Spinal Cord Disorders and Neurologic History

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Questions and Answers

What are some symptoms that may indicate neurological issues during patient assessment?

Symptoms may include vertigo, blurred vision, numbness, and episodes of loss of consciousness.

How does cultural and language diversity affect patient descriptions of neurological symptoms?

Cultural and language differences can complicate the interpretation of symptoms, as patients may use different terms or convey meanings that differ from the clinician's understanding.

Why is corroboration of the patient's history from others significant in neurological assessments?

Corroboration provides valuable insights that may clarify the patient's symptoms and experiences, especially when communication is impaired.

What role does memory loss play in a patient's ability to communicate their neurological issues?

Memory loss can impair the patient’s capacity to accurately describe their symptoms and experiences during the assessment. Signup and view all the answers

What are the essential components of a neurological examination that clinicians should be familiar with?

Clinicians should be familiar with assessing memory, language, insight, and overall neurologic function. Signup and view all the answers

What might the term 'blurred vision' indicate in a neurological context?

'Blurred vision' may indicate unilateral visual loss, transient monocular blindness, or diplopia. Signup and view all the answers

Why is it important for all clinicians to understand the basics of a neurological examination?

Understanding the basics allows clinicians to effectively screen for neurologic dysfunction, which is critical for patient care. Signup and view all the answers

What factors might impair a patient's ability to communicate openly during a neurologic examination?

Factors like intoxication, aphasia, or psychological conditions such as anxiety or depression can impair communication. Signup and view all the answers

What clinical signs may indicate the need for a lumbar puncture in patients with suspected meningitis?

Encephalopathy or other significant clinical signs may indicate a need for a lumbar puncture. Signup and view all the answers

How do antibody tests relate to Sjögren's syndrome diagnosis?

Antibody tests such as anti-SSA and anti-SSB are critical in diagnosing Sjögren's syndrome. Signup and view all the answers

What is the prognosis for patients with severe motor weakness after spinal cord infarction?

Patients with severe motor weakness and persistent areflexia usually have a poor prognosis. Signup and view all the answers

Which factors can influence the prognosis following a spinal cord infarction?

The severity of the deficits at presentation plays a crucial role in determining prognosis. Signup and view all the answers

List some other tests that may be employed if a vitamin deficiency is suspected in a patient.

Tests for vitamin B12, copper, and zinc levels may be performed to investigate deficiencies. Signup and view all the answers

What regions of the CNS are primarily involved in indicating multiple sclerosis (MS) in a young adult?

The cerebral cortex and spinal cord are primarily involved in indicating MS in a young adult. Signup and view all the answers

What symptom associated with warmth or exercise may suggest conduction block in demyelinated axons?

Symptoms that worsen after exposure to heat or exercise may suggest conduction block in demyelinated axons. Signup and view all the answers

In the peripheral nervous system (PNS), what types of nerves could be primarily affected by a disorder?

Both motor and sensory nerves could be primarily affected in a disorder of the PNS. Signup and view all the answers

What condition is characterized by recurrent episodes of diplopia and dysarthria associated with exercise or fatigue?

Myasthenia gravis is characterized by recurrent episodes of diplopia and dysarthria associated with exercise or fatigue. Signup and view all the answers

What visual phenomenon, described as slowly advancing visual scotoma with luminous edges, indicates spreading cortical depression?

The visual phenomenon is termed fortification spectra, indicating spreading cortical depression. Signup and view all the answers

How does the neurologic history aid in diagnosing conditions before examination?

The neurologic history allows for accurate localization and determination of probable cause based on symptoms. Signup and view all the answers

What surgical treatments are indicated for worsening signs of cord compression?

Decompression by laminectomy or a spinal fixation procedure. Signup and view all the answers

Name one neurologic disorder that has a high number of global disability-adjusted life-years (DALYs).

Cerebrovascular diseases have a high number of global DALYs, totaling 143,232,184. Signup and view all the answers

What is the significance of examining symptoms substantiated by family members in neurologic diagnosis?

Examining these symptoms helps focus the neurologic examination and leads to better diagnostic accuracy. Signup and view all the answers

Under what circumstances might a patient not respond positively to therapy?

If the patient has a radioresistant tumor causing high-grade spinal cord compression. Signup and view all the answers

What proportion of patients may experience recovery of motor function after treatment?

