NEUROLOGY + NEUROSURGERY
MOVEMENT DISORDER
PromptWhat are the two descending pathways responsible for voluntary movement
ResponseCoritospinal tract = Skeletal muscle
Corticobulbar tract = cranial nerves
Corticobulbar tract = cranial nerves
PromptWhat part of nervous system is responsible for involuntary control of movement
ResponseExtrapyramidal system
Basal ganglia and subthalamic nucleus
Basal ganglia and subthalamic nucleus
PromptHemiballismus (location, causes, clinical features)
ResponseSubthalamic nucleus of basal ganglia
Causes - CVA, TBI, ALS, Neoplasm, demyelination, HIV, tuberculoma
Clinical - Irregular flinging movements of one side of body (HEMI), large amplitude movements of proximal muscles
Causes - CVA, TBI, ALS, Neoplasm, demyelination, HIV, tuberculoma
Clinical - Irregular flinging movements of one side of body (HEMI), large amplitude movements of proximal muscles
PromptChorea (location, causes, clinical features)
ResponseCorpus striatum of basal ganglia
Causes - Autoimmune post group A strep, huntingtons, antipsychotics, CVA, hyperthyroid
Clinical - Continuous random irregular movements, flow from one part of body to next with no pattern
Causes - Autoimmune post group A strep, huntingtons, antipsychotics, CVA, hyperthyroid
Clinical - Continuous random irregular movements, flow from one part of body to next with no pattern
PromptPartial Seizure (location, causes, clinical features)
ResponseBrain (anywhere)
Causes - Drugs + withdrwawal, infection, head injury, hypoglycaemic/metabolic, structural lesion, idiopathic
Clinical - Uncontrolled shaking movements, usually one part of body involved, no impairment of consciousness, rapid repeated contraction + relaxation of muscles.
Causes - Drugs + withdrwawal, infection, head injury, hypoglycaemic/metabolic, structural lesion, idiopathic
Clinical - Uncontrolled shaking movements, usually one part of body involved, no impairment of consciousness, rapid repeated contraction + relaxation of muscles.
PromptAUTONOMIC DYSREFLEXIA
Responselife-threatening medical emergency characterized by hypertension and cardiac arrhythmias. Most cases of AD occur in individuals with spinal cord injuries with lesions at or above the T6 - Wiki
PromptTriggers of autonomic dysreflexia
ResponseUrinary retention >500 mL
Cystitis
Renal colic (CT KUB)
Constipation - History, firm stool on PR
LL trauma - LL assessment/XR
Pressure sore - log roll
Cellulitis - Full skin inspection
Cystitis
Renal colic (CT KUB)
Constipation - History, firm stool on PR
LL trauma - LL assessment/XR
Pressure sore - log roll
Cellulitis - Full skin inspection
PromptComponents of management
ResponsePositioning - sit patient up
Release tight clothing
Treat cause (eg: drain bladder)
Vasodilators (GTN) to lower BP
Release tight clothing
Treat cause (eg: drain bladder)
Vasodilators (GTN) to lower BP
PromptComplications of Autonomic dysreflexia
ResponseSeizure
Pulmonary oedema
Cerebral haemorrhage
Renal failure
Same as hypertensive emergency
Pulmonary oedema
Cerebral haemorrhage
Renal failure
Same as hypertensive emergency