sensory, motor interp, language
cerebrum
d/o of cerebrum
stroke cerebral palsy alcoholism alzheimer's tumor
balance, coordination, dysmetria (past point), dyssynergia (lack of coord), diadochokinesia (rapidly alternating movements), tandem gait
cerebellum
d/o of cerebellum
MS
alcoholism
form of CP
two point discrim, vibration, joint position sense
post columns
d/o of post columns
MS
tabes dorsalis
leprosy
voluntary motor, flexors of hands and feet
corticospinal (pyramidal)
-UMNL is d/o
path longitudinal cyst of CENTRAL CANAL of SC, fluid filling cavities expand in adult years
-loss of pn/temp over shoulders, cape like
syringomyelia
- demylination of CNS causing demyelination of SC, brain
- motor, sens affected
- F 20-40, exacerbation and remission
- worse moving from cold to warm*
MS
diplopia, scotomas, transient blindness, optic neuritis, pain, vertigo, UMNL in legs causing distal weakness, + Lhermitt’es
MS
-dx best with MRI
charcot triad of MS
scanning speech
intention tremors
nystagmus
-F 20-40, AI dz body makes antibodies against ACh receptors, myoneural jxn dysfx, wk in CNs then prox muscles
myasthenia gravis
ptosis, diplopia, dysarthria, fatigue of mm (esp w exercise), muscle weakness worse at end of day
myasthenia gravis
-dx with tensilon test, tx with cholinesterase inhib drugs
- corticospinal tract, anterior horn affected
- begins in hands/feet and life expect is short
- fascic, spasticity, inc DTR
amyotrophic lateral sclerosis
MOTOR ONLY
LMNL in arms and UMNL in legs
ALS
-ddx lateral canal stenosis
degen of post columns and corticospinal tracts, B12 def
+schilling test, irrev neuro sx
*** glove and stocking paresthesia
posterolateral sclerosis
hemisection sc caused by injury
-ipsi loss of MOTOR + dorsal clumns, contra loss of PN/TP
brown sequard syndrome
nonprogressive motor d/o of cerebral cortex dt anoxia to brain prenatally or during birth drama
CP
scissor gait, spastic paralysis, athetoid and choreiform movements, normal intelligence
CP
- chronic progressive cond assoc w loss of dopamine in substantia nigra causing basal ganglionic dysfx
- extrapyramidal tract involvement
- gradual onset over 50
parkinsons aka paralysis agitans
resting tremors, mask like faces, festinating gait, cogwheel/lead pipe rigidity, fwd stooped posture, bradykinesia
parkinsons
- inflam polyneurop of PNS linked to recent immunizations or after recent flu infx
- ASCENDING paralysis, sens sx
- can be med emergency if at diaphragm
guillain-barre syndrome
-clinical condition of tertiary syph, wasting of POST columns
-irreg of pupil (argyll robertson- accomodates but does not respond)
coordination and balance
slappage gait
tabes dorsalis
- sex linked recessive d/o, boys 3-7
- prox musc wk, WADDLING GAIT, toe walk, hyperlordosis, psydohypertrophy of calves, gower sign
muscular dystrophy (erb duchenne)