Up to one-third of patients may experience recovery of motor function. Signup and view all the answers

What is the relevance of the patient's ability to ambulate at presentation?

A good response to therapy can be expected in individuals who are ambulatory at presentation. Signup and view all the answers

What imaging technique is used to identify thoracic meningiomas?

Magnetic resonance imaging (MRI) is used to identify thoracic meningiomas. Signup and view all the answers

How does a vertebral compression fracture contribute to cord compression?

It can create instability that leads to further compression of the spinal cord. Signup and view all the answers

What is shown in the MRI findings of an intramedullary astrocytoma?

The MRI shows altered signal characteristics within the spinal cord, indicating the presence of a tumor. Signup and view all the answers

What specific MRI feature indicates a spinal epidural abscess due to tuberculosis?

The MRI shows hyperintense areas that indicate an infection or abscess in the spinal epidural space. Signup and view all the answers

What is the role of glucocorticoids in the treatment of transverse myelitis?

High doses of glucocorticoids are administered initially to reduce inflammation and must be tapered slowly while monitoring clinical and MRI signs. Signup and view all the answers

What can be concluded if no underlying cause is identified in a case of myelitis?

Approximately one-quarter of myelitis cases have no identifiable underlying cause, and some may later show symptoms of an immune-mediated disease. Signup and view all the answers

How does transverse myelitis clinically present in patients?

It presents as bilateral sensory symptoms, unilateral or bilateral weakness, and bladder and/or bowel disturbances. Signup and view all the answers

Which imaging technique can be used to assist in the diagnosis of myelitis?

Magnetic resonance imaging (MRI) is the imaging technique used to assist in the diagnosis of myelitis. Signup and view all the answers

What are some potential causes of inflammatory myelopathies?

Possible causes include infections, systemic autoimmune diseases, demyelinating conditions such as MS and NMO, and postinfectious myelitis. Signup and view all the answers

Explain the significance of the erythrocyte sedimentation rate (ESR) in the context of myelitis.

ESR is a laboratory test that may show elevated values in inflammatory conditions but is elevated in only a minority of myelitis cases. Signup and view all the answers

What additional diagnostic test can help in evaluating myelitis cases?

A gallium scan may assist in the diagnosis by detecting inflammation in the spinal cord. Signup and view all the answers

List some viruses associated with myelitis mentioned in the content.

Viruses associated with myelitis include EBV (Epstein-Barr virus), HHV (human herpes virus), HSV (herpes simplex virus), and VZV (varicella-zoster virus). Signup and view all the answers

What are the characteristic imaging findings of an abscess in the upper cervical spine as described?

The imaging shows an irregular hypointense mass replacing the posterior elements of C3 with peripheral enhancement compressing the spinal cord. Signup and view all the answers

What symptoms are commonly associated with an abscess in the cervical spine?

Common symptoms include fever, elevated white blood cell count, and progressive weakness or myelopathy. Signup and view all the answers

Which antibiotic is commonly used empirically before surgery for skin infections that may cause spinal abscess?

Broad-spectrum antibiotics such as vancomycin are typically used empirically. Signup and view all the answers

What role does the sedimentation rate and C-reactive protein play in diagnosing spinal infections?

Elevated sedimentation rate and C-reactive protein indicate inflammation, which can be a sign of an infection. Signup and view all the answers

What risk factors are associated with the development of a spinal abscess?

Risk factors include impaired immune status, IV drug abuse, and infections of the skin or other tissues. Signup and view all the answers

What is the significance of venous congestion and thrombosis in the context of spinal abscesses?

Venous congestion and thrombosis can lead to further spinal cord damage and worsening myelopathy. Signup and view all the answers

Why might patients experience irreversible deficits after several days of myelopathy symptoms?

After several days, irreversible deficits may occur due to extensive damage to the spinal cord. Signup and view all the answers

How long is antibiotic treatment generally continued in cases of spinal abscess?

Antibiotic treatment is typically continued for 6 to 8 weeks. Signup and view all the answers

Flashcards

MS in young adults

Multiple sclerosis (MS) is a disorder affecting the central nervous system (CNS), potentially causing problems with the cerebral cortex, basal ganglia, brainstem, cerebellum, or spinal cord.

Compressive cervical spondylosis

A condition primarily affecting the cervical spine in older adults, potentially leading to neurological issues.