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This case report describes a 67-year old female patient who presented with speech disorders, signs of extrapyramidal syndrome including bradykinesia and rigidity. MRI showed a stroke in the right basal ganglia. Over time, her symptoms progressed to include dysarthria, inability to move her eyes vertically, falls, and instability. A follow-up MRI showed atrophy of the midbrain, suggesting a diagnosis of progressive supranuclear palsy (PSP), a rare neurodegenerative tauopathy. While PSP typically progresses slowly over years, this case was unusual in that symptoms intensified rapidly following the basal ganglia stroke, making the diagnosis more challenging.
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Parkinsonism is a clinical syndrome characterized by motor symptoms like bradykinesia, tremor, and rigidity. It has multiple causes including Parkinson's disease, which is the most common form. Parkinson's disease is a neurodegenerative disorder caused by the loss of dopamine-producing neurons in the substantia nigra. The motor symptoms are diagnosed based on the presence of two of the four cardinal features - bradykinesia, tremor, rigidity, and postural instability. There is no cure for Parkinsonism currently, so treatment focuses on relieving the motor symptoms and managing non-motor issues.
parkinsonism-180214104126.pdf
Parkinsonism is a clinical syndrome characterized by motor symptoms like bradykinesia, tremor, and rigidity. It has multiple causes including Parkinson's disease, which is the most common form. Parkinson's disease is a neurodegenerative disorder caused by the loss of dopamine-producing neurons in the substantia nigra. The motor symptoms are diagnosed based on the presence of two of the four cardinal features - bradykinesia, tremor, rigidity, and postural