Term
|
Definition
o A transient disturbance of cerebral function caused by an abnormal neuronal discharge
o SAH, EtOH Withdrawal |
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Term
|
Definition
| group of disorders characterized by recurrent seizures |
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Term
|
Definition
| partial seizure experienced as a peculiar sensation preceding the onset of a generalized seizures or complex partial seizure that my take the form of a gustatory, visual or auditory experience; a feeling of dizziness or numbness; or just “a funny feeling” |
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Term
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Definition
| o Early clinical manifestations, such as malaise, headache, or sense of depression, that may occur hours to a few days before the onset of a seizure |
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Term
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Definition
| state of muscle contraction in which there is excessive muscle tone |
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Term
|
Definition
state of alternating contraction and relaxation of muscles
Rhythmic movement that occurs |
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Term
VITAMEN
Vascular, Idiopathic, Trauma, Autoimmune, Metabolic, Endocrine, Nature |
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Definition
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Term
• Benign febrile convulsions of childhood
• Idiopathic epilepsy
• Head trauma
• Stroke/vascular malformations
• Mass lesions
• Meningitis or encephalitis
• HIV encephalopathy |
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Definition
| List primary neurologic disorders |
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Term
• Idiopathic-- young ppl
• Febrile--children…not accustomed to fevers
• Metabolic--biphasic (children and elderly)
• Infection/Trauma-- younger(more exposed)
• Stroke/tumor--Later in life |
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Definition
|
|
Term
Generalized Seizures
o Tonic-clonic (grand-mal) – rigid, shake
o Absence (petit mal) – just staring into space, no motor manifestation
o Other types (tonic, clonic, myoclonic)
Partial Seizures
o Simple partial
o Complex partial
o Partial Seizures w/ secondary generalization |
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Definition
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Term
)– Fasting glucose
– Serum calcium
– Serum FTA-ABS
– Serum electrolytes
– Complete blood count
– Erythrocyte sedimentation rate (screening)
– Renal function studies
– Hepatic function studies |
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Definition
| Seizure: Ancillary evaluation Blood studies (list |
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Term
positive in 20–59% of first EEG
Positive in 59–92% with repeated EEGs |
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Definition
| EEG % positive for seizures... |
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Term
| Benign Febrile Convulsions |
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Definition
2-4% of children ranging in age from 3 mo. to 5 y.o.
Usually will occur during the first day of a febrile illness
Last for less than 15 mins
Lack focal features (not just arm…tend to be generalized)
Over 60% experience a single seizure (might repeat 1 time)
Fewer than 0.1% than three seizures
Differential Diagnosis includes meningitis or encephalitis |
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Term
convulsionsgenerally self limiting
Diazepam 0.3mg/kg po, IM or IV prn TOC
Rule out an infectious or structural cause
CT scan (rule out mass effect), LP
Anticonvulsants not indicated unless
Persistent neurologic deficits
Recurrent seizures develop |
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Definition
|
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Term
|
Definition
more than 75% of all seizure disorders
No specific structural or other cause can be established for seizures
Usually begins between the ages of 5 and 25 years and more than 75% of these patients have their first seizure before 18 years old |
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Term
|
Definition
Recurrence rates range from about 30-70% in different published reports
Higher (more likely) in patients w/:
•Electroencephalographic abnormalities such as a generalized spike-and-wave pattern
•Postictal Todd Paralysis or persistent neurologic abnormalities
•Focal weakness in part of the body after a seizure
•Multiple seizures prior to evalulation
•Family history of afebrile seizures |
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Term
|
Definition
oInitial manifestations are unconsciousness and tonic (rigidity) contractions
oUsually without aura or other warning
oIf there is a warning it usually consists of nonspecific symptoms
oContraction of masticatory muscles may cause tongue trauma
oPatient falls may cause injury
oThere is postictal confusion and often headache
oOrientation commonly takes 10-30 mins |
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Term
|
Definition
seizures that continue for more than 30 minutes without ceasing spontaneously, or which recur so frequently that full consciousness is not restored between successive episodes
A medical emergency that may cause permanent brain damage if untreated
Seizure-- Postictal state-- Another seizure for at least 30 minutes (you do not recover from the first before the second) |
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Term
| Absence (Petit mal) seizures |
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Definition
• Genetically transmitted seizures that always begin in childhood and rarely persist into adolescence
• Characterized by brief loss of consciousness (5-10 seconds) w/o loss of postural tone
• Subtle motor manifestations, such as eye blinking or a slight head turning, are common
• Full orientation immediately follows cessation of the seizures
• Characteristically inducible by hyperventilation (can do in office)
• More often picked up by teachers (lights on but not home) |
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Term
|
Definition
• Characterized by continuing muscle contraction that causes fixation of the limbs and axial musculature in flexion or extension (board like)
• The cessation of ventilator movements leads to cyanosis
• Consciousness is lost
• No clonic phase |
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Term
|
Definition
• Characterized by repetitive clonic jerking
• Accompanied by loss of consciousness
• No initial tonic component |
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Term
|
Definition
• Sudden, brief, shock like contractions that may be localized to a few muscles or one or more extremities or that may have a more generalized distribution
• Not accompanied by loss of consciousness |
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Term
|
Definition
motor, sensory, or autonomic phenomena
Clonic movement in the face, a limb, or the pharynx
Jacksonian March (moves along the motor cortex…face-- arm, etc…)
Autonomic symptoms may consist of pallor, flushing, sweating, pupillary dilation, vomiting, incontinence
Psychic symptoms include dysphasia, distortions of memory
Consciousness is preserved
No postictal state; can provide info bc they were awake |
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Term
|
Definition
•Consciousness, responsiveness or memory is impaired
•Seizure discharge usually arises from the temporal lobe or medial frontal lobe
aura
automatism-- orobuccolingual (75%) other head/neck (50%)
Secondary generalization may occcur
Not processing info properly, but not unconscious |
|
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Term
|
Definition
• Episodes that resemble seizures and may be manifestations of a psychiatric disturbance
• Usually can be distinguished by the clinical exam findings and normal EEG
• Patients will rarely harm themselves |
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Term
|
Definition
o Oral lading dose of 1000 mg in 2-4 divided doses over 12-24 hrs
o Maintenance dosage of 300-400 mg/d in 1-2 doses
o Requires lab testing with a therapeutic range of 10-20 g/mL
o Indicated for Partial, Generalized, and Partial Seizures with generalization
o 20% will develop gingival hyperplasia (red, beefy, gums) lead to decay, dental dz |
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Term
| Carbamezapine or tegretol seizure tx |
|
Definition
o Initial dose 100 mg bid and increase to a total dose of 400-1600 mg/d
o Requires lab testing: range of 4-12 mcg/mL
o Useful for Partial Seizures including the generalized partial seizures
o Hematologic problems that occur aplastic anemia, agranulocytosis (OBTAIN CBC) |
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Term
| Valproic acid or depakote seizure tx |
|
Definition
o Requires no loading dose and is initiated b/w 750-3000 mg/d in 2-3 doses
o Requires lab testing with a range of 50-150 mcg/mL as therapeutic
o Useful for the full range of seizures including:
Generalized tonic-clonic
Myoclonic
Absence
Partial
Secondary generalization
o MUST BE SURE IT’S RECURRENT, comes in sprinkly form for children |
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Term
• Blood pressure: exclude hypertensive encephalopathy or hypoperfusion
• Temperature: exclude hyperthermia
• Pulse: exclude life-threatening cardiac arrhythmia
• Lab studies for glucose, calcium, electrolytes, hepatic and renal function, CBC, ESR, and toxicology as well as ABG and urine for toxicology
• Insert intravenous line and administer glucose (50 mL of 50% dextrose)
• Rapid physical examination
• CT Scan to rule out mass lesion or hemorrhage (MRI?)
