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PA 570 Neurology Week 1
Essential Tremor
Characteristics
Most Common Tremor in Adults
Positive Family History
Clinical Findings
Bilateral Upper Extremities
Worse with Physical and Psychological Stress
Better with Rest and Alcohol
Management
Beta Blockers
Primidone
1 min
Parkinson's Disease Assessment
Assessment
Decreased Dopamine
Older Adult
Cogwheel Rigidity
Bradykinesia
Shuffling Gait
Resting Tremor
Pill-Rolling
Mask-Like Face
Cognitive Decline
2 mins
Parkinson's Disease Interventions
Medications
Levodopa/Carbidopa (Sinemet)
Entacapone (Comtan)
Selegiline (Eldepryl)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Benztropine (Cogentin)
Considerations
Allow Extra Time
Ensure Patient Safety
Surgery As Last Resort
2 mins
Huntington's Disease
Pathophysiology
Autosomal Dominant
Trinucleotide Repeat
CAG Repeats
Chromosome 4
Anticipation
Caudate
Decrease of ACh
Decrease of GABA
Signs and Symptoms
Chorea
Dementia
Depression
Glutamate Toxicity
Neuronal Death via NMDA Binding
3 mins
Tourette Syndrome
Characteristics
Motor and Vocal Tics
Onset Before Age 18
> 1 year
Associations
Obsessive-Compulsive Disorder (OCD)
Attention Deficit Hyperactivity Disorder (ADHD)
TREATMENT
Cognitive Behavioral Therapy
High-Potency Antipsychotics
Atypical Antipsychotics
Alpha-2 Agonists
Tetrabenazine
4 mins
Amyotrophic Lateral Sclerosis (ALS)
Assessment
Progressive Muscle Weakness
Systemic Muscle Wasting
Fasciculations
Spasticity
Fatigue
Considerations
Riluzole (Rilutek)
Stretching
Little to No Cognitive Decline
Respiratory Support
Palliative Care
2 mins
Cerebral Palsy (CP)
Cause/Mechanism
Maternal Infections
Fetal Hypoxia
Assessment
Developmental Delay
Neurological Dysfunction
Spasticity
Dysphagia
Interventions
Muscle Relaxants
Muscle Exercises
Assistive Devices
Braces
2 mins
Multiple Sclerosis Assessment
Cause/Mechanism
Nerve Fiber Demyelination
Assessment
Motor Issues
Cerebellar Signs
Fatigue
Paresthesias
Spasticity
Urinary Incontinence
Optic Neuritis
Considerations
Women Between 20-50 Years Old
Relapse and Remission of Symptoms
2 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
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
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
1 min
Myasthenia Gravis Assessment
Weakness with Muscle Use
Diplopia
Ptosis
Dysphagia
Difficulty Speaking
Fatigue
Complications
Cholinergic Crisis
Overmedicated
Myasthenic Crisis
Not Enough Medication
Respiratory Muscle Paralysis
2 mins
Carpal Tunnel Syndrome
Median Nerve Entrapment
Compression at Carpal Tunnel
Numbness, Tingling and Pain in Hand
Diagnosis
Phalen's Maneuver
Tinel's Sign
Treatment
Splints
Surgery
Steroids
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
Peripheral Neuropathy
Hyporeflexia
Muscle wasting
Decreased sensation
Carpal Tunnel Syndrome
Meralgia Paresthetica
Diabetes
Amyloidosis
Kidney Failure
Small Cell Lung Cancer
Drugs
Alcohol
Guillain-Barre syndrome
Ischemia
Charcot Marie Tooth Disease
Nicotinic acid
1 min
Cranial Nerve Pathologies
Cranial Nerve Pathologies
Horner Syndrome
Trigeminal Neuralgia
Bell's Palsy
Brain or Brainstem Lesion
Microvascular Cranial Nerve Palsy
Glossopharyngeal Neuralgia
Multiple Sclerosis
Arnold Chiari Malformation
Amyotrophic Lateral Sclerosis (ALS)
Guillain Barre’ Syndrome
Parkinson's Disease
3 mins
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