillary dissociation
4) convergence retraction nystagmus |
|
|
Term
| What area of the cortex is pursuit in? |
|
Definition
|
|
Term
|
Definition
| slow phase toward damaged side (labyrinth, nerve, nuclei); fast phase in opposite direction; nystagmus stays in the same direction of all gazes. slow phase decreased with fixation and increased by loss of fixation. |
|
|
Term
| At what stage of sleep are central and obstructive apneas seen? |
|
Definition
|
|
Term
|
Definition
| Slow wave, low seizure threshhold (nocturnal frontal lobe seizures). Confusion arousals and sleep eating. |
|
|
Term
| During which stage(s) of sleep do you dream? |
|
Definition
|
|
Term
| What area of the brain generates sleep deprivation sleepiness |
|
Definition
| Basal forebrain sleep homeostat |
|
|
Term
|
Definition
| painful monocular visual loss due to demyelination, viral and bacterial infections, sarcoid, syphilis, or Lyme disease |
|
|
Term
|
Definition
• Consciousness NOT lost
• Often symptomatic (secondary)3
• Only a portion of brain is affected
• EEG is focal
• Carbamazepine, oxcarbazepine are drugs of choice |
|
|
Term
| Partial (focal) Seizures: inter-ictal EEG correlate |
|
Definition
| focal epileptiform discharges |
|
|
Term
| Generalized Seizures: inter-ictal EEG feature |
|
Definition
| generalized spike and wave discharges |
|
|
Term
| 4 A's of a complex partial seizure |
|
Definition
�� Aura
�� Alteration of consciousness
�� Automatisms
�� Amnesia |
|
|
Term
| Main differences between simple and complex partial seizures. |
|
Definition
| Simple: Consciousness is not affected, no post-ictal alteration of consciousness |
|
|
Term
| Benign Rolandic Epilepsy (Epilepsy with centro-temporal spikes). |
|
Definition
The most
common seizure disorder of childhood.
o Seizure type: partial or secondarily generalized sensory-motor seizures
occurring at the transitions between wakefulness and sleep. usually affect
oral-motor function particularly. infrequent (weekly or less)
o Etiology: idiopathic. often familial.
o Age: childhood (5-12years)
o EEG: focal, centrotemporal (Rolandic) spikes (i.e., located over the
rolandic sulcus... yes, you got it, where the sensory-motor strip is found)
o Treatment: no treatment, oxcarbazepine or carbamazepine.
o Prognosis: excellent. easy seizure control. remission in 95%. no long
term sequellae. |
|
|
Term
|
Definition
(infantile spasms). Defined by a specific seizure type
occurring in infancy with generally dire implications. Outcome is generally poor.
o Seizure type: clustered generalized myoclonic jerks known as “infantile
spasms” (usually at least one cluster per day or more). usually associated
with decline in behavioral function.
o Etiology: variable: any bad brain condition in infancy can cause this:
tuberous sclerosis accounts for about 15% of cases; others: brain damage
fromperinatal hypoxia-ischemia, infection, trauma, metabolic disorders,
you name it!
o Age: infancy: peak age 6 months.
o EEG: hypsarrhythmia:
o Treatment: ACTH; vigabatrin (available in civilized world, not the US) o Prognosis: usually very poor; although some, if treated early and no
cause evident, can do well. |
|
|
Term
|
Definition
The most characteristic malignant seizure disorder
of childhood. Involves frequent, mixed seizures that are hard to control usually
associated with severe developmental decline.o Seizure types: mixed seizures with absence, atypical absence, myoclonic,
astatic and generalized tonic-clonic. Nocturnal generalized tonic seizures
are common. Usually associated with decline in behavioral and cognitive
function, often leading to intellectual impairment and/or autistic features.
o Etiology: variable: sometimes due to the same conditions causing
infantile spasms at a younger age (e.g., tuberous sclerosis). Can evolve
from infantile spasms. However, often appears in otherwise completely
normal children and no cause can be discovered.
o Age: 2-10 years (peak is 3-5).
o EEG: “slow” generalized spike and wave discharges (2 to 2.5 cycles per
second).
o Treatment: often frustratingly unsuccessful: valproic acid,
benzodiazepines, felbamate.
o Prognosis: very poor; although some can undergo unexpected remission
or improvement. |
|
|
Term
|
Definition
Abnormal in 95% of children with absence seizure, 60% with complex partial. 3 per second spike and wave, centro-temporal spikes,
focal epileptiform discharges |
|
|
Term
| What would you use ethosuximide for and what is the mechanism? |
|
Definition
| Absence seizures, Ca channel stabilization |
|
|
Term
| Which antiepiletics act soley by Na channel stabilization |
|
Definition
| Oxcarbazepine, Carbamazepine, Phenytoin |
|
|
Term
| Which antiepiletics act soley by GABA enhancement |
|
Definition
| Phenobarbital, Lorazepam, Diazepam |
|
|
Term
| What drug will valproic acid inhibit the degradation of? |
|
Definition
|
|
Term
Two AEDs have rare but serious toxicity that (usually) requires “routine”
laboratory monitoring |
|
Definition
valproic acid—liver toxicity and
thrombocytopenia (monitor ALT, AST and CBC with differential);
carbamazepine—agranulocytosis (monitor same as above). |
|
|
Term
| Which antiepileptics reduce the efficacy of oral contraceptive medications |
|
Definition
enzyme inducers (PHT, PHB, CBZ),
Oxcarbazepine, and topiramate |
|
|
Term
| Solitary tract and nucleus |
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Definition
| are structures in the brainstem that carry and receive visceral sensation and taste from the facial (VII), glossopharyngeal (IX) and vagus (X) cranial nerves. Also recieves input from carotid sinus and baroreceptors of aorta. |
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Term
| Cell bodies for taste from the anterior 2/3 of the tongue synapse |
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Definition
| In the rostral nucleus solitarius |
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Term
| taste pathway from posterior third of tongue |
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Definition
| Glossopharyngeal ganglia, solitary nucleus, VPM, insula |
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Term
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Definition
| sensory neurons of the facial nerve located in the facial canal of the head. It receives fibers from the motor, sensory, and parasympathetic components of the facial nerve and sends fibers that will innervate the lacrimal glands, submandibular glands, sublingual glands, tongue, palate, pharynx, external auditory meatus, stapedius, posterior belly of the digastric muscle, stylohyoid muscle, and muscles of facial expression. |
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