• Lumbar puncture, unless the cause of seizures is known |
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Definition
| Emergent evaluation for status epilepticus |
|
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Term
Ativan or Lorazepam 0.1 mg/kg IV1 at rate not greater than 2 mg/min
•Effective half life is 14 hours (better choice
Valium or Diazepam 10 mg IV over 2 minutes
•Effective half-life is 15 minutes
•Treats the current seizure
•Abrupt respiratory depression or hypotension in 5%
•Seizures recur in 50% of patients- add anticonvulsant
•Cerebryx (Fosphenytoin) 20 mg/kg IV at <150 mg/min which results in peak serum concentration 10-20 mins |
|
Definition
| Emergent tx of status epilepticus |
|
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Term
• Repeat Cerebryx 10 mg/kg IV
• Repeat Ativan or Diazepam IV
• Propofol 1–2 mg/kg IV bolus followed by 2–4 mg/kg/h infusion and titrate infusion between 1 and 15 mg/kg/h (ANESTHESIA)
• Intubation and ventilatory support required
• Hypotension is can be a factor and vasopressors may be required- dopamine up to 10 mcg/kg/min |
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Definition
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Term
Injury has occurred to any of the following structures:
o Bony elements
o Soft tissues
o Neurological structures |
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Definition
| Spinal trauma defined as... |
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Term
• Instability of the vertebral column
• Actual or potential neurological injury |
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Definition
| 2 concerns of spinal trauma |
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Term
|
Definition
| Loss of normal relationship between anatomic structures with a resulting alteration of natural function |
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Term
• Fracture of vertebral body, lamina, and/or pedicles
• Dislocation of anatomic components caused by disruption of soft tissues
• Fracture and dislocation may occur together |
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Definition
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Term
|
Definition
Traumatic forces:
• Fibers are pushed together in a crushing manner
• Tends to fracture vertebrae in multiple pieces
• Usually associated with flexion, extension, or rotational injuries |
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Term
|
Definition
Traumatic forces:
• Bony, disc, or soft tissue elements are pulled apart
• Usually associated w/flexion or extension injuries |
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Term
|
Definition
traumatic forces:
• Severe forward bending of the neck or trunk
• Causes compressive force on the anterior vertebral column; teardrop or wedge type fracture to v. body |
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Term
|
Definition
Traumatic forces:
• Severe backward bending of the neck or trunk
• Axial loads often also associated
• Compressive force on facet, lamina, spinous processes and distractive force on anterior aspect of cord
• Causes fractures to the spinous process and lamina |
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Term
|
Definition
Traumatic forces:
• Force parallel to the surface on which it acts; results in a translation or subluxation movement
• Usually result in anterior or lateral displacement of affected elements
• Hit from the side |
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Term
|
Definition
Traumatic Force:
• Torsional force that creates a rotational tension on tissue fibers
• Often associated with axial forces |
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Term
Used to grade thoracolumbar and cervical fractures
Based on 3-column theory of the spine:
o Anterior = ALL and anterior 2/3 of vertebral body/disc
o Provides support to contain nuclear material in disk
o Middle = posterior 1/3 of vertebral body/disc and PLL (make up middle column of spine)
o Posterior = pedicles, lamina, facets, post. Ligaments |
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Definition
| Denise Classification Method |
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Term
|
Definition
trauma to spinal cord, cauda equina, nerve roots
Can result from bone, bone fragments, or disc material compressing on neurologic structures
All structures innervated by the affected neurologic structure may lose all or partial function |
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Term
| only structures it innervates |
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Definition
| o Injury to a specific nerve results in neurologic loss to |
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Term
| permanent loss of neurologic function below the affected level |
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Definition
| Complete cord lesion results: |
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Term
| can show some neurologic improvement, particularly when motor function remains intact |
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Definition
| Imcomplete cord lesion results; |
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Term
complete or incomplete neuro function
complete loss of function with no chance of recovery |
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Definition
o Injury to cauda equina may result in ___
o Injury to conus medullaris generally results in ___ |
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Term
o A = Complete loss of motor and sensory function
o B = Only sensory function remains
o C = Motor function is present but of no practical use (i.e., can move legs but not walk)
o D = Motor function impaired (i.e. can walk but not with normal gait)
o E = No neurologic impairment noted |
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Definition
| Frankel Score (reverse order) for Classification of Neurologic Injury |
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Term
| Thoracolumbar Flexion compression fracture |
|
Definition
o Frequently occur at T12, L1 levels
o Usually anterior column failure
o Usually, if middle and posterior columns are intact, fracture is considered stable
o Verterbral body in anteriro column gives way first.. If it extends further may have progression into posterior column |
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Term
| Thoracolumbar Flexion-distraction fracture |
|
Definition
o “Chance fractures”
o All 3 columns may fail
o Bone, ligament, and disc injuries
o Anterior subluxation
o Common seatbelt injury |
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Term
|
Definition
o Violent compressive load with failure of anterior and middle columns; unstable fracture
o Loss of vertebral height
o Risk of retropulsed bone and neurologic injury
o Most common fracture with deer stand injuries
o If you get enough compression, then you get retropulsed bone |
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Term
| Low lumbar flexion distraction fracture |
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Definition
o “Jumper’s fracture”
o Severe compressive load on anterior column; distractive forces on middle/posterior columns
o Associated with high degree of lower extremity fractures
o Falls are most common cause |
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Term
| Low lumbar Compression, torsion, translation fracture |
|
Definition
o Occur with or without flexion
o Compression effects on lateral margins of vertebral body
o Torsion/translation affects vertebral body, disc, ligamentsg
o Twisting component instead of vertebral bodies being aligned, they will be pushed off to the side. |
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Term
|
Definition
A degenerative condition of the cervical spine manifest by disc collapse, osteophyte formation and neural encroachment
As the population ages this is becoming more common
Usually includes one or more of the following symptoms
o pain and stiffness in the neck
o pain in the arms with or without a motor deficit
o sensory deficit in the arms
o upper motor neuron deficit in the legs |
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Term
|
Definition
Hand sensory complaints are initial symptoms
o Particularly fine movements
o Most often have a long history of neck discomfort
o Unusual to see incontinence
o Good proximal strength but very poor dexterity in hands
o Atrophy of small muscles– slow progression . |
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Term
|
Definition
o Weakness with atrophy of small muscles
o Spasticity
o Hyper active reflexes (clonus)
o Lhermitte sign
o Gait disturbances
o Manifestations of upper motor neuron w/fine motor deficits in their hands |
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Term
|
Definition
o Is the momentary paresthesia (shocklike or tingling sensation) that shoots down the trunk or limbs during active or passive flexion of the neck.
