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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
Causes of Dementia
Reversible Causes
Intoxication or Medications
Depression
Normal Pressure Hydrocephalus
Vitamin B12 Deficiency
Metabolic Conditions
Irreversible Causes
Lewy Body Dementia
Prion Disease
Pick's Disease
AIDS Dementia
Alzheimer's Disease
Multi-infarct (Vascular) Dementia
2 mins
5 A's of Alzheimer's Disease
Agnosia
Anomia
Aphasia
Apraxia
Amnesia
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 Drugs
Parkinsons Characteristics
Decreased Dopamine
Increased Acetylcholine
Drug Names
BALSA Acronym
Bromocriptine
Amantadine
Levodopa
Selegiline
Antimuscarinics
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
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
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
Normal Pressure Hydrocephalus
Mechanism
Elderly
Idiopathic
Decreased Absorption of CSF
Ventricular Enlargement
Symptom Triad
Urinary Incontinence
Ataxia (Gait)
Cognitive Dysfunction
2 mins
Cauda Equina Syndrome
Acute Loss of Lumbar Plexus Function
Surgical Emergency
Saddle Anesthesia
Causes
Inflammatory Disorders
Spinal Stenosis
Trauma
Lesions
Symptoms
Urinary and Fecal Incontinence
Sciatica
Diagnosis
Magnetic Resonance Imaging (MRI)
Clinical
1 min
Kluver-Bucy Syndrome
Bilateral Amygdala Lesion
Associated with HSV-1
Hyperorality
Hypersexuality
Disinhibited Behavior
1 min
Lewy Body Dementia
Pathophysiology
Unknown Etiology
Decreased Acetylcholine
Alpha-synuclein Defect
Eosinophilic Cytoplasmic Inclusion
Signs and Symptoms
Visual Hallucinations
Progressive Dementia
Fluctuating Cognition
REM Sleep Behavior Disorder
Parkinsonism
Treatment
Acetylcholinesterase Inhibitors
3 mins
Craniopharyngioma
Hypopituitarism
Remnants of Rathke's Pouch
Tooth-enamel Like Calcification
Cholesterol Crystals
Yellow Viscous Fluid
Headache
Bitemporal Hemianopsia
1 min
Pilocytic Astrocytoma
Occurs Most Commonly in Kids
Posterior Fossa
Cerebellum
Well Circumscribed
GFAP
Rosenthal Fibers
Eosinophilic Corkscrew Fibers
1 min
Ependymoma
Occur in Children
Fourth Ventricle
Hydrocephalus
Perivascular Pseudorosettes
Rod Shaped Blepharoplasts
Cauda Equina in Adults
Poor Prognosis
Neurofibromatosis Type II
2 mins
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