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Neurodiagnosis Final
NWHSU- Comprehensive Conditions involving the nervous system
| Question | Answer |
|---|---|
| Define: Agnosia | Inability to interpret sensations and therefore cannot recognize things. Occurs with brain damage |
| Define: Akathisia | Subjective feeling, defined as a sense of inner restlessness, that may be associated with adventitious movements. Sensation of inner restlessness tends to elicit movements that help relieve the inner tension. |
| Define: Allodynia | Pain response to a non-noxious stimulus |
| Define: Analgesia | A loss of pain sense [pg 22 lab] |
| Define: Anesthesia | Insensitivity to pain |
| Define: Anosmia | Loss in the sense of smell |
| Define: Aphasia | problems understanding and/or speaking language that is written or spoken |
| Define: Apraxia | Inability to perform particular purposive actions. Usually results from brain damage. |
| Define: Ataxia (gait, trunk) | unsteadiness in the absence of any sensation of movement. Disequilibrium w/o any fluctuation in consciousness, abnormal gait. |
| Define: Athetosis | Moving dystonia. Slow, writhing dystonic posturing of the distal limbs, especially fingers, hand, wrist. |
| Define: Asterixis | Sudden relaxation of muscles held against gravity. "negative myoclonus". "flapping tremor" |
| Define: Ballismus | Wild, flailing, sometimes violent movements. It is a subtype of chorea ("big chorea") Fast, usually proximal movements, usually one-side (hemiballism) (caused by sub thalamic stroke) |
| Define: Bradykinesia | Slow movement |
| Define: Chorea | Rapid and flowing movement of one or more body parts that is not stereotyped, manifested as a random event. Involuntary. |
| Define: Choreiform Movement | Brief, quick jerky movements accompanied by brief, purposeless movements of upper limbs, head, neck, and face. Walking can have extreme lurching/dancing quality |
| Define: Clonus | Spasmodic alternation of contraction and relaxation (sign of UMN dz) |
| Define: Cognitive Deficits | |
| Define: Diminished Visual Acuity | |
| Define: Diplopia | Double vision |
| Define: Dizziness | Uncomfortable inner feeling of confusion (types include: vertigo, light-headedness, imbalance, psychic change) |
| Define: Dysarthria | Trouble Speaking |
| Define: Dysdiadokinesia | Diminution in alternate motion rate and the irregularity of its rhythm, precision, and amplitude |
| Define: Dysesthesia | Unpleasant, abnormal sense of touch |
| Define: Dyskinesia | Abnormality or impairment of voluntary movement |
| Define: Dysmetria | Over or undershooting movements |
| Define: Dysphagia | Difficulty or discomfort swallowing |
| Define: Dysphonia | Difficulty in speaking due to a physical disorder of the mouth, tongue, throat, or vocal cords. |
| Define: Dyssynergia | Difficulty with coordination in movement (ex. dressing, buttoning clothing) |
| Define: Dystaxia | Uncoordinated movement due to muscle control problem causing an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fro motion of the middle of the body (trunk) and an unsteady gait (walking style). It can also affect the limbs. |
| Define: Dystonia | Continuous, intermittent contraction of many muscles making body parts turn. Bizarre and unpredictable movements. Spasmodic torticollis. |
| Define: Fasciculation | Irregular contractions of muscle fascicles (classic sign of LMN disease). Twitches observed/palpated in resting muscle. |
| Define: Fever | Abnormally high body temperature, usually accompanied by shivering, headache, and in severe instances, delirium. |
| Define: Fibrillation | Spontaneous independent contractions of individual muscle fibers. Cannot be observed or palpated. (EMG evidence can be found in denervated muscle beginning 10-21 days AFTER muscle has been deprived of nerve supply) |
| Define: Flaccidity | Complete loss in muscle tone |