o Can also occur with cough or straining
o Like Tenil sign for median nerve |
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Term
|
Definition
Injury to nerves w/I the spinal cord as they exit the lumbar and sacral regions:
• Usually fractures below L2
• Can also occur w tumors
• Specific dysfunction depends on level of injury |
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Term
|
Definition
• Flaccid-type paralysis of lower body
• Bladder and bowel impairment
• Won’t have reflex changes, or spinal cord injury patterns bc it is a lower motor neuron process. (can’t have clonus) |
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Term
Motor
o Strength/Tone
o Reflexes
o Spasticity
Sensation
o Pain and Position
o Think in terms of all different tracts
Rectal Tone
o Bulbocavernousus Reflex |
|
Definition
| Cauda Equina Syndrome Exam... |
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|
Term
STERIODS:
Solumedrol Protocol
o 30 mg/kg IV initially over 15 minutes
o 5.4 mg/kg IV for 23 hours
This must be started within 3 hours of SCI |
|
Definition
|
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Term
|
Definition
High thoracic or low cervical injury with loss of SNS
Eliminates the “fight” or “flight” response
Get all Parasympathetic response
o Vasodilation below injury level
o Pooling of Blood (at risk for blood clot)
o Decreased venous return to heart
o Decreased cardiac output |
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Term
|
Definition
• Lesion @ or above T6
• Usually occur after acute phase of SCI or spinal shock
• Noxious stimuli is trigger
• Can come about from UTI, impaction, infection, cellulitis |
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Term
|
Definition
• Sympathetic response (tachycardia, sweating)
• Severe elevated BP
• Flushed head/neck, cool lower ext
• Pallor
• Headache
• Bradycardia
• Pupil dilation |
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Term
+address immediate problem with BP control, then go looking for cause .
+Relieve Trigger |
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Definition
|
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Term
|
Definition
• Not “true” tumors; evaluated and treated as such
• Patients are teens or 20s
• Occur most frequently in posterior elements
• Slight predominance in Females
tx
• Embolization and surgical resection |
|
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Term
|
Definition
• Very aggressive
• Primarily in sacrum
• Women> men
• Age 30-40
• May be associated with bladder/bowel dysfunction
tx
• Wide en-bloc (all in one) resection; adjunctive radiation therapy |
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Term
|
Definition
• Most asymptomatic; found on incidental exam
• Symptomatic lesions seen in pts 30-40 yrs
• Vertebral body affected
• Frequentlly seen in thoracic spine
• Risk of pathologic compression:
o Fracture
o Hematoma
o Expanding tissue mass
o Neurologic compromise
tx
• Based on size, location, neurologic involvement, pt age and health
• TOC-- complete excision |
|
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Term
|
Definition
• Common in spine
• Males 20-40 yr
• Posterior elements of lumbar spine: lamina or pedicle
• Lesion size about 2cm
• Scoliotic deformity may be present
tx
• Complete surgical resection |
|
|
Term
|
Definition
• Similar histologically to osteoid osteoma; more aggressive but not as common
• Males 20-30 years old
• Posterior elements lumbar spine
• Lesion size <2cm
o Smaller, so may not be quite as problematic
• Potential to become malignant
o Can differentiate into sarcoma
tx
• Total resection |
|
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Term
|
Definition
• Rare, slow-growing, slow to metastasize over sacum
• Originate from cells of primitive nervous system
• 2:1 male to female ratio
• Patients 50-70 years of age
• Half of all chordomas occur in sacrococcygeal region
• Also found at base of skull near foramen
tx
• Surgical treatment usually difficult due to location; excision if possible
• Low patient survival rate |
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Term
|
Definition
• Rare, highly malignant
• Affect younger population; increased frequency in males
• Vertebral body most often affected; pedicles and posterior elements may also be involved
tx
• Treatment of choice is radical excision with chemotherapy/radiation
• Generally poor prognosis due to metastases |
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Term
|
Definition
• Rare; arise from cartilaginous tissue
• Slow growing; patient may not present until tumor is well established
• In spine, most common in thoracic, lumbar, sacrum
• 2:1 male-to-female
tx
• Surgical treatment difficult due to location in spine; tend to be resistant to chemo and radiation
• Overall poor prognosis |
|
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Term
|
Definition
• Group of malignant tumors classified by histological similarity
• Also called plasma cell tumors
• Highly malignant;occur frequently in spine
• Includes
o Plasmacytoma
o Multiple Myeloma
o Lymphoma
o Ewing’s Sarcoma |
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|
Term
|
Definition
• 3:1 male-to-female; >50 years of age
• Thoracic spine
• Half of patients go on to develop multiple myeloma
tx
• Treatment of choice is radiation therapy
• Surgery may be used for decompression/stabilization |
|
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Term
|
Definition
• Most common bone malignancy in adults!!
