Stroke
- Acute stroke is characterised by sudden onset of focal neurological deficit e.g. hemiplegia
- Can be ischaemic or haemorrhagic
- If function recovers within 24 hours then it is termed a transient ischaemic attack (TIA
Where does the upper motor neurone go?
Starts from motor cortex to the cranial nerve nuclei in the brain and anterior horn cells in spinal cord
Where does the lower motor neurone go?
Anterior horn cell/cranial nerve nucleus via peripheral nerve to motor end plate
Motor Neurone Disease
- Progressive disorder of unknown aetiology
- Onset usually after age 50. Males more likely to be affected.
- Present with combination of both UMN and LMN signs without sensory involvement.
- Symptoms include – limb weakness, cramps, disturbance of speech or swallowing.
- Signs – wasting and fasciculation of muscles, pyramidal tract involvement causing spasticity and exaggerated tendon reflexes
- Symptoms can start focally but become widespread with time
Cerebellar lesions
- Patients have a wide unsteady gait
- Impaired coordination
- Uncontrolled repetitive eye movements
- Difficulty with fine motor tasks
- Intentional Tremor
- Slurred speech
What supplies the circle of Willis?
Internal carotid artery
Myasthenia Gravis
- Condition of the neuromuscular junction
- Acetylcholine receptors are blocked by an auto immune reaction between the receptor protein and anti-acetylcholine receptor antibody.
- Women more affected than men. Presents between 15 to 50 years.
- Main symptom is abnormal fatigable weakness of muscles.
- First symptoms are usually ptosis or diplopia.
- Weakness of chewing, swallowing, speaking or limb movement can occur.
What does rupture of a posterior communicating aneurysm lead to?
Sub arachnoid haemorrhage
Frontal lobe lesion characteristics:
- Decreased lack of spontaneous activity - no desire to do anything and is unable to plan activities.
- Loss of attention - lack of interest and is easily distracted.
- Memory is normal but the patient cannot be bothered to remember.
- Loss of abstract thought - eg, cannot understand proverbs.
- Perseveration - a tendency to continue with one form of behaviour when a situation requires it to change.
- Change of affect - the patient either becomes apathetic and ‘flat’ or becomes over-exuberant and childish or uninhibited with possibly inappropriate sexual behaviour.
Carpal tunnel syndrome
This due to compression of the median nerve in the carpal tunnel.
• Wasting of the abductor pollicis brevis can develop with the following distribution of numbness and pain.
What causes paralysis and foot drop?
Nerve root damage
