Term
| trigeminal lesion (symptoms) |
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Definition
| loss of sensation to face and mucous membranes, loss of corneal reflex (V1), flaccid paralysis of muscles of mastication, deviation of jaw to weak side due to unopposed lateral pterygoid, paralysis of tensor tympani leading to hypacusis (partial deafness to low pitch) |
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Term
| trigeminal neuraligia / tic dolourex (symptoms, cause, demographic, treatment) |
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Definition
Paroxysms: sudden outbursts of sharp pain on side of face in a trigeminal division usually maxillary. Can turned only light touch, there can be remission than pain again
usually in women over 50 yrs
loop of superior cerebellar (small aberrant a according to Soltesz lecture) impinges on trigeminal root causing demyelination of axons
treat with surgery or crabamaspine / tegretol (if idipoathic), lesioning of trigeminal ganglion or sensory root of trigeminal nerve |
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Term
| herpes zoster opthalamius (cause, symptoms) |
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Definition
viral infection in sensory ganglion (usually V1)
burning pain, itching, skin erruptions, corneal ulceration
may involve CN III, IV, VI |
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Term
| paratrigeminal (reader) syndrome (cause, symptoms) |
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Definition
lesion of trigeminal ganglion of sympathetic fibers usually in parasellar region
mitosis, ptosis, facial pain, trigeminal palsy
may involve CN III, IV, Vi |
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Term
| cavernous sinus syndrome (cause, possible effected fibers) |
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Definition
aneurysm of cavernous sinus
may involve: oculomotor nerves (if CN III it is complete internal opthalmoplegia), trigeminal V1 and V2, postganglionic sympathetic fibers to the orbit (horner syndrome) |
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Term
| autistic neuroma / schwannoma (possible affected areas and their symptoms, cause) |
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Definition
extramedullary tumor of CN VIII in cerebellopontine angle or internal acustic meatus, associated with neurofibromatosis II bilateral
Cn VIII lesion: tinnitus and heading loss
CN VII lesion: facial weakness, loss of efferent limb of corneal reflex
if it expands it affects spinal trigeminal tract: loss of pain and temp and corneal reflex afferent limb |
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Term
| onion skin distribution / dejerine (areas affected, cause, symptoms per area) |
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Definition
lesion on spinal trigeminal tract and nucleus possibly after surgical sectioning of spinal trigeminal nucleus
lower levels of the nucleus: peripherial areas of face, scalp, ears, chin
higher levels of the nucleus: more central areas, nose, cheeks, lips
highest levels of the nucleus: mouth, teeth, pharyngeal cavity
higher areas may be spared preserving pain and temperature in nose, upper lip, and mouth and removing them in the forehead, cheeks, and chin (analegesia distribution, non-physologic does not follow dermatome) |
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Term
| thalamic pain syndrome (cause, symptoms) |
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Definition
lesion in somatosensory path, especially VPL or VPM
exaggerated disagreement to cutaneous stimulation
emotional instability, spontanious pain |
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Term
| subacute combined degneration (cause, symptoms) |
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Definition
bilateral demyelination and loss of nerve fibers in dorsal and dorsolateral funiculi
vitamin B12 deficiency leads to pernicious anemia causing loss of senses of discrimitive touch and vibration and ataxic gait |
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Term
| asterognosis (cause, symptoms) |
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Definition
| cant identify object with eyes closed (tactile anginosa), lesion to somatosensory association cortex |
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Term
| neglect syndrome (cause, symptoms) |
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Definition
| patient cant recognize other side of their body and objects and surroundings on that side, often lesion in paracentral lobule, lesion of somatosensory association cortex |
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Term
| lesion in primary sensory cortex |
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Definition
| impairs fine somatic sensation (exact location and judging), positional movement, tactile sensation is fine |
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Term
| lesion in vestibular part of CN VIII (symptoms) |
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Definition
| vertigo, disequlibrium, nystagmus |
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Term
| lesion in chcolear part of CN VIII (symptoms) |
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Definition
destructive: hearing loss (sensorineural deafness)
irritative: tinnitus
auditory processing disorders |
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Term
| transection of CN II symptoms |
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Definition
| ipsilateral bindness, loss of direct pupillary light reflex, will not regenerate |
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Term
| increase in intracrainial pressure symptoms |
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Definition
| papilledema (swollen optic disc), hemmorhages, exudates, optic atrophy (white disc, a late finding. cup preserved) |