• Most often found in the spine
• Male-to-female ratio is equal; most patients 50-80 years of age
• Other systemic organs may be involved; renal failure common
tx
• Surgery rare except to decompress and stabilize; treatment of choice is radiation/chemo because of multiplicity of tumors |
|
|
Term
|
Definition
• Usually non-Hodgkin’s type
• Most patients 40-60 years of age
• Usually widely disseminated throughout the body
• Anterior column most frequent spinal site
• Respond to radiation and chemo; surgical decompression/stabilization may be indicated |
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|
Term
|
Definition
• Common in children 10-15 years
• 2:1 male-to-female
• May have associated soft tissue mass
• Half of tumors occur in sacrum
• High incidence of neurologic involvement
tx
• Tri-modal treatment: surgical excision, radiation and chemo
• 5-year survival rate is <20% |
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|
Term
o Direct erosion from near-by neoplasm
o Arterial metastasis through nutrient arteries (lung tumors thought to spread through segmental arteries)
o Venous distribution through azygous system (prostate and breast cancers)
o Dissemination through lymphatic system; suspected but not clearly demonstrated |
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Definition
| Four theorized mechanisms for metastasis |
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|
Term
Intramedullary (10%) or inside the spinal cord
o Ependymomas are the most common type (approximately 60% of cases; gliomas make up the remainder--> astrocytoma is the most common; oligodendroglioma)
Extramedullary (90%) or outside the spinal cord (May be extradural or intradural)
• Neurofibromas and meningiomas are relatively common, benign tumors which can be intra- or extradural |
|
Definition
| • Tumors can be divided into two groups |
|
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Term
|
Definition
Pain is a conspicuous feature and usually the initial abnormality for any of the tumors that we’ve reviewed
o Not relieved by rest
o Often occurs at night
o No difference in severity of pain from benign or malignant tumors |
|
|
Term
o Radicular or
o Localized to the back or
o Diffusely in an extremity
o May be aggravated by coughing or straining
o May develop motor symptoms (heaviness, weakness, stiffness ) of one or more extremities
o May have paresthesias or numbness, especially in the legs |
|
Definition
| With extradural lesions the pain may be |
|
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Term
|
Definition
o an unpleasant sensation produced by a stimulus that would usually be painless
o taking stimulus that normally wouldn’t be problematic but in this condition it will be unpleasant; is painful from otherwise normal thing |
|
|
Term
|
Definition
o abnormal spontaneous sensations, such as burning, tingling, or pins and needles
o abnormal, fall asleep on arm feeling; can be painful |
|
|
Term
|
Definition
| o Non specific term used by patients to describe a sense of heaviness, weakness or deadness and sometimes to signify any sensory impairment |
|
|
Term
Idiopathic inflammatory
metabolic & nutritional
infectious/granulomatous
vasculitic
neoplastic and paraproteinemic
drug-induced and toxic
hereditary
Entrapment |
|
Definition
| 8 categories of peripheral neuropathies... |
|
|
Term
|
Definition
| Acute or sub-acute polyneuropathy that can follow minor infective illnesses, vaccines or surgery |
|
|
Term
|
Definition
Presents with gradual onset of symmetric weakness
+Usually begins in the legs
+Typically an ascending weakness which is greater than the sensory loss
+Will progress over several weeks
+Can ascend to point of causing bowel/bladder dysfunction
+May have autonomic dysfunction
+May develop respiratory failure |
|
|
Term
|
Definition
Lumbar puncture may reveal
Increased CSF protein after 1 week
CSF white blood cell count less than 10/mcl |
|
|
Term
Usually symptomatic/ supportive
+Weakness will gradually recede after 4 weeks
+Prevent complications
respiratory failure
vascular collapse– lose arterial tone w/o proper innervation… causes dilation and blood pressure decreased… need something to cause vasoconstriction
+Plasmapheresis may reduce the time required for recovery and may decrease the likelihood of residual neurologic deficits |
|
Definition
| tx for guillain barre syndrome |
|
|
Term
| chronic inflammatory demyelinating polyneuropathy |
|
Definition
Very similar to Guillain-Barré
Chronic progression or characterized by relapses with no improvement within the 6 months after onset |
|
|
Term
| Chronic inflammatory demyelinating polyneuropathy |
|
Definition
| EMG reveals a demyelinative neuropathy with superimposed axonal degeneration |
|
|
Term
Often responsive to treatment with corticosteroids
+Prednisone 60–100 mg/d for 2–4 weeks then slowly tapered to 5–20 mg every other day
May have to be continued long-term |
|
Definition
| tx for chronic inflammatory demyelinating polyneuropathy |
|
|
Term
|
Definition
due to
+radiculoplexopathy, +polyradiculopathy +polyradiculoneuropathy |
|
|
Term
|
Definition
+postural hypotension
+disturbances of cardiac rhythm
-- doesn’t regulate BP, HR, or temperature
+impaired thermoregulatory sweating
+disturbances of bladder, bowel, gastric and sexual function
--can have diabetic gastroparesis |
|
|
Term
|
Definition
+ Damage to muscle nerves and atrophy/decrease in size b/c of innervation damage
+Pain, weakness and atrophy of pelvic girdle and thigh muscles
+absent quadriceps reflexes and little sensory loss |
|
|
Term
| diabetic mononeuropathy multiplex |
|
Definition
+characterized by pain and weakness
+often has a vascular basis
+ described as nerve entrapment or acute vascular injury |
|
|
Term
+Anticonvulsants
--Tricyclic antidepressants
--Elavil– old medication that can be utilized and is very effective
--Give at bed time– sedating– helping them sleep and get mood improvement
+Anti arrhythmics
+Topicals including capsaicin and lidocaine
+Surgically implanted stimulators |
|
Definition
| Medical intervention for diabetic neuropathy-- |
|
|
Term
|
Definition
When a nerve is compressed, stretched, or angulated by adjacent anatomic structures to such an extent that dysfunction occurs.
