Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral...

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Neurological Syndromes Jolanta Strzelecka Klinika Neurologii Dziecięcej WUM

Transcript of Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral...

Page 1: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

NeurologicalSyndromesJolantaStrzelecka

KlinikaNeurologiiDziecięcejWUM

Page 2: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Pyramidalsyndrome

•  paralysis,paresiso=enmassive(mulAplemusclegroups)•  monoplegia,monopareza•  hemipareza,hemiplegia•  tatrapareza,tetraplegia•  parapareza,paraplegia•  enhanceofmusculartension-typepocketknife•  hyperreflexiadeepreflexeswithJacobsonreflex,patella

shakeandfootshake•  eliminaAonorweakeningoftheskinreflexes(abdominal,

plantar)•  pathologicalreflexes(Babiński,Rossolimo,Oppenhaim,

Gordon,Chedock)

arisesfromdamagetothepyramidaltract

Page 3: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Thetypesofsyndromesspas8cparalysis,dependingontheloca8onoflesions

•  monopareza-damagetothecerebralcortex•  paralysisoftheshoulder-faceorbothlegs

onthesameside-subcorAcalwhitemaQerdamage

•  par8alparalysisonthesidecontrarytothesidewherenervesaredamaged,parAalydamagedfeelings,hemianopsiahomonyma,hearingdamage-capsulainternadamage,

•  alterna8ngsyndrome-damagetothebrainstematdifferentlevels(paralysisofthecranialnervesatthesidewherethebraindamageisandhemiparesisontheoppositeside)

•  tetraplegiatetrapareza–damageinthespinalsteminthecervicalspine

•  paraplegia(parapareza)damageinthespinalsteminthethoracicspine

Page 4: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Flaccidsyndromedamagetoperipheralneu(ron)alpathwayi.e.

inthecaseofdamageofganglioncellsofanteriorhorncellsofthespinalcordorthesamemotornucleusofthecranialnerve,anteriorrootsandperipheralnerves

Page 5: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

•  paralysisorparesisofmuscleswithnervesbydamagedbyperipheralneuron(limitedparalysis

•  decreaseinmusclestension•  decreaseordisapperanceofdeepreflexes•  muscularatrophy•  electricalreacAondegeneraAonorneurogenicrecordinEMG

Page 6: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Sensoryirrita8onsyndromes

Page 7: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Scia8ca(Ischialgia)syndrome

•  Spontaneouspainalongthenerve`slength•  Painfulcompressionalongthenerve•  Stretchablepain

arisesasaresultofirrita8onofrootofperipheralnerves

Page 8: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Sensibledeficitsyndromes

Theyareformedasaresultofdamagetothesensorypathways

•  Symptomes:reducAon(hypaesthesia)ordisappearance(anesthesia)ofsensaAon

Sensorydeficitperipheralsyndrome

Page 9: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Syndromaradiculare

•  sensorydisturbancescorrespondtotherootinnervaAon

•  superficialsensorydisturbancesapplytoallkindsofsensiAvity

•  therecanalsooccurdeepsensorydisturbances

Page 10: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Mixedsyndromes

Hemiparaplegic

syndrome–causedbydamagetoonehalfof

thespinalcord

Page 11: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Transversusspinalcordrupturesyndrome

•  damageofspinalcordindorsalpart-paralysisoflegs(lowerlimbs)

•  damageofspinalcordincervicalpart–paralysisofallthelimbs

•  disappearanceofallkindsofsensoryofcord-typebelowtheinjurysiteinthespinalcord

•  disappearanceofbodylocaAonsensors•  appearanceofadefensereflexasasignofspinalautomaAsm

•  analsphinctersdysfuncAonusuallyofastopnature•  erecAledysfuncAon

Page 12: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Cerebellarsyndrome•  ataxia-incoordinaAon,incoherence•  dismetria-lackofadequatemeasures

inthemovements•  adiadochokinesia-inabilitytomake

rapidalternaAngmovement•  decreasedneuromusculartone•  nystagmus•  imbalance,posiAveRomberg`stest–

paAentfallswhenstandingwithfeettogether,openorclosedeyesandhandsinfront.

Page 13: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Cerebellopon8neanglesyndrome

symptomscausedbyatumorintheareapon8neangle-cerebellar

•  symptomsofnervedamageVIII:hearingdisorders,uncomfortableAnnitus,verAgo

•  symptomsofnervedamageV:decreaseorlackofcornealreflex,hypoesthesiaoftheface

•  symptomsofnervedamageVII:peripheralparesis

•  symptomsofdamagetothenervesIX,XandXII

Page 14: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Bulbarpalsy

•  dysphagia(difficultyinswallowing)•  difficultyinchewing•  nasalregurgitaAon•  slurringofspeech•  difficultyinhandlingsecreAons•  chokingonliquids•  dysphonia(defecAveuseofthevoice,inabilitytoproducesoundduetolaryngealweakness)

•  dysarthria(difficultyinarAculaAngwordsduetoaCNSproblem)

Page 15: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Extrapyramidalsyndrome

•  movementsslowbutgoodmusclestrength

•  abnormalpostureandmuscletone

•  abnormalphysiologicaladdiAonalmovements-nobalancinglimbswhenwalking

•  disordersintheareaofcomplexuncondiAonedreflexes-protecAngheadagainsthi_ng,runningaway

•  abnormalfacialexpressions,gesAculaAon,voicemodulaAon

arisesfromdamagetothebasalganglia

Page 16: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Parkinsonsyndrome

damagetotheglobuspallidus,the

substanAanigra

Page 17: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Choreasyndrome

damagetothestriatum(caudatenucleus)

Page 18: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Intracranialhipertensionsyndrome(raisedICP)

It’seleva8onofthepressureinthecranium.Itarisesfromtherela8onbetweenthecapacityandthecontentsoftheskull.

•  Headaches•  ProjecAlevomiAngwithoutnausea,usuallyinthefasAngstate•  Dizziness•  Bradycardia-lowheartrate•  Generalizedseizures•  AlteredmentalfuncAoningintheformofaslowdown,apathy•  PapilloedemaattheboQomoftheeye•  EdemaintheEEG

Page 19: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

Meningealsyndrome

Meningismarisesfrominflamma8on,hemorrhage,tumor

•  meningialsigns-Kernig`s,Brudziński`ssigns•  Opistothonus•  hyperaesthesiatotacAlesAmuli,sound,light–increasedsensiAvitytosAmulaAon

•  headaches,vomiAng

Page 20: Neurological Syndromes - Warszawski Uniwersytet Medyczny fileFlaccid syndrome damage to peripheral neu(ron)al pathway i.e. in the case of damage of ganglion cells of anterior horn

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