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Term
| oculomotor paralysis symptoms |
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Definition
transtentorial herniation: subduaral or epidural
diploa: double vision when looking in direction of paretic muscle
denervation of levator palpareae causes pitosis (drooping of upper lid)
denervation in extraocular muscles causes looking down and out to lateral rectus and superior oblique
interrupted parasympathetic dilates popul and stops accommodation (cycloplegia) |
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Term
| transtentorial herniation cause and symptoms |
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Definition
increased supratentorial pressure forces hippocampal uncus through tentorial notch and compresses oculomotor nerve
pupilloconstrictor fibers affected first dilating and fixing pupil
somatic efferent fibers next causing external strabismus (extraopia) |
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Term
| aneurysm of carotid or posterior communicating artery symptoms |
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Definition
compresses oculomotor nerve in cavernous sinus of interpenducular cistern
affects peripherial pupilloconstrictor fibers first via uncal herniation |
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Term
| diabetes mellitus effects on CN |
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Definition
| diabetic oculomotor palsa, damages central fibers of CN III, spares pupilloconstrictior fibers |
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Term
| trochlear nerve paralysis symptoms |
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Definition
| extorsion of the eye, weak down gaze, vertical diplopia increases when looking down, head tilting to compensate for extorsion |
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Term
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Definition
convergent strabismus (eostropia): inability to abduct eye due to unopposed action of medial rectus
horizontal diplopia: max seperation of double images when looking to paraetic lateral rectus |
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Term
| ansomia (cause, symptoms) |
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Definition
| loss of smell ipsilatera, involves fracture to floor of anterior crainial fossa, cracks cribiform plate damaging olfactory nerve |
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Term
| cerebral fluid rhinorrhea (cause, symptoms) |
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Definition
leaking CSF from subarachnoid into nasal cavity
fracture and tear of meninges
provide route for bacteria entry |
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Term
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Definition
occurs with age
degenerative diseases like parkinsons and alzheimers
neuronal loss of corticomedial nuclei in the amygdala |
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Term
| what can cause taste disorders |
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Definition
| head trauma, virus, lesion in root of VII (loss of taste in ant 2/3 tounge vestibular schwanoma), psyc issues |
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Term
| bells palsy (cause, symptoms, treatment) |
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Definition
edema of VII via virus, idiopathic unilateral facial nerve paralysis usually self limiting caused by trauma to facial canal, tumors like acoustic neuroma, Gillian barre, diphtheria, Lyme disease,ear infections, sarcoidosis, herpes simplex
Loss of taste in ant 2/3 of tongue, paralysis of muscles of facial expression, pain around ear,sensitivity to sound, can't close eye, wrinkling of forehead, pulling up corners of mouth
Rapid onset of partial or complete paralysis often overnight, rarely bilateral
Manage with corticosteroids |
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Term
| ageusia (cause, symptoms) |
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Definition
| complete loss of taste, rare, lots of CN involved |
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Term
| dysgeusia (cause, symptoms) |
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Definition
| distortion of taste. (cause may be medication) |
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Term
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Definition
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Term
| coacoagusia (cause, symptoms) |
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Definition
| unplesant taste triggered by seizure of central taste processing area. aura for people with seizures |
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Term
| What is an issue that can happen to the glomus chordieum? |
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Definition
| Calcification in the elderly seen on CT or X-ray |
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Term
| Non communicating hydroencephalus ( cause ) |
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Definition
Obstruction in cerebral aquduct or interventricular foramen or ventricle to subarachnoid
Ventricles enlarge |
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Term
| Communicating hydroencephalus ( cause) |
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Definition
| Impaired csf reabsorption into granulations causes excess csf production |
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Term
| Normal pressure hydroencephalus ( demographic, cause, symptoms, differential diagnosis, treatment) |
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Definition
In elderly
Chronically dialated ventricles, thought to be a form of communicating
Fair disturbance, urinalysis incontinence, mental decline, csf pressure normal
Differential diagnosis is Alzheimer's or Parkinson's