Initial clinical complaints are of sensory symptoms or pain |
|
|
Term
Carpal Tunnel
Ulnar Tunnel– either at wrist or cubital tunnel
Thoracic Outlet
Tarsal Tunnel |
|
Definition
| more common entrapment neuropathy syndromes... |
|
|
Term
|
Definition
Commonly seen with
+Cumulative trauma
+Pregnancy
Trauma/fracture dislocation/pregnancy fluid retention/injury edema– all can lead to compression in the canal, raising pressure |
|
|
Term
+Tinel’s sign
--Tapping on the median n. at the wrist
--if positive then reproduce symptoms in median distribution (1/2 of ring, long, index, and palmar side of thumb; dorsal side to first joint)
+Phalen’s sign
--Pressing the backs of hands together with the wrist flexed
+Nerve conduction velocity testing |
|
Definition
| testing for carpal tunnel syndrome includes |
|
|
Term
|
Definition
Compression at the elbow worsened by repetitive use
+“Cubital tunnel”
+Can be seen at the wrist in Guyon’s tunnel but more likely to occur over medial olecranon (funny bone) |
|
|
Term
Tinel’s sign at elbow and NCS
Test abductor pollicis brevis on thumb… shouldn’t be able to push thumb in…
Put pinky and thumb together– shouldn’t be able to pull finger through the connection |
|
Definition
| test for ulnar neuropathy |
|
|
Term
|
Definition
"Saturday Night Palsy”
Compression of the radial nerve in the axilla by pressure from crutches or sleeping on the arm |
|
|
Term
|
Definition
Weakness in wrist extensors with associated sensory loss
+Dorsum of hand to first joint is nerve distribution
+Wrist drop and sensory loss |
|
|
Term
Neurologic or Vascular
+Cervical rib seen in about 1% of the population
+Hypertrophy in scalene muscle or presence of 1st bony rib |
|
Definition
| causes of thoracic outlet syndrome |
|
|
Term
|
Definition
Pain and paresthesia in the C8-T1 distribution
Doesn’t give aboslute weakness b/c of multiple innervations in brachial plexus |
|
|
Term
“hand’s up” test
+‘Hands up’ position with elbows braced firmly backwards, chin elevated: Hands clenched and opened for 3 min
+Positive test:
pain, heaviness or profound arm weakness or numbness and tingling of the hand
Allen Test
+The examiner flexes the patient’s elbow to 90° while the shoulder is extended horizontally and rotated laterally
+The patient turns his head to the opposite side
+Keep palpating the radial pulse
+Positive Test
Radial pulse disappearance-Decrease in pulse decrease in blood flow from radial artery |
|
Definition
| test for thoracic outlet syndrome |
|
|
Term
peroneal nerve palsy
tarsal tunnel syndrome
femoral neuropathy
lateral femoral cutaneous |
|
Definition
| list lower extremity neuropathies... |
|
|
Term
|
Definition
trauma or pressure at the head of the fibula
dorsiflexion weakness of the foot (looks like L5 root) |
|
|
Term
|
Definition
Located at the ankle immediately below and behind the medial malleolus
Burning pain in the foot usually at night
Not really associated with weakness as no major motor function comes from tarsal tunnel |
|
|
Term
|
Definition
Rare but can be seen with diabetes and retroperitoneal problems
symptoms and signs relate to weakness of the quadriceps muscle with absent or decreased reflex |
|
|
Term
| lateral femoral cutaneous |
|
Definition
“meralgia paresthetica”
Sensory changes in the anterolateral aspect of the thigh
Pregnant women and fat guys with big belts! “burning in pockets” |
|
|
Term
|
Definition
| associated with inflammatory mono- or polyradiculopathy, brachial plexopathy, mononeuropathy (including facial palsy), and mononeuropathy multiplex |
|
|
Term
|
Definition
Facial weakness of the lower motor neuron type
Idiopathic although there is some suggestion that HSV 1 may be implicated in some cases.
More common in pregnant women and diabetics
Complete and incomplete types based on the degree of motor weakness |
|
|
Term
|
Definition
+Taste change
+Lacrimation
+Hyperacusis (increased hearing)
+Eye drooping |
|
|
Term
Most patients recover completely w/o tx
+May take several days or several months
+Poor prognosis for complete recovery present initially with severe pain and complete palsy |
|
Definition
|
|
Term
Treatment with corticosteroids
+Must be started within 5 days after the onset of palsy
+Prednisone 60 mg/d orally for 3 days, tapering over the next 7 days |
|
Definition
|
|
Term
|
Definition
Muscular weakness which is the result of a variable block of neuromuscular transmission related to an immune-mediated decrease in acetylcholine receptors
Occurs at any age
More common in females than males |
|
|
Term
|
Definition
Most commonly involves
+External ocular muscles
+Certain other cranial muscles:
--masticatory, facial, pharyngeal, and laryngeal muscles.
+Respiratory and limb muscles |
|
|
Term
|
Definition
+fluctuating weakness
+easy fatigability of voluntary muscles
Muscle activity cannot be maintained and initially powerful movements weaken readily
Not progressive!! |
|
|
Term
Confirmed by the benefit that anticholinesterase drugs have on the power of affected muscles
Tensilon (edrophonium) test:
+Cholinergic agonist
+10mg/ml given as 2 mg IV and then 8 mg after 30 seconds
+Strength will be dramatically improved for about 5 mins
+Watch for cholinergic crisis
--Treat with Atropine
CT scan of the chest r/o thymoma
Serum acetylcholine receptor antibody levels often elevated |
|
Definition
| dx/test for myasthenia gravis |
|
|
Term
Mestinon (Pyridostigmine )
+Anticholinesterase inhibitor
+Helpful in maintaining overall strength
+ 60 mg qid |
|
Definition
|
|
Term
|
Definition
• Lambert-Eaton Syndrome
• Usually seen in conjunction with neoplasm or pernicious anemia
• Tumor antibodies react with Ach release
• Extraocular muscles are spared and strength will increase if contraction is maintained
• Muscle get stronger as you hold the strength rather than fatiguing
works on pre-synaptic region |
|
|
Term
|
Definition
| Group of disorders characterized by weakness and muscular wasting without sensory change |
|
|
Term
+Usually occur in the first year of life
+Fairly uncommon
SMA1, SMA2 and SMA3 |
|
Definition
| infantile motor neuron disease... |
|
|
Term
Usually occurs between 30-60 yrs old
men more than women |
|
Definition
| Adult motor neuron disease... |
|
|
Term
|
Definition
| Difficulty in swallowing, chewing, coughing, breathing and talking |
|
|
Term
progressive bulbar palsy
pseudobulbar
progressive spinal muscular atrophy
primary lateral sclerosis
amyotrophic lateral sclerosis |
|
Definition
| Adults have 5 varieties of motor neuron disease distinguished by their clinical presentations |
|
|
Term
|
Definition
Motor nuclei of cranial nerves
Drooping of the palate; a depressed gag reflex; pooling of saliva in the pharynx; a weak cough; and a wasted, fasiculating tongue |
|
|
Term
|
Definition
Bilateral corticobulbar involvement
the tongue is contracted and spastic and cannot be moved rapidly from side to side |
|
|
Term
| progressive spinal muscular atrophy |
|
Definition
| Primarily lower motor neuron |
|
|
Term
| primary lateral sclerosis |
|
Definition
| Pure upper motor neuron in limbs |
|
|
Term
amyotrophic lateral sclerosis
"lou gehrig's disease" |
|
Definition
Mixed UMN and LMN deficits are found in the limbs
May be bulbar involvement
Dx made clinically when
+Definite Upper and Lower motor neuron signs in the bulbar and two spinal regions or in three spinal regions
Tx is generally supportive
Riluzole 100 mg daily may reduce mortality/slow progression
fatal 3-5 years |
|
|
Term
|
Definition
Results from nerve trauma
+improper IM injection or placement of an arterial catheter at the wrist
Onset of pain may be at any time within the first 6 weeks after nerve injury
+Severe persistent pain, often burning in quality
+ Radiates to a more extensive territory
exquisite tenderness |
|
|
Term
reflex sympathetic dystrophy
"complex regional pain syndrome" |
|
Definition
more general term that denotes sympathetically mediated pain syndromes precipitated by a wide variety of tissue injuries
following soft tissue injury or fractures
+extremity sweating
+temperature
+color changes
sympathetic blockade with anesthetics
surgical sympathectomy
Great success has been seen with spinal stimulation |
|
|
Term
|
Definition
Radicular pain is localized to the distribution of one or more nerve roots
+Motor weakness in the appropriate myotome
+Reflex change
+Sensory change in the appropriate dermatome |
|
|
Term
|
Definition
Causes of are numerous!