| Define: Gait Abnormality: ATAXIA | Clumsiness and uncertainty, feet planted too far apart, swing leg lifted abruptly and too high and planted with a slap/stomp. Tendency to sway or totter. |
| Define: Gait Abnormality: STEPPAGE | Patient with foot drop lifts the hip and knee to avoid dragging the toe. Atrophy of distal leg muscles, decreased leg/foot sensation |
| Define: Gait Abnormality: SPASTIC | Characterized by stiffness of legs, feet, and toes |
| Define: Gait Abnormality: FESTINATING | Gait in which the trunk is flexed , legs are flexed at the knees and hips, but stiff |
| Define: Gait Abnormality: CIRCUMDUCTING | Gait in which the leg is stiff, without flexion at knee and ankle, and with each step is rotated away from the body, then towards it, forming a semicircle. |
| Define: Hearing Loss, SENSORINEURAL | Conduction of sound to oval window is okay, but cochlea, acoustic nerve or brain is dysfunctional. Usually permanent. |
| Define: Hearing Loss, BONE CONDUCTION | Anything that interferes with conduction of sound waves from the outer ear to the oval window |
| Define: Hyperpathia/Hyperalgesia | Increase in pain sense [pg 22 lab] |
| Define: Hyperreflexia | Increase in response of reflexes. Due to a lesion of UMN |
| Define: Hypertonicity | Increased muscle tone (causes include extrapyramidal tract dz, pyramidal dz, sensory irritation) [pg 25 lab] |
| Define: Hyperventilation | Rapid or deep breathing that can occur with anxiety |
| Define: Hypokinesia | Unusually still [pg 25 lab] |
| Define: Hyperkinesia | Hyper-active [pg 25 lab] |
| Define: Hypomimia | Decreased degree of facial expression |
| Define: Hypophonia | Soft speech, often resulting from a lack in coordination in vocal musculature. (often in Parkinson's dz) |
| Define: Hyporeflexia | Decrease in reflex response. Due to a lesion of LMN. |
| Define: Hypotonicity | Decreased muscle tone (causes include cerebellar dz, primary muscular dz, LMN disorders) [pg 25 lab] |
| Define: Incoordination | |
| Define: Intention Tremor | a trembling of a part of the body when attempting a precise movement, associated especially with disease of the cerebellum |
| Define: Ataxic Tremor | Unsteady and clumsy motion of the Limbs or trunk due to a failure of the gross coordination of muscle movements. This includes cerebellar, sensory, and vestibular ataxia |
| Define: Loss of Consciousness | |
| Define: Loss of Discriminative Sensory FXN | |
| Define: Loss of Proprioception | |
| Define: Memory Loss | |
| Define: Myoclonus | Involuntary, lightning-like jerk of an area of the body |
| Define: Myokimia | Rippling movements observed under the skin, usually in the face |
| Define: Numbness | |
| Define: Nystagmus | Fast, uncontrollable movements of the eyes |
| Define: Oscillopsia | Visual disturbance in which objects in the visual field appear to oscillate. The severity of the effect may range from a mild blurring to rapid and periodic jumping |
| Define: Neurogenic Pain | Pain due to dysfunction of the peripheral or central nervous system, in the absence of nociceptor (nerve terminal) stimulation by trauma or disease |
| Define: Referred Pain | Pain felt in a part of the body other than its actual source |
| Define: Pallanesthesia | Loss of Vibration Sense [pg 23 lab] |
| Define: Papilledema | Optic disc swelling that is caused by increased intracranial pressure. The swelling is usually bilateral and can occur over a period of hours to weeks |
| Define: Paralysis | Loss of the ability to move (and sometimes to feel anything) in part or most of the body, typically as a result of illness, poison, or injury |
| Define: Paresthesia | Abnormal sensation, typically tingling or pricking (“pins and needles”), caused chiefly by pressure on or damage to peripheral nerves |
| Define: Postural Tremor | Observed when a limb is maintained against gravity |
| Define: Resting Tremor | Tremor that occurs when the limb is in a position of repose. No voluntary muscle contraction. |
