Neurological Disorders and Syndromes Quiz

Neurological Disorders and Syndromes: Key Points

• CN IX (glossopharyngeal nerve) bilateral lesion causes loss of taste in the posterior tongue, weakness of the stylopharyngeus muscle, and difficulty swallowing.
• CN X (vagus nerve) bilateral lesions result in dysphagia, hoarse voice, altered cough reflex, and impaired regulation of respiratory and cardiovascular function.
• Lesion of CN XI (spinal accessory nerve) leads to paralysis of the trapezius and sternocleidomastoid muscles, resulting in the inability to shrug shoulders and rotate the head.
• Lesion of CN XII (hypoglossal nerve) can cause deviation of the tongue to the side of the lesion, with different patterns depending on whether it is an upper motor neuron or lower motor neuron lesion.
• Orthostatic hypotension is characterized by a drop in blood pressure upon assuming a vertical position, often caused by diabetes, syphilis, hypertension medication side effects, or CNS/PNS diseases. Treatment involves mineralocorticoids to increase blood volume.
• Horner's syndrome is characterized by miosis (constriction of the pupil), anhidrosis (lack of sweating), and ptosis (eyelid droop), often resulting from a lesion in the hypothalamus, brainstem, upper cervical cord, or other causes. Treatment focuses on addressing the underlying cause.
• Raynaud's disease is characterized by spasmodic vasoconstriction of arteries in the fingers and toes, usually in response to cold or emotional stress. Treatment involves sympathetic blockers.
• Congestive heart failure results in insufficient pumping of blood to the body, leading to overactive sympathetic activity, which becomes deleterious over time. Causes include cardiomyopathy, myocardial ischemia/infarction, and high blood pressure. Treatment involves ACE inhibitors, vasodilators, diuretics, and digitalis.
• Neurogenic bladder can be caused by various conditions such as traumatic brain injury, spinal cord injury, tumors, and neurological diseases. It can manifest as either a spastic or flaccid bladder, with different symptoms and management approaches.
• Autonomic dysreflexia is a potentially dangerous condition that can occur in spinal cord injuries at T6 or above. It is triggered by various stimuli and results in a severe increase in blood pressure and excessive sympathetic response. The first step in managing autonomic dysreflexia is to sit the patient up to control blood pressure.
• Lateral medullary syndrome (Wallenberg's syndrome) is caused by occlusion of the posterior inferior cerebellar artery (PICA) or vertebral artery, resulting in various neurological deficits, including loss of pain and temperature sensation, ataxia, loss of gag reflex, vertigo, and Horner's syndrome.
• Medial medullary syndrome (Weber syndrome) and paramedian midbrain syndrome (Benedict

Neurological Disorders and Syndromes: Key Points

• CN IX (glossopharyngeal nerve) bilateral lesion causes loss of taste in the posterior tongue, weakness of the stylopharyngeus muscle, and difficulty swallowing.
• CN X (vagus nerve) bilateral lesions result in dysphagia, hoarse voice, altered cough reflex, and impaired regulation of respiratory and cardiovascular function.
• Lesion of CN XI (spinal accessory nerve) leads to paralysis of the trapezius and sternocleidomastoid muscles, resulting in the inability to shrug shoulders and rotate the head.
• Lesion of CN XII (hypoglossal nerve) can cause deviation of the tongue to the side of the lesion, with different patterns depending on whether it is an upper motor neuron or lower motor neuron lesion.
• Orthostatic hypotension is characterized by a drop in blood pressure upon assuming a vertical position, often caused by diabetes, syphilis, hypertension medication side effects, or CNS/PNS diseases. Treatment involves mineralocorticoids to increase blood volume.
• Horner's syndrome is characterized by miosis (constriction of the pupil), anhidrosis (lack of sweating), and ptosis (eyelid droop), often resulting from a lesion in the hypothalamus, brainstem, upper cervical cord, or other causes. Treatment focuses on addressing the underlying cause.
• Raynaud's disease is characterized by spasmodic vasoconstriction of arteries in the fingers and toes, usually in response to cold or emotional stress. Treatment involves sympathetic blockers.
• Congestive heart failure results in insufficient pumping of blood to the body, leading to overactive sympathetic activity, which becomes deleterious over time. Causes include cardiomyopathy, myocardial ischemia/infarction, and high blood pressure. Treatment involves ACE inhibitors, vasodilators, diuretics, and digitalis.
• Neurogenic bladder can be caused by various conditions such as traumatic brain injury, spinal cord injury, tumors, and neurological diseases. It can manifest as either a spastic or flaccid bladder, with different symptoms and management approaches.
• Autonomic dysreflexia is a potentially dangerous condition that can occur in spinal cord injuries at T6 or above. It is triggered by various stimuli and results in a severe increase in blood pressure and excessive sympathetic response. The first step in managing autonomic dysreflexia is to sit the patient up to control blood pressure.
• Lateral medullary syndrome (Wallenberg's syndrome) is caused by occlusion of the posterior inferior cerebellar artery (PICA) or vertebral artery, resulting in various neurological deficits, including loss of pain and temperature sensation, ataxia, loss of gag reflex, vertigo, and Horner's syndrome.
• Medial medullary syndrome (Weber syndrome) and paramedian midbrain syndrome (Benedict

Summary of Neuroanatomy and Neurophysiology

• Muscle reinnervation can occur through collateral sprouting and axon regeneration, resulting in motor control and sensory function.
• Somatosensation varies depending on the stimulus threshold, with the face, fingers, toes, and lips having the lowest thresholds and the shoulder, calf, and thigh having the highest thresholds.
• The auditory system pathway involves the cochlea, spiral ganglion, cochlear nerve, cochlear nuclei, superior olivary complex, lateral lemniscus, inferior colliculus, MGN, and BA 41/42.
• Conduction deafness occurs due to damage to the external or middle ear, and sensorineural deafness is caused by damage to the auditory nerve.
• The vestibular system pathway involves Scarpa's ganglion, CN VIII, vestibular nuclei in the brainstem, and the medial longitudinal fasciculus for the vestibulo-ocular reflex (VOR).
• Nystagmus is a result of a lesion in the brainstem or cerebellum, affecting the VOR, while vertigo is the sensation of rotation in the absence of actual movement.
• Glaucoma is caused by inadequate drainage of aqueous humor, leading to high intraocular pressure and damage to retinal neurons.
• Cataracts, which account for half of the world's blindness cases, are opacities in the lens that can be protected by sunglasses from UV exposure.
• Accommodation of the lens varies depending on the distance of the object, with zonule fibers and ciliary muscles contracting or relaxing.
• Myopia occurs when the cornea is too curved or the eyeball is too long, while hypermetropia is caused by an eyeball that is too short or a weak refraction system.
• Presbyopia is the loss of lens elasticity with age, making near vision difficult, and macular degeneration is the leading cause of vision loss in individuals over 55.
• The visual pathway involves the optic nerve, pretectum, EW nucleus, oculomotor nerve, ciliary ganglion, and constrictor muscles, and visual field defects can occur due to lesions in various areas along the pathway.
• Neuroplasticity involves retrograde and anterograde degeneration, which can be influenced by therapies like Constraint-Induced Movement Therapy (CIMT), and specific principles such as use, repetition, intensity, time, salience, age, and transference.