+Muscular
--sprain and strain
+Skeletal
--Fracture
--Osteoarthritic |
|
|
Term
|
Definition
Arises from facet and intervertebral age-related changes that reduce the patient’s quality of life
Degenerative process that results in narrowing of overall diameter of spinal canal
Neurogenic claudication |
|
|
Term
|
Definition
| Inability to walk or stand for any length & progressively worsens |
|
|
Term
• Disc Bulge/Herniation
• Hypertrophied Ligamentum flavum
• Narrowed Spinal Canal
• Narrowed Lateral Recesses
• Hypertrophied Facets |
|
Definition
| lumbosacral spine disease characteristics |
|
|
Term
|
Definition
• Represent about 75% of total sleep time
• Starts with the withdrawal of NT from the RAS and inhibits the arousal mechanisms from the cortex
• Pulse, BP, breathing, and BMR are all decreased |
|
|
Term
o Stage I – light sleep w/ alpha waves and slow eye movement
o Stage II – Further slowing of EEG
o Stage III – Low frequency Delta Waves
o Stage IV – Delta Wave |
|
Definition
|
|
Term
|
Definition
Represents about 25% of total sleep time
Occurs about every 90 minutes (cycle)
Associated with increased pulse and B/P as well as altered breathing |
|
|
Term
|
Definition
| There is atonia of muscles which can lead to respiratory obstruction involving the tongue and upper pharynx |
|
|
Term
Insomnia
o Trouble falling asleep…total sleep time is disturbed
Primary Sleep Disorders
o Sleep Apnea
o Restless Leg Syndrome
Hypersomnia
o Narcolepsy |
|
Definition
| classes of sleep disorders |
|
|
Term
|
Definition
“Difficulty in initiating or maintaining sleep”
More common in males
-May be transient or long-term
-Assoc. w/ daytime sleepiness and fatigue
-Problems initiating sleep are more common w/ psych issues
-Problems maintaining sleep are more likely medical |
|
|
Term
Education is the cornerstone of initial treatment:
-Caffeine avoidance after lunch
-No alcohol prior to bed time
-Sleep hygiene
-Room prep
-The three S’s schedule, sex, sleep…bed used solely for these things |
|
Definition
| insomnia tx cornerstone... |
|
|
Term
Multiple classes of medications available
-OTC products
>>Benadryl
>>Melatonin
-Benzodiazepines (dangerous in elderly)
>>Restoril (tomazepam)
>>Clonazepam (Klonopin)
-Non-benzodiazepines
>>Ambien
>>Sonata
-Antidepressants
>>Elavil
>>Trazodone |
|
Definition
|
|
Term
|
Definition
-May be assoc. w/ PLMS
>>Periodic Limb Movement Syndrome
>>Rhythmic movement of the extremities every 20-40 sec that interrupt normal sleep
>>Common entity that occurs in 50% >65 y.o.
-Motor & Sensory changes may be related to spinal dz or other problems such as anemias |
|
|
Term
Underlying disease may be the first treatment
Alternate agents may include
Benzodiazepine
-- clonazepam or Klonopin
GABAergic
--Baclofen or Lioresal (muscle relaxant, titrate dosage to effect)
--Gabapentin or Neurontin (also for HA, neuralgia)
Dopaminergic
--Ropinirole or Requip
--Pramipexole or Mirapex 2 mg at bedtime |
|
Definition
| tx for restless leg syndrome |
|
|
Term
|
Definition
Breath cessation for at least 10 seconds
Central – from brainstem…not obstructive process! |
|
|
Term
|
Definition
| decrease in airflow w/ drop in hemoglobin saturation of at least 4% |
|
|
Term
|
Definition
| absent ventilator effort during the episode which is very uncommon |
|
|
Term
|
Definition
| ventilator effort during the episode but no airflow occurs because of transient obstruction of the upper airway |
|
|
Term
|
Definition
| occurs if absent ventilator effort precedes upper airway obstruction during the episode |
|
|
Term
|
Definition
Patient may report:
daytime somnolence
morning sluggishness
headaches
daytime fatigue
cognitive impairment
recent weight gain
impotence |
|
|
Term
|
Definition
Bed Partner may report:
loud cyclical snoring
breath cessation or apnea
Restlessness or thrashing in bed
Personality changes |
|
|
Term
may appear sleepy and a "bull neck" appearance is common
Oropharynx may be narrowed by
--excessive soft tissue folds
--large tonsils
--pendulous uvula– predisposed by an anatomic structure
--prominent tongue
Nasal obstruction
--deviated nasal septum
--poor nasal airflow
Note if there is a “nasal twang” to the speech |
|
Definition
| physical exam for sleep apnea reveals |
|
|
Term
weight loss
CPAP
BIPAP
uvulopalatopharyngoplasty
nasal septoplasty
radiofrequency reduction of tissue
tracheotomy |
|
Definition
|
|
Term
|
Definition
| Sudden, brief (about 15 minutes) sleep attacks that may occur during any type of activity |
|
|
Term
|
Definition
Cataplexy – sudden loss of muscle tone
Sleep paralysis
hallucinations
starts early adult life, levels off around 30 y.o. |
|
|
Term
|
Definition
| On PSM, these attacks are characterized by an abrupt transition into REM sleep – a necessary criterion for diagnosis (GOLD STANDARD) |
|
|
Term
Dextroamphetamine or Dexedrine
Modafinil or Provigil – helps w/ orientation to time zones |
|
Definition
|
|
Term
• Electroencephalography
• Electro-oculography
• Electromyography
• Electrocardiography
• Pulse Oximetry
• Measurement of Respiratory effort/airlow |
|
Definition
| A true sleep study would include |
|
|
Term
|
Definition
| A disorder which impairs the regulation of voluntary motor activity without directly affecting strength, sensation or cerebellar function |
|
|
Term
|
Definition
Sometimes AKA “extrapyramidal disorders”
Can be hyperkinetic or hypokinetic
Most are a dysfunction of the basal ganglia
Strength is fine…movement is not |
|
|
Term
Myoclonus
Ballismus
Chorea
Athetosis
Dystonia
Tics
Tremors |
|
Definition
| types of abnormal movement |
|
|
Term
|
Definition
-Sudden, brief, shock-like involuntary movements
>>Positive myoclonus – caused by active muscle contraction
>>Negative myoclonus – caused by inhibition of ongoing muscle activity (eg. Asterixis) relaxation causes movement
-Generalized widespread throughout body
-Focal/Segmental restricted to particular part of body |
|
|
Term
|
Definition
-Physiologic
