Term
| Meningitis: organism access |
|
Definition
blood (septicemia)
directly through meninges (compound fx, sx, lumbar puncture) |
|
|
Term
| Meningitis: organisms involved |
|
Definition
bacterial
viral
spirochetes (syphilis, Lyme's)
mycobacterium (tuberculosis) |
|
|
Term
| Meningitis: typical symptoms |
|
Definition
chills, fever
HA
N&V
**stiff neck** |
|
|
Term
| Meningitis: typical signs |
|
Definition
+ meningeal signs (Kernig, Brudzinski) possible UMN signs possible photophobia
possible incr ICP |
|
|
Term
| Meningitis: signs of ↑ ICP |
|
Definition
HA
vomiting without nausea
ocular palsies
altered LOC
papilledema (if prolonged/high) |
|
|
Term
|
Definition
swelling of optic disc (disc margins blurred, congestion of retinal vv.)
caused by stasis of axoplasmic flow >> intraaxonal edema
common with any condition that ↑ ICP |
|
|
Term
|
Definition
↑ serum WBC
urinalysis: possible albumin, casts, RBCs
CSF: WBCs present, ↑ protein (Igs) |
|
|
Term
| Subdural empyema: description |
|
Definition
collection of pus between brain and dura
S/Sx similar to meningitis
pain/swelling at origin of infection
CT usually shows area of pus collection |
|
|
Term
| Intracranial epidural abscess: description |
|
Definition
| infection outside dura, assoc c infection of overlying bone |
|
|
Term
| Intracranial epidural abscess: S/Sx |
|
Definition
|
|
Term
| Intracranial epidural abscess: Lab/imaging |
|
Definition
CT usually effective
CSF not usually helpful |
|
|
Term
| Intracranial epidural abscess: typical cause |
|
Definition
|
|
Term
| Spinal epidural abscess: description |
|
Definition
| infection outside dura, within spinal canal |
|
|
Term
| Spinal epidural abscess: cause |
|
Definition
spread of infection from adjacent tissue
metastasis through blood
penetrating wound
(side effect of anesthetic epidural block) |
|
|
Term
| Spinal epidural abscess: S/Sx |
|
Definition
fever
HA
pain in neck/back
weakness in extremities
possible paraplegia
+ meningeal signs
local percussion tenderness over spine |
|
|
Term
| Spinal epidural abscess: Lab |
|
Definition
leukocytosis
↑ ESR
Xray usually normal, but may visualize adjacent osteomyelitis
myelogram: demos extradural block (CT may visualize as well) |
|
|
Term
| Spinal epidural abscess: organisms causing |
|
Definition
viral (herpes simplex, varicella, polio, rubella, Epstein-Barr, etc)
fungal (cryptococcosis neoformans)
parasite (roundworm/trichinosis, tapeworm/cysticercosis) |
|
|
Term
| Spinal epidural abscess: viral manifestations (3) |
|
Definition
| meningitis, encephalitis, myelitis |
|
|
Term
| Spinal epidural abscess: meningitis |
|
Definition
| self-limiting; signs of meningeal irritation |
|
|
Term
| Spinal epidural abscess: encephalitis |
|
Definition
infection of brain tissue
>> seizures, altered LOC, focal neurologic deficits |
|
|
Term
| Spinal epidural abscess: myelitis |
|
Definition
infection of cord tissue
motor nn (polio), sensory nn, autonomic nn (bladder paralysis), demyelination of white matter (transverse myelitis) |
|
|
Term
| Spinal epidural abscess: Dx |
|
Definition
| isolate virus in cultures of blood, CSF, other tissue; biopsy of verve or brain |
|
|
Term
| Spinal epidural abscess: cycticercosis (tapeworm) |
|
Definition
"neurocysticercosis"
>> encapsulated cysts in brain
(cortical cyst >> seizures;
