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neuro
Multiple Sclerosis Features and Mechanisms
Features
More Common in Women
Presents in 20's and 30's
Northern Europeans
Mechanism
Unknown mechanism, genetic factor
HLA-DRB1
Autoimmune Demyelination of CNS
White Matter of Brain and Spinal Cord
T Cell Mediated Inflammation
2 mins
Multiple Sclerosis Symptoms and Diagnosis
Symptoms
Optic Neuritis
Internuclear Ophthalmoplegia
Scanning Speech
Urinary and Fecal Incontinence
Motor Issues (Intention Tremor, Paresis)
Numbness and Pain
Depression
Relapsing Symptoms
Diagnosis
Gold Standard = Plaques on MRI
Increased CSF Immunoglobulins (IgG)
Oligoclonal Bands
4 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
2 mins
Guillain-Barre Syndrome Assessment
Assessment
Ascending Paralysis
Muscle Weakness
Paresthesias (Pins and Needles)
Diplopia
Difficulty Speaking
Dysphagia
Labile Blood Pressure
Loss of Bowel and Bladder Control
Considerations
Aggressive Airway Management
2 mins
Lambert-Eaton Syndrome
Mechanism
Autoantibody to the Presynaptic Calcium Channel on Motor Neurons
Inhibits Acetylcholine (ACh) Release at Neuromuscular Junction
Paraneoplastic Syndrome
Small Cell Lung Cancer
Symptoms
Proximal Muscle Weakness
Improves with Muscle Use
Autonomic Symptoms
Extraocular Muscle Sparing
2 mins
Autonomic Dysreflexia
Injury Above T6
Assessment
Paroxysmal Hypertension
Bradycardia
Diaphoresis
Flushing Above Lesion
Piloerection
Nasal Congestion
Headache
Interventions
Elevate Head of Bed
Remove Noxious Stimuli
2 mins
Types of Strokes
Warning Signs
Transient Ischemic Attack (TIA)
Reversible Ischemic Neurologic Deficit (RIND)
Types
Ischemic
Thrombotic
Atherosclerosis
Embolic
Atrial Fibrillation
Hemorrhagic
Severe Hypertension
3 mins
Left Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Side to Side Discrimination
Aphasia
Agraphia
Slow Performance
Aware of Deficits
Anxiety
Depression
2 mins
Right Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Poor Proprioception
Disoriented to Person, Place, Time
Can't Recognize Faces (Prosopagnosia)
Loss of Judgement and Awareness
Impulsiveness
Personality Changes
Tonal Hearing Loss
2 mins
Middle Cerebral Artery
Contralateral paralysis upper limb and face
Contralateral loss of sensation of upper limb and face
Affects Wernicke's area and Broca's area
Aphasia if Lesion in Dominant (Left) Hemisphere
Hemineglect if lesion in nondominant (right) hemisphere
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