>>Nocturnal (usually on falling asleep)
>>Hiccups (steroids induce hiccups that can last days)
-Essential which occurs in the absence of other abnormalities
>>Benign and sometimes inherited
-Epileptic from a demonstrable cortical source
-Symptomatic secondary to a disease process
>>Neurodegenerative (eg. Wilson’s Dz)
>>Infectious (eg. CJD, Viral encephalitis)
>>Toxic (eg. PCN, antidepressants)
>>Metabolic – anoxic brain damage, hypoglycemia, hepatic failure (asterixis) or renal failure |
|
|
Term
| segmented/focal myoclonus |
|
Definition
-Can arise from lesions anywhere in the CNS and originates from many of the processes that can cause generalized myoclonus
-Example is “palatal myoclonus” audible clicking sound or synchronus movements of ocular or facial muscles
-This type is not altered by sleep or stress
-Depends on where they originate…may see on PSN…won’t change if awake vs. sleeping |
|
|
Term
Valproic acid or Depakote is the drug of choice
Anticonvulsants
May respond to benzodiazepines such as clonazepam or Klonopin
Also may benefit from
5-hydroxytryptophan which is the metabolic precursor of the neurotransmitter serotonin
-- This is available as an herbal supplement which Griffonia simplicifolia |
|
Definition
|
|
Term
|
Definition
-volent “flinging” movement of entire limb
>>More volatile b/c of larger groups of muscles
-Involves proximal musculature sometimes thought of as a “proximal unilateral chorea”
-Usually due to a CVA in contralateral subthalmic nucleus |
|
|
Term
|
Definition
-Consist of rapid irregular muscle jerks that occur involuntarily and unpredictably in different parts of the body
In florid cases the often forceful involuntary movements of the limbs and head and the accompanying facial grimacing and tongue movements are unmistakable
-Strength is generally intact but they may be able to maintain muscular contraction
>>Classic example is the “milkmaid grip”
>>Creates difficulties w/ gait, swallowing, and speech
>>The jerking disappears w/ sleep (Ballismus and some myoclonus do not) |
|
|
Term
|
Definition
-Slow flowing, often twisting movements
-Occurs mainly distally in the hands or fingers but can affect face and tongue
>>Very find motor/small muscle type of movement
-Sometimes see it referred to as choreoathetosis due to overlap between this and chorea
>>Continuation of movement that co-exists |
|
|
Term
|
Definition
| condition in which there is a sustained abnormal posture or limb position |
|
|
Term
|
Definition
-Blepharospasm: involuntary foreceful closure of eyes
-Toritcollis: tendency of neck to twist to one side
-Writer’s cramp: posturing of arm when hands used to perform specific task (e.g.) writing , playing piano |
|
|
Term
|
Definition
| Classified as: Transient simple, chronic simple, persistent simple or multiple |
|
|
Term
|
Definition
-May be suppressed voluntarily or with distraction
-Not usually present during sleep
-Voluntary suppression over time leads to significant anxiety
-Worse under stress/movement
-Tourette’s |
|
|
Term
|
Definition
| Rhythmic oscillatory movement which can be resting, postural, or intention |
|
|
Term
|
Definition
>>AKA Familial Tremor--Autosomal Dominant:
>>One or both hands (not anywhere else…at least not often)
>>Can involve head & voice (fluctuation b/c it involves muscles in articulation
>>Legs tend to be spared
>>Neuro exam is otherwise without normality
>>May worsen w/ age, but does not progress to a disability |
|
|
Term
-Propanolol (Inderal)-- Beta Blocker
>>Often used for stage fright @ very low doses (10mg)
-Primodone (Mysoline)-- Anticonvulsant
-Alprazolam (Xanax)-- Benzodiazapine
>>Habituating and probably not a great long-term med |
|
Definition
|
|
Term
| The normal balance between the two antagonistic neurotransmitters dopamine and acetylcholine is disturbed in the basal ganglia |
|
Definition
|
|
Term
Parkinsonism Tremor
Rigidity
Hypokinesia
Abnormal Gait and Posture |
|
Definition
| clinical findings of parkinsonism |
|
|
Term
++Clinical dx but there are numerous other conditions w/overlapping symptoms
++MRI scanning to rule out tumor, NPH, stroke
++Lab testing to include heavy metals, thyroid disease, urinary copper |
|
Definition
|
|
Term
Early medication choices may include blocking the acetylcholine
Benztropine (Cogentin)
Trihexyphenidyl (Artane) |
|
Definition
| early medications for parkinsonism |
|
|
Term
Later medication choices will involve increasing the dopamine
Amantadine (Symmetrel)
Levodopa (Sinemet) |
|
Definition
| later medications for parkinsonism |
|
|
Term
| Thalamotomy or pallidotomy |
|
Definition
|
|
Term
|
Definition
++Characteristically a resting tremor
++Increases with emotional stress
++Improves during voluntary activity
++It commonly begins in the hand or foot
rhythmic flexion-extension of the fingers termed a “pill rolling” tremor
rhythmic pronation-supination of the forearm
++It frequently involves the face in the area of the mouth or tongue |
|
|
Term
|
Definition
| described as “cogwheeling” because of ratchet-like interruptions of passive movement that may be due to the presence of tremor |
|
|
Term
|
Definition
++Slowing of voluntary movements and a reduction in automatic movement, such as swinging the arms while walking
++“Masklike facies ”
--Widened palpebral fissures
--Infrequent blinking (poverty of movement)
--Fixed facial expression and a smile that develops and fades slowly
--Voice is of low volume
++Handwriting is small (micrographia)
++Poverty of motion |
|
|
Term
|
Definition
++Gait consists of small, shuffling steps and absence of the arm swing that normally accompanies locomotion
++Unsteadiness on turning
++May have difficulty stopping |
|
|
Term
|
Definition
Hereditary disorder which manifests as the gradual onset of both
Dementia
Chorea
One or the other is first onset… don’t appear at same time
Paternal descent with a 50% rate of transmission
Genetic counseling very important
Most commonly seen in 30 to 50 y.o.