ventricular cyst >> ↑ ICP via obstructive hydrocephalus >> position-dependent HA |
|
|
Term
| Hydrocephalus: description |
|
Definition
| ↑ CSF volume, ventricular dilation |
|
|
Term
| Hydrocephalus: classifications |
|
Definition
obstructive
normal pressure hydrocephalus (NPH)
communicating hydrocephalus
hydrocephalus ex vacuo |
|
|
Term
| Obstructive hydrocephalus: causes |
|
Definition
congenital malformation (Arnold-Chiari, etc)
postinflammatory/posthemorrhagic
mass lesions (tumor, cyst, ectasia of basilar a.) |
|
|
Term
| Normal pressure hydrocephalus: description |
|
Definition
normal CSF, ventricular dilation
unknown etiology |
|
|
Term
| Communicating hydrocephalus: causes |
|
Definition
overproduction of CSF (choroid plexus papilloma)
defective absorption of CSF (congenital agenesis of arachnoid villi)
venous drainage insufficiency |
|
|
Term
| Hydrocephalus ex vacuo: description |
|
Definition
| ↑ CSF volume, no change in CSF pressure 2º brain tissue loss (Alzheimer's) |
|
|
Term
|
Definition
HA
lethargy
malaise
incoordination
weakness
papilledema
DeJerine's triad
altered LOC
ocular nerve palsies
ataxia
corticospinal tract signs
dementia |
|
|
Term
|
Definition
(symptoms ↑ with ↑intrathecal pressure)
cough
sneeze
strain |
|
|
Term
| Hydrocephalus: first tissue affected |
|
Definition
| paraventricular white tracts (corticospinal); gray matter may be preserved |
|
|
Term
|
Definition
| insidious; gradual development over weeks/months |
|
|
Term
|
Definition
may be NO symptoms… or
HA
irritability
sleepiness
blurred/double vision
↓ appetite |
|
|
Term
| **NPH: triad of symptoms** |
|
Definition
dementia
ataxia
urinary incontinence |
|
|
Term
|
Definition
| previous inflammation of brain surface (SAH, meningitis) >> ↓ CSF absorption by arachnoid villi |
|
|
Term
|
Definition
↑/normal CSF pressure
CT/MRI demonstrates ventricular enlargement |
|
|
Term
| Syringomyelia: description |
|
Definition
intramedullary accumulation fo CSF within cord >> CSF-filled cysts ("syrinx")
syrinx grow, eventually damage cord if not drained |
|
|
Term
|
Definition
Type I = communicating
Type II = noncommunicating |
|
|
Term
|
Definition
communicating;
associated with Arnold Chirari malformation |
|
|
Term
|
Definition
noncommunicating;
2º to complications following cord injury, etc (meningitis, tumor, tethered cord syndrome) |
|
|
Term
|
Definition
sensation loss/N&T: at levels of pressure from syrinx (diffuse presentation)
pain: neck, back, other; ↑ with DeJerine's triad; severe HA with type I |
|
|
Term
|
Definition
central cord syndrome presentation (unilat/bilat ∆s, sensory/motor; UE>LE)
diplopia/nystagmus (bulbosyrinx)
paresis/paralysis (ant horn syrinx)
scoliosis (unilat LMN weakness)
UMN signs
incontinence |
|
|
Term
|
Definition
| ↑ brain volume 2º to ↑ water/sodium content >> ↑ ICP |
|
|
Term
|
Definition
| ↑ brain volume 2º to obstruction of cerebral vv./sinuses OR aa. Vasodilation |
|
|
Term
| Brain edema: categories (3) |
|
Definition
vasogenic
cellular
interstitial |
|
|
Term
| Vasogenic edema: etiology |
|
Definition
| ↑ permeability of capillary endothelium (↑ CSF proteins >> water 'follows') |
|
|
Term
| Vasogenic edema: causes (6) |
|
Definition
| tumor, abscess, hemorrhage, infarction, contusion, meningitis |
|
|
Term
|
Definition
