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A progressive degenerative disease of the brain found in people with a history of repetitive brain trauma; can begin at a time immediately following or distant from the last incident
Chronic traumatic encephalopathy (CTE)
Spasticity in the core (BP ciff around chest) lasting 1-2 minutes and can happen frequently throughout the day; not everyone gets this symptom
MS hug
Age of onset of MS
20-50 yo
T/F: Increased incidence of having MS if person is born in a southern state?
False, Northern state
Progressive disability from onset with clear, and usually intense, clinical attacks; may have some recovery between exacerbations; most rare and most aggressive
Progressive-relapsing (PRMS)
What is the criteria to be diagnosed with MS? (2)
1. 2 or more episodes of inflammatory demyelination on MRI at least one month apart
2. Prognostic symptoms consistent of MS
First symptoms of MS are usually ________ and/or _________
Sensory and/or visual
Stress; lack of sleep; elevated body temperature; caffeine; smoking; inflammatory foods are an example of what
Exacerbation triggers of MS
How does diagnosis of CTE happen?
Postmortem via brain proteins and astrogliosis
Episodes (exacerbations of the MS) of demyelination; full recovery between exacerbations or with little residual deficit; most common
Relapsing-remitting (RRMS)
Hug sign, fatigue, gait difficulty, dysesthesia, spasticity, weakness, vision, vertigo and dizziness, bowel, pain, cognitive changes, emotional changes, depression
Most common symptoms of MS
SE of these medications if prolonged use include causing symptoms of other disorders such as blindness, leukomalacia, benign tumors.
Common meds for MS
s/s of: memory loss; confusion; impaired judgement; impulse control problems; aggression; depression; progressive dementia ;; similar to AD, but progresses much quicker
CTE
The major concern with taking MS medications is
Developing progressive multifocal leukoencephalopathy (PML)
Begins as RRMS; in time, the recovery between exacerbations becomes less and less causing a progressive presentation
Secondary-progressive (SPMS)
Coordinate all reflex and voluntary muscle activity
Cerebellum
Ataxia; hypotonia; postural changes; dysdiadochokinesis; dysarthria; reflexes loss or impairment; nystagmus
Damage to the cerebellum issues
Inability to perform rapid alternating movements
EX: flipping hands into pronation and supination
EX: shin slides
Dysdiadochokinesis
Name the two types of ataxia and their differences
1. Spinocerebellar ataxia = autosomal dominant
2. Friedreich's ataxia = autosomal recessive
Progressive disability from onset of MS; may have plateaus in progression but no real recovery; if some minor recovery is seen it is most likely from the inflammation resolving that occurs with the demyelination; multiple exacerbations, dont get better
Primary-progressive (PPMS)
1. spino and friedreichs ataxia
2. cerebellar cortical atrophy
3. multisystem atrophy
4. paraneoplastic disorders
Diagnoses of the cerebellum
Purkinje cell deformation; protein disruption/aggregation; very rare disease
Spinocerebellar atrophy
Which area of cerebellum?
1. Truncal ataxia ; "drunken" gait
2. Equilibrium is affected; nystagmus - involuntary eye movements
1. Spinocerebellar (superior section)
2. Vestibulocerebellum (Inferior aspect and very tip top superior)
Which part of the cerebellum?
- ataxia of limbs; jerky voluntary muscle movements; loss of coordination; dysmetria (difficulty judging distance); dysdiadochokinesis; rebound phenomena; intention tremor
Neocerebellum (middle section)
Single episode of inflammatory demyelination evidenced on MRI; if additional episode occur, the dx become RRMS
Clinically isolated syndrome (CIS)