| Define: Lead-pipe Rigidity | Type of increased muscle tone due to an extrapyramidal lesion in which pathologic resistance to passive extension of a joint is constant throughout the range of motion |
| Define: Cogwheel Rigidity | Presents as a jerky resistance to passive movement as muscles tense and relax |
| Define: Paratonic Rigidity | Involuntary variable resistance during passive movement |
| Define: Spasticity | Stiff or rigid muscles. It may also be called unusual tightness or increased muscle tone. Reflexes (for example, a knee-jerk reflex) are stronger or exaggerated |
| Define: Terminal Tremor/Endpoint Tremor | seen as a moving limb nears a target |
| Define: Tic | Simple or complex stereotyped motor behaviors that occur in response to an irresistible urge; partial voluntary control. (Ex. eye blinking, grimacing, vocalizations, jumping) |
| Define: Tinnitus | Ringing in the ears (can be caused by aspirin or Vit. C in high doses) |
| Define: Vertigo | Illusion of motion, sensation of spinning, nausea/vomiting, aggravation of symptoms by head movement |
| Define: Weakness | Lack of strength |
| Neurological Presentation/DDX: Acoustic Neuroma | Numbness in face, deafness, facial palsy, early sign is a problem with speech discrimination. Unremitting. |
| Neurological Presentation/DDX: Alcoholism | |
| Neurological Presentation/DDX: ALS/Lou Gehrig's | Weakness, fasciculations, intact cognition/sensation/bowel & bladder fxn. Bulbar dysfunction=problems with swallowing, talking, breathing. UMN & LMN findings. |
| Neurological Presentation/DDX: Alzheimer's Disease | |
| Neurological Presentation/DDX: Bell's Palsy | Sudden onset of unilateral facial paralysis. A benign LMN disorder. DDX= Ramsay Hunt syndrome, brainstem stroke, lyme dz, MG gravis, Cerebral tumor, Guillain Barre syndrome |
| Neurological Presentation/DDX: BPPV | Patient experiences vertigo when head is in a particular position, but abates if the head is not moved (usually in 15 seconds) |
| Neurological Presentation/DDX: Carpal Tunnel Syndrome | PX and Paraesthesias in palmar surface of thumb, radial 2.5 fingers. Clumsiness w/ precision gripping. Nocturnal Px. DDX= Pronator teres syndrome, |
| Neurological Presentation/DDX: Cerebral Palsy | |
| Neurological Presentation/DDX: Cervicogenic Vertigo | |
| Neurological Presentation/DDX: Cubital Tunnel Syndrome | Medial forearm px and Paresthesia into 5th and medial aspect of the 4th digit. History of throwing, playing tennis, resting on elbow increase stretch on ulnar nerve. DDX= Guyon's tunnel syndrome, Ulnar Claw Hand, Dupetren's Contracture, Ulnar Neuropathy |
| Neurological Presentation/DDX: Diabetes Mellitus | |
| Neurological Presentation/DDX: Cervical Disc Herniation | |
| Neurological Presentation/DDX: Thoracic Disc Herniation | |
| Neurological Presentation/DDX: Lumbar Disc Herniation | |
| Neurological Presentation/DDX: Encephalopathy | |
| Neurological Presentation/DDX: Freidreich's Ataxia | |
| Neurological Presentation/DDX: Genitofemoral Nerve Entrapment | Results in change in sensation in the upper anterior thigh, Can become entrapped in the psoas major muscle. Supplies the scrotal skin/mons pubis, labia majora. |
| Neurological Presentation/DDX: Guillain-Barre Syndrome | |
| Neurological Presentation/DDX: Cluster Headache | Vascular Type HA. Strictly unilateral. Pain is usually severe, lasts 15 to 90 minutes. Autonomic associated symptoms (usually involving the eye) |
| Neurological Presentation/DDX: Migraine Headache | Unilateral, moderate to severe pain, lasts 4-72 hr, throbbing quality, more likely to occur in females. May occur with aura, nausea/vomiting. |
| Neurological Presentation/DDX: Rebound Headache | |
| Neurological Presentation/DDX: Tension Headache | Myogenic/cervicogenic Type HA. Occurs bilaterally, pain may be mild to moderate, lasts 30 min- 7 days. Pressing/tightening quality. Occurs more often in females. |