| damaged cells >> chemical release >> capillary endothelium spreads out |
|
|
Term
|
Definition
| brain cell swelling (no ↑ in CSF protein) |
|
|
Term
| Cellular edema: common causes |
|
Definition
hypoxic states (MI)
hypo-osmolality (water intoxication) |
|
|
Term
| Interstitial edema: etiology |
|
Definition
| obstruction of CSF flow >> CSF driven across walls of ventricles >> ↑ interstitial fluid |
|
|
Term
| Interstitial edema: common cause |
|
Definition
| obstructive hydrocephalus |
|
|
Term
|
Definition
antibiotics (if caused by infection)
surgical decompression
shunting
steroids (↓ inflammation)
osmotherapy
hyperventilation, hypothermia, barbiturates |
|
|
Term
| Brain edema: osmotherapy Rx |
|
Definition
| introduce hypertonic solutions into blood >> draw water out of brain and into blood |
|
|
Term
| Primary CNS tumor classifications |
|
Definition
Intracranial (85%)
Spinal cord (15%) |
|
|
Term
| Intracranial tumors: locations |
|
Definition
skull & CNs
meninges
supportive tissue
pineal
pituitary gland
congenital
blood vessel
metastatic/granuloma
multiple tumors of CNs |
|
|
Term
| S/Sx of pituitary gland tumor |
|
Definition
↓ libido
lateral visual field cuts |
|
|
Term
| Determining the site of the lesion - Framework (11) |
|
Definition
Cortex
Internal Capsule
Basal Ganglia
Cerebellum
Brainstem
Cord
Cauda Equina
Nerve root
Peripheral nerve
Neuromuscular disorders/Muscular disease
Autonomic involvement |
|
|
Term
| General concepts to help localize lesions (4/6) |
|
Definition
age
gender
tempo (date/speed of onset)
Med Hx
S/Sx
Response to tests |
|
|
Term
| Muscular dystrophy: typical age at onset |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| F>M (SLE, MS, myasthenia gravis) |
|
|
Term
|
Definition
|
|
Term
| HA: immediate onset suggests... |
|
Definition
|
|
Term
| HA: slower onset suggests... |
|
Definition
|
|
Term
| GBS: typical onset (length) |
|
Definition
|
|
Term
| Remission/exacerbation characteristic of... (2 diseases) |
|
Definition
|
|
Term
| Cortical disease suggested by: (3) |
|
Definition
generalized manifestations (seizures, delirium, dementia)
focal signs attributable to particular area of brain
"frontal release" signs (release of primitive reflexes) |
|
|
Term
| "Frontal release" signs (5) |
|
Definition
Exaggerated mm stretch reflex (Babinski, Hoffman, grasp reflex)
Glabellar reflex (Myerson sign)
Sucking reflex
Orbicularis oris reflex
Palmomental reflex |
|
|
Term
| Internal Capsule: damage >> |
|
Definition
| motor (UMNL) and/or sensory loss |
|
|
Term
| Basal Ganglia damage >> (2) |
|
Definition
|
|
Term
| Manifestations of hypokinetic disordesr (4) |
|
Definition
bradykinesia
hypkinesia (undershoot, dysdiadochokinesia)
difficulty initiating
resting tremor |
|
|
Term
| Manifestations of hyperkinetic disorders (4) |
|
Definition
chorea
athetosis
ballismus
tics |
|
|
Term
|
Definition
motor loop
oculomotor channel
limbic channel
prefrontal channel |
|
|
Term
| BG channel: oculomotor channel |
|
Definition
| to frontal eye fields; involved in eye mvmt control |
|
|
Term
| BG channel: limbic channel |
|
Definition
involved in regulation of EMOTIONS and MOTIVATION
believed to play central role in many neurobehavioral/psychiatric disorders |
|
|
Term
|
Definition
| cognitive processes involving frontal lobes; "executive functions" |
|
|
Term
