movement disorders
Terms
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- What diagnostic test would you order for multiple sclerosis
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MRI
Cerebral or Spinal plaques - possible causes of MS
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Possible infectious stimulus
Epstien Barre Virus - Positive Prognostic factors of MS
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More benign in women
earlier age of dx
relapsing form of disease - symptoms of ms
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Cognitive
Paroxysmal: trigeminal neuralgia, pain, paresthesia, weakness, tonic seizure, dysarthia and ataxia, pruritus, diplopia, akinesia, dystonia
TWS PAD PAD PD - treatment of MS
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Rebif/avonex
anticonvulsants
NSAID
Benzodiazepine
Modafinil
Corticosteroids
Interferon
Immunosupprestents - pathophysiology of Myasthenia gravis
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autoimmune disease affecting blockage or neuromuscular junction
auto antibodies against acetylcholine receptors
some have thymic abnormalities
some have SLE RA Graves - the cardinal feature of mG is
- degree of muscle weakness increases with exercise and improves with rest.
- clinical presentation of mg
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Bulbar muscles affected ie myasthenic snarl, nasal speech, loss of consanants, chewing and swallowing difficulties, head falls foward
Limb and trunk muscles
Myashenic crises of respiratory muscles may require intubation - What is a tensilon test and when is it used?
- Diagnostic for MG. Test is positive if there is a temporary improvement in muscle strength.
- medication for MG
- The standard medication is anticholinestgerase : Pyridostigmine (mestinon) 30 mg q6
- Treatment for mg
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thymectomy (controversial)
immunosuppresive agents
corticosteroids
azathioprine
cyclosporine (monitor kidney and htn) - in the case of mg crises what is the therapy
- plasmapheresis 2-4 l 2-3x/wkx2weeks
- Treatment for MG crises
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1. Respiratory assistance, pulmonary phsiotherapy/ Intubation
2. Stop Anticholenesterase meds
3. Treat underlying infection with antibiotics
4.Plasmapharesis
IAAP - Describe Gullian Barre syndrom
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idiopathic acute inflammatory demylinateing polyneuropathy
Acute onset, starts distal
progressive muscle weakness