| Neurological Presentation/DDX: Herpes Zoster | |
| Neurological Presentation/DDX: Huntington's Chorea | |
| Neurological Presentation/DDX: Intracranial Mass | |
| Neurological Presentation/DDX: Labyrinthitis | Inner ear infection in which hearing is typically affected. DDX= BPPV |
| Neurological Presentation/DDX: Maigne's Syndrome | |
| Neurological Presentation/DDX: Meniere's Disease | Vertigo, hearing loss, nausea/vomiting. Paroxysmal and difficult to treat. |
| Neurological Presentation/DDX: Meningitis | Rigidity, fever, increasing headache. Inflammation of the meninges. |
| Neurological Presentation/DDX: Meralgia Paresthetica | Numbness or tingling in the antero-lateral thigh. History of prolonged sitting, diabetes, tight-fitting pants, keys in front pockets. DDX= femoral N. lesion, upper lumbar n. entrapment, lumbar NR lesion |
| Neurological Presentation/DDX: Multiple Sclerosis | Recurrent, occasionally progressive inflammatory demyelination of the white matter of brain and spinal cord. Incoordination, balance problems, clumsiness, diplopia, paresthesias, stiffness. DDX= ALS, Lyme dz, ataxia, brainstem tumor |
| Neurological Presentation/DDX: Muscular Dystrophy | |
| Neurological Presentation/DDX: Myasthenia Gravis | |
| Neurological Presentation/DDX: Myelopathy | Pain with movement, Gait disturbance, loss of balance, numbness or tingling, loss of hand dexterity, alteration in handwriting, decrease in bowel/bladder/sexual fxn. |
| Neurological Presentation/DDX: Neurofibromatosis | |
| Neurological Presentation/DDX: Optic Neuritis | |
| Neurological Presentation/DDX: Parkinson's Disease | Age related (40-70 y.o.). Slow movements, pill-rolling tremor, mask facies, rigidity/stiffness, constipation, myalgia. |
| Neurological Presentation/DDX: Peroneal Tunnel Syndrome | |
| Neurological Presentation/DDX: Piriformis Syndrome | |
| Neurological Presentation/DDX: Pronator Teres Syndrome | The median nerve becomes entrapped by the 2 heads of the pronator teres. Weakness associated w/ abductor pollicis brevis, flexor pollicis brevis, opponens pollicis |
| Neurological Presentation/DDX: Cervical Radiculopathy | |
| Neurological Presentation/DDX: Lumbar Radiculopathy | |
| Neurological Presentation/DDX: Stroke | |
| Neurological Presentation/DDX: Supinator Syndrome/Radial Tunnel Syndrome | Pain & tingling. Persistent px around lateral epicondyle. Px may be dull and diffuse in the dorsal antebrachium. Nocturnal px common. DDX= Posterior interosseous n. syndrome, Saturday night palsy, Cheiralgia Paresthetica/Wartenberg's dz |
| Neurological Presentation/DDX: Syringomyelia | Fluid-filled cavity in the spinal cord that can occur with spinal cord tumors, following trauma, congenital anomalies of craniocervical jxn DDX= Arachnoiditis, Arnold Chiari malformation, MS) |
| Neurological Presentation/DDX: Tarsal Tunnel Syndrome | Pain, numbness/tingling across bottom of foot, medial ankle/toes, distal branches of the posterior tibial n |
| Neurological Presentation/DDX: Thoracic Outlet Syndrome | Compression of the lower brachial plexus &/or subclavian arteries. Weakness/atrophy of the C8-T1 innervated muscles, sensory loss. |
| Neurological Presentation/DDX: Thyroid Disorders | Hypothyroidism/hyperthyroidism |
| Neurological Presentation/DDX: TIA | |
| Neurological Presentation/DDX: Tourette's Syndrome | Chronic disorder starting in youth that includes vocalizations, organic disorder & does not simply reflect psychological factors, genetic link |
| Neurological Presentation/DDX: Trigeminal Neuralgia | |
| Neurological Presentation/DDX: Vestibular Neuritis | Patients experience severe rotational vertigo associated with nausea/vomiting, horizontal-torsional nystagmus DDX= BPPV, labyrinthitis DDX= Meniere's dz, acoustic neuroma, acute labyrinthitis. |
| Neurological Presentation/DDX: Whiplash Injuries |
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