|
Definition
dysdiadochokinesia
dysmetria
action/intention tremor
+ Romberg
ataxia
dysarthria
scanning speech
+ Rebound Test of Holmes
asthenia
titubations |
|
|
Term
|
Definition
|
|
Term
|
Definition
CNs
motor(ant pons+medulla) and sensory(post) changes
"locked in" syndrome |
|
|
Term
|
Definition
|
|
Term
|
Definition
motor/sensory changes
spastic gait
bowel/bladder probs
compressive lesion >> neck/back pain
no pain could signify MS |
|
|
Term
|
Definition
LBP
LE pain/claudication, sensory changes
Saddle paresthesias
Bladder/bowel probs
Loss of anal tone/sensation
LMN (NO UMN!!) |
|
|
Term
|
Definition
dermatomal/myotomal patterns
LMN |
|
|
Term
|
Definition
peripheral nerve distributions
LMN |
|
|
Term
| Neuromuscular disorders/muscular disease signs |
|
Definition
Non-myotomal muscle weakness WITHOUT sensory changes
Appears to be LMN |
|
|
Term
| Autonomic dysfxn signs (7) |
|
Definition
Miosis (pupil constriction)
Anhydrosis
eyelid ptosis
OH
sphincter symptoms
impotence
vasomotor abnormalities |
|
|
Term
| Examples of vasomotor abnormalities (i.e. autonomic dysfxn) |
|
Definition
tachycardia
rapid ∆s in BP
flushing
sweating |
|
|
Term
|
Definition
|
|
Term
| Thoracolumbar autonomic cell bodies located... |
|
Definition
| lateral horn of spinal cord |
|
|
Term
|
Definition
|
|
Term
| Primary parasympathetics (CNs) |
|
Definition
|
|
Term
| Neurofibromatosis: aka... |
|
Definition
| von Recklinghausen's disease |
|
|
Term
| Neurofibromatosis: characterized by... (4) |
|
Definition
autosomal dominant inheritance (variable expression)
multiple cafe au lait spots
multiple benign tumors (hamartomas) of PNS, skin, organs
neurofibromas on CN VIII or other CNs; can be bilateral |
|
|
Term
| Infections of the nervous system: (5) |
|
Definition
meningitis
subdural empyema
intracranial epidural abscess
spinal epidural abscess
other viral, fungal, parasitic infections |
|
|
Term
|
Definition
hydrocephalus
syringomyelia
brain edema |
|
|
Term
|
Definition
Sydenham's Chorea
Huntington's disease
Tourette Syndrome
Benign essential tremor
Parkinsonism
Progressive Supranuclear Palsy |
|
|
Term
| Common causes of chorea - hereditary (3/5) |
|
Definition
Huntington's disease
Hereditary nonprogressive chorea
Wilson disease (copper poisoning)
ataxia-telangiectasia
Lesh-Nyhan syndrome |
|
|
Term
| Common causes of chorea - secondary; categories |
|
Definition
infections/immunologic
drug induced
metabolic and endocrine
vascular |
|
|
Term
| Common causes of chorea - secondary; infections/immunologic |
|
Definition
Sydenham chorea
Encephalitis
Systemic Lupus |
|
|
Term
| Common causes of chorea - secondary; drug induced |
|
Definition
Levodopa
Anticonvulsants
Anticholinergics
Antipsychotics |
|
|
Term
| Common causes of chorea - secondary; Metabolic and endocrine |
|
Definition
chorea gravidarum (in pregnancy)
hyperthyroidism
birth control pills |
|
|
Term
| Common causes of chorea - secondary; vascular |
|
Definition
| CVA in subthalamic nucleus |
|
|
Term
| Spinal cord tumors: locations |
|
Definition
intramedullary
extramedullary
extradural |
|
|
Term
| Neoplasms: symptoms related to... |
|
Definition
type of cells involved
production of substance (e.g. hormone)
rate of growth
location of tumor |
|
|
Term
| Neoplasms: symptoms result from... |
|
Definition
direct damage from growth