Treatment reduce csf volume |
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Term
| Glossopharyngeal lesion symptoms |
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Definition
Loss of gag reflex via interruption of afferent limb
Loss of carotid sinus reflex via interruption of sinus nerve
Loss of taste sensation in post 1/3 of tongue
Glossopharyngeal neuralgia |
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Term
| Vagus lesion symptoms and causes |
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Definition
Tardive dyskinesia: laryngeal muscles ipsilateral paralysis of soft palate, pharynx, larynx, hoarseness, dyspnea, dysphasia, loss of gag reflex (efferent), anesthesia of pharynx and larynx leads to loss of cough reflex
Could be compressed by aortic aneurism, neck or thorax tumor,vasectomy for weight loss |
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Term
| Accessory lesion symptoms |
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Definition
Paralysis of scm: difficult to turn head contralateral
Paralysis of trapezius: shoulder droop, can't shrug ipsilateral shoulder
Paralysis of larynx |
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Term
| Hypoglosseal lesion symptoms and upper vs lower neuron lesion |
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Definition
Hemi paralysis of tongue, points to week side due to unopposed contralateral genioglossus
Upper motor neuron lesion: tongue deviates to opposite side and muscles don't atrophy
Lower motor neuron lesion: tongue deviates to same side muscles atrophy on affected side |
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Term
| Facial nerve lesion symptoms |
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Definition
Flaccid paralysis to muscles of facial expression
Loss of corneal or blink reflex efferent limb which may lead to ulceration (keratitis paralytica)
Hyperacusis: increased acuity to sound nerve paralysis, usually self limiting |
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Term
| Central facial palsy / supra nuclear palsy (cause and symptoms) |
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Definition
Transaction of corticobulbar fibers in internal capsule
Contralateral facial weakness below orbit
Upper motor neuron lesion affecting lower face muscles |
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Term
| Crocodile tears syndrome (cause and symptoms) |
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Definition
Lacrimation during eating
Facial lesion proximal to geniculate ganglion
Regenerating preganglionic salivating fibs misdirected to pterygopalatine ganglion which projects to lacrimal gland |
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Term
| Moebius syndrome symptoms |
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Definition
Congenital oculofacial paralysis
Facial diplegia (CN VII)
Convergent strabismus (CN VI) |
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Term
| Syringomyelia (cause, symptoms, location) |
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Definition
Cavitation or softening of central spinal cord
Disrupts pain and temp propagating in anterior white comissure: yolk like loss of pain and temp
Most evident in cervical enlargement
Classic symptoms: burn that isn't painful |
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Term
| Irritation of peripheral nerve (symptoms, cause ) |
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Definition
External pressure or local inflammation stimulates pain and temp, burning in affected roots
Example: herniated disc |
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Term
| Local anesthetics (moa, effects, example) |
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Definition
Block conduction along C fibers
Low does reduces pain perception with out much loss of tactile sensation
Example: lidocaine |
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Term
| Ischemia of nerve (cause, symptoms) |
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Definition
Cause is tourniquet that blocks conduction of a fibers
Causes burning pain before complete failure of conduction |
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Term
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Definition
Surgical section of spinothalamic and spinoreticular pathways to relieve intractable pain
Considered for militant diseases of pelvic origin
Unilateral of bilateral
Pain may return several weeks after due to alternate ascending pathways |
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Term
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Definition
Analgesic procedure
Decussating spinothalamic and spinoreticular axons are cut by medial inclusion at a few sections above level of source of pain |
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Term
| Botulinum toxin (used to treat, moa) |
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Definition
Treats acute or chronic spasticity
Blocks release of ach from presynaptic terminal causing flaccid paralysis of muscle
Inhibits peripheral and central sensations, reducing pain
Treats non-neurological muscle conditions like neck and low back pain, myocardial pain syndrome, fibromyalgia, tmj pain, headache |
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Term
| Cone snail ( moa, functional molecules) |
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Definition
Complex venom with neuropeptides that immobilize prey by targeting voltage channels. Blocks Ca entry into neurons, blocking neurotransmitter release from nociceptive afferents
Delivered into subarachnoid space via intrathecal administration
Zconotide (prialt) was isolated for clinical use. No tolerance or addiction,may cause suicidal thoughts,
Omega contoxin is being tested for post surgical pain |
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