Occurs in all ethnic groups |
|
|
Term
|
Definition
Normal Dopamine and normal Acetylcholine
Concentrations of GABA are decreased in the basal ganglia of these patients |
|
|
Term
|
Definition
Dementia may initially consist of
Irritability
Moodiness
Antisocial behavior
Chorea– won’t always start off as classical chorea-form movement
Fidgeting
Restlessness |
|
|
Term
Radiographic imaging r/o mass lesions may demonstrate atrophy of the caudate nucleus
Genetic testing will confirm
Differential would include
Benign hereditary chorea: has no dementia
Tardive dyskinesia: often related to medication |
|
Definition
|
|
Term
No cure is available and is fatal over 10 t0 15years
Medications may include
++Dopamine blockers
Haldol
Chlorpromazine
++Dopamine depleting
Reserpine
++Most important tx: would be patient education given the high rate of transmission
Genetic counseling!! |
|
Definition
|
|
Term
| drug induced tardive dyskinesia |
|
Definition
Syndrome of involuntary stereotyped movements of the face, mouth, tongue, trunk or limbs
Medication induced
Occurs after months or years of neuroleptic treatment in 20–35% of patients
Predisposing factors
Older age
Cigarette smoking
Diabetes mellitus |
|
|
Term
Difficulty sticking out tongue or fine tongue movements
Facial tics
Increased blink frequency
Jaw movements look like tics |
|
Definition
| early signs of tardive dyskinesia |
|
|
Term
Lip smacking
Chewing motions
Disturbed gag reflex
Puffing of the cheeks
Respiratory distress
Disturbed speech
Choreoathetoid movements |
|
Definition
| late signs of tardive dyskinesia |
|
|
Term
Range antipsychotics to gastric motility drugs:
++Phenothiazine class drugs such as
--Thorazine or thioridazine
++Metoclopramide or Reglan
++Pimozide or Orap
++Amoxapine or Ascendin
++Risperidone or Risperdal |
|
Definition
| drug induced tardive dyskinesia tx |
|
|
Term
| neuroleptic malignant syndrome |
|
Definition
Life-threatening neurological disorder
often caused by an adverse reaction to neuroleptic or antipsychotic medication (halidol commonly associated and reason for its rare usage)
Associated with anesthetic agents |
|
|
Term
| neuroleptic malignant syndrome |
|
Definition
It generally presents with
Muscle rigidity
Fever (very high, 105-107 w/malignant hyperthermia)
Autonomic instability
Cognitive changes such as delirium |
|
|
Term
| Diagnosis is proven with a raised creatine phosphokinase(CPK) |
|
Definition
| dx neuroleptic malignant syndrome |
|
|
Term
Generally supportive including cessation of the implicated medication
Start on Dantrolene– only medication available to tx malignant hyperthermia
1-2.5 mg/kg IV |
|
Definition
| neuroleptic malignant syndrome tx |
|
|
Term
|
Definition
++Non specific term describes a static impairment of muscle strength, coordination or movements
++Non progressive
++Seen in about 0.2% of surviving infants |
|
|
Term
|
Definition
**static!** not a progressive or deteriorating process
Approximately 75% of cases involve spasticity of the limbs;
Monoplegia
Hemiplegia
Paraplegia
Quadraplegia
The second most common form is ataxia (15%)
Other forms: involuntary movement and hypotonia |
|
|
Term
|
Definition
Quite variable and include
+Spasticity
+Hyperreflexia
+Ataxia
+Involuntary movement
+Microcephaly is common |
|
|
Term
|
Definition
Hemiplegia frequently have smaller and shortened limbs
Develop limb atrophy b/c of weakness and muscular development doesn’t occur… shrunken appendages
Tone could create a lot of contortion |
|
|
Term
Blindness and/or Deafness commonly coexist
Seizure disorders occur in about 50%
Severe mental retardation in about 27%
Milder mental retardation in about 26% |
|
Definition
| associated neuro deficits of cerebral palsy |
|
|
Term
+Muscular relaxants
+Braces– allow/guide movement and prevent from developing contractures
+Injection procedures–
botox: neuromuscular blockade to help extend/reduce contracture and resteblsih ROM
Surgery: stretching process… can go in surgically and lengthen Achilles |
|
Definition
|
|
Term
All tracts disrupted
Cord mediated functions below transection are permanently lost
-No sacral sparing (this is a TRUE SC injury)
Determined ~ 24 hours post injury
Possible results
-Quadriplegia
-Paraplegia |
|
Definition
| complete spinal cord injury... |
|
|
Term
Some tracts and cord mediated functions remain intact
Potential for recovery of function
Possible syndromes
-Brown-Sequard Syndrome
-Anterior Cord Syndrome
-Central Cord Syndrome
-Posterior Cord Syndrome |
|
Definition
| incomplete spinal cord injury |
|
|
Term
|
Definition
loss of motor and/or sensory function in thoracic, lumbar or sacral segments of Spinal Cord
Some arm function is spared |
|
|
Term
|
Definition
loss of motor and/or sensory function in the cervical segments of Spinal Cord
(***You are still considered a Quadraplegic if you have a CERVICAL injury but also have some function of the arms…it has to do w/ the location of the injury) |
|
|
Term
| anterior spinal artery syndrome |
|
Definition
Supplies the anterior 2/3 of the spinal cord to the upper thoracic region
Caused by bony fragments or pressure on spinal arteries
Complete motor paralysis (arms > legs)
Sensory anesthesia and sparing of posterior function
Proprioception (position sense) and vibration are preserved |
|
|
Term
|
Definition
Loss of proprioception, vibration and deep pressure sensations
No motor loss
RARE ! |
|
|
Term
|
Definition
Most common incomplete cord injury seen frequently in the elderly following a hyperextension injury
Arms >>> Legs
(PROFOUND upper extremity weakness w/ NORMAL lower strength) |
|
|
Term
SCIWORA
Spinal Cord Injury Without Radiographic Abnormality |
|
Definition
Seen most often in children/infants
CHILDREN ARE HYPERFLEXIBLE AND CAN GET A TRUE SC INJURY BY JUST STRETCHING THE CORD AND NOT BREAKING THE BONE |
|
|
Term
|
Definition
Incomplete Cord Injury
Injury to one side of the cord (Hemisection)
Often due to penetrating injury or vertebral dislocation
Complete damage to all spinal tracts on affected side
Good prognosis for recovery |
|
|