secondary damage (incr ICP, etc; usually causes majority of symptoms) |
|
|
Term
| Neoplasms: histological makeup (%) |
|
Definition
gliomas 51%
meningiomas 25%
cranial & spinal nerve tumors 7% |
|
|
Term
| Neoplasms: common primary sites of CNS metastases |
|
Definition
lung 45%
breast 13%
GI 9%
leukemia 7%
GU 7%
melanoma 3%
upper respiratory 3% |
|
|
Term
|
Definition
HA (intermittent, irregular)
vomiting (2º to pressure on vomiting centers in brainstem)
diplopia, blind spots, blurred vision
papilledema
seizures
altered LOC
behavioral changes (tumor on area that affects personality) |
|
|
Term
| PT approach to seizures without dx |
|
Definition
| REFER OUT; could be only sign of slowly growing tumor |
|
|
Term
| Neoplasms: possible behavioral changes (6) |
|
Definition
lethargy
drowsiness
personality ∆s
disorders of conduct
psychotic episodes
altered sensations (smell, taste) |
|
|
Term
|
Definition
| S/Sx of diplopia, but brain suppresses info from one eye |
|
|
Term
|
Definition
| can demo changes, but primarily replaced by CT/MRI |
|
|
Term
|
Definition
| can help localize cortical tumors |
|
|
Term
|
Definition
| abnormal cells, incr protein, decr glucose |
|
|
Term
| Neoplasms: labs - best tests |
|
Definition
CT/MRI,
angiography (angiogenesis 2º to tumor) |
|
|
Term
| Peripheral neuropathy: def'n |
|
Definition
| disorder of diffuse lesions of peripheral nerves |
|
|
Term
| Mononeuropathy multiplex = |
|
Definition
| focal involvement of 2+ nerves |
|
|
Term
| Peripheral neuropathies: onset |
|
Definition
|
|
Term
| Peripheral neuropathies: motor or sensory? |
|
Definition
typically both;
exceptions: tick paralysis = 1º motor; B6 poisoning = 1º sensory) |
|
|
Term
| Peripheral neuropathies: S/Sx (sensory) |
|
Definition
distal pain, paresthesias, sensory loss
stocking/glove distribution
affects any mode of sensation |
|
|
Term
| Peripheral neuropathies: S/Sx (motor) |
|
Definition
LMN:
weakness (primarily distal; sometimes CNs)
hypo-/areflexia
fasciculations
atrophy |
|
|
Term
| Peripheral neuropathies: S/Sx (autonomic) |
|
Definition
miosis
anhydrosis
eyelid ptosis
OH
sphincter symptoms
impotence
vasomotor abnormalities |
|
|
Term
| Peripheral neuropathies: S/Sx (mononeuropathies) |
|
Definition
| focal motor/sensory/reflex changes in distribution of specific nerve involved |
|
|
Term
| Peripheral neuropathies: etiology (2+) |
|
Definition
hereditary (Charcot-Marie-Tooth)
acquired (diabetic neuropathy, GBS, alcoholic polyneuropathy, nerve entrapments/injuries) |
|
|
Term
| Peripheral neuropathies: Lab (6) |
|
Definition
EMB/NCV: denervation/fibrillation, conduction block; helps determine distribution of pathology
Nerve biopsy (info on axonal degeneration/segmental demyelination)
ESR
ANAs (anti-nuclear antibodies)
electrophoresis of serum/urine immunoproteins
CSF (incr protein in demyelinating conditions) |
|
|
Term
| Charcot-Marie-Tooth syndrome = |
|
Definition
| peroneal muscular atrophy |
|
|
Term
| Charcot-Marie-Tooth syndrome: genetics |
|
Definition
genetic defect
8 genetic variants |
|
|
Term
| Charcot-Marie-Tooth syndrome: characteristics |
|
Definition
slowly progressive weakness, beginning in distal limb mm
LEs before UEs
"stork leg" and pes cavus appearance 2º to progressive mm atrophy |
|
|
Term
| Charcot-Marie-Tooth syndrome: exam/lab (7) |
|
Definition
**weakness/clumsiness**
diminished reflexes
diminished deep sensation
+ family hx
EMG/NCV demo slowing
biopsy with characteristic findings
genetic testing (50-60% + for type 1A) |
|
|
Term
| Most common cause of rapid paralysis = |
|
Definition
|
|
Term
|
Definition
acute onset of PN/CN dysfxn
ascending, symmetrical weakness (LMN signs; motor>sensory)
autonomic instability 2º to PNS involvement |
|
|
Term
|
Definition
| unclear; often follows bacterial/viral infection (often respiratory) |
|
|
Term
|
Definition
CSF: incr protein, incr mononuclear cells, normal glucose
EMG/NCV: slowed 2º to demyelination |
|
|
Term
| Diabetic neuropathy: location |
|
Definition
nn of any organ;
60-70% of diabetics (esp with dz >25yr) will develop neuropathy |
|
|
Term
| Diabetic neuropathy: possible etiology |
|
Definition
| incr levels of blood glucose >> nn damage (compromise of microvascular blood supply?) |
|
|
Term
| Diabetic neuropathy: Types |
|
Definition
peripheral (toes, feet, legs, hands, arms)
proximal (thighs, hips, buttocks, LEs)
autonomic (digestion, bowel/bladder, sexual, sweating)
focal (sudden dysfxn in one nn or group of nn) |
|
|
Term
| Diabetic neuropathy: S/Sx (3/9) |
|
Definition
first symptom = N&T/pain in feet
glove/stocking presentation (distal, symmetrical)
length-dependent (longer axon = more likely to be affected)
atrophy of intrinsic hand/foot mm
indigestion, nausea, vomiting
diarrhea/constipation
OH
erectile dysxn or vaginal dryness
weakness |
|
|
Term
| Mononeuropathy: most common location (3) |
|
Definition
|
|
Term
|
Definition
Sydenham's chorea
Huntington's disease
Tourette syndrome
Benign essential tremor
Parkinsonism
Progressive Supranuclear Palsy |
|
|
Term
| Sydenham Chorea: aka... (3) |
|
Definition
acute chorea
chorea minor
St Vitus Dance |
|
|
Term
| Sydenham Chorea: characteristics |
|
Definition
5-15 yo
rapid, irregular, aimless, involuntary mvmts of limbs/face/trunk
emotional lability |
|
|
Term
| Sydenham Chorea: etiology |
|
Definition
unknown; believed to be manifestation of rheumatic fever (autoimmune rxn to streptococcal infection)
gradual/acute onset usually within 6 mos of infection |
|
|
Term
|
Definition
dyskinesia
lack of mm weakness (except Warner Hand)
lack of sensory changes
mental changes |
|
|
Term
| Sydenham Chorea: dyskinesia |
|
Definition
intensity varies
voluntary mvmt performed quickly to avoid interference with involuntary mvmt |
|
|
Term
| Sydenham Chorea: Warner Hand |
|
Definition
wrist √ with finger /
when UEs held in front of body |
|
|
Term
| Sydenham Chorea: S/Sx - mental changes |
|
Definition
range from mild to severe
"fretful, irritable, emotionally unstable" OR apathetic |
|
|
Term
|
Definition
no good tests; most values normal
clinical dx based on age, previous strep infection, and symptomology |
|
|
Term
|
Definition
| symptomatic: bed rest, sedatives, diazepam |
|
|
Term
|
Definition
self-limiting; 3-6 weeks
usually complete recovery
mortality 2% due to cardiac complications
35% recurrence after months/years |
|
|
Term
|
Definition
progressive hereditary disorder appearing in adult life (30s)
characterized by choreic mvmt, dementia, personality disorder |
|
|
Term
| Huntington disease: genetics |
|
Definition
| autosomal dominant (child has 50% chance of getting it from parent) |
|
|
Term
| Huntington disease: pathology |
|
Definition
| generalized brain atrophy (esp cortex, caudate, putamen) |
|
|
Term
| Huntington disease: loss of _______ tissue >> dementia |
|
Definition
|
|
Term
|
Definition
onset usually 35-40 yo
**dyskinesia**
**personality disorder**
**mental deterioration** |
|
|
Term
| Huntington disease: early symptoms |
|
Definition
clumsiness
mood swings, depression, irritability, loss of interest
difficulty learning new things, loss of memory |
|
|
Term
|
Definition
| typically 15 yr... >>death |
|
|
Term
|
Definition
CSF, U/A, blood normal
CT: enlarged ventricles with "butterfly" appearance (degeneration of caudate)
PET (fluorodeoxyglucose): hypometabolism in caudate, putamen |
|
|
Term
|
Definition
|
|
Term
| Tourette Syndrome: characteristics |
|
Definition
| "tics": BOTH body and vocal |
|
|
Term
| Tourette Syndrome: "tics" |
|
Definition
involuntary, repetitive, stereotyped mvmts
e.g. eye blinking, facial grimacing, shoulder shrugging, head/shoulder jerking |
|
|
Term
|
Definition
|
|
Term
| Tourette Syndrome: common 'comorbidity' |
|
Definition
| hyperactive behavior, obsessive/compulsive symptoms |
|
|
Term
| Tourette Syndrome: greatest symptom intensity (age) |
|
Definition
|
|
Term
| Benign Essential Tremor: aka... |
|
Definition
familial tremor
senile tremor |
|
|
Term
| Most common mvmt disorder = |
|
Definition
|
|
Term
| Benign Essential Tremor: characteristics |
|
Definition
postural tremor usually affecting both hands symmetrically
may involve head, voice
tremor frequency = 8-10 Hz
diminishes during *rest* and *mvmt*
most severe in morning/when UEs held out in front |
|
|
Term
| Benign Essential Tremor: common test |
|
Definition
| ask pt to draw progressively larger circles without resting UE on paper |
|
|
Term
| Benign Essential Tremor: effect of alcohol |
|
Definition
| suppresses tremor (with rebound exacerbation) |
|
|
Term
| Benign Essential Tremor: etiology |
|
Definition
genetic disorder; autosomal dominant
onset in adults |
|
|
Term
| Progressive Supranuclear Palsy: characteristics |
|
Definition
adult onset
early: balance problems, diplopia
later: bradykinesia, rigidity, mild tremor in 1 or 2 hands, impaired ocular mvmts/VOR
emotional lability
"surprised look" facies
disturbed gait
progressive dysarthria
progressive dysphagia
dementia |
|
|
Term
| Progressive Supranuclear Palsy: differentiation from Parkinson's |
|
Definition
| imapired ocular mvmts, VOR |
|
|
Term
| Progressive Supranuclear Palsy: impaired ocular mvmts |
|
Definition
| cannot voluntarily look down, but head ext will cause downward gaze (vestibular reflex) |
|
|
Term
| Progressive Supranuclear Palsy: cause |
|
Definition
| "disconnect" between vertical gaze cortex and CN nuclei |
|
|
Term
| Progressive Supranuclear Palsy: "surprised look" facies |
|
Definition
sustained frontalis contraction,
lid retraction,
infrequent eyeblink |
|
|
Term
| Progressive Supranuclear Palsy: course |
|
Definition
| person typically deceased in 6-10 yrs |
|
|
Term
| Progressive Supranuclear Palsy: lab |
|
Definition
unremarkable;
CT/MRI may show atrophy of pontine/midbrain tegmentum (sparing pons/cerebellum) |
|
|
Term
| Progressive Supranuclear Palsy: Dx |
|
Definition
triad:
mental disorder,
supranuclear opthalmoplegia,
abnormal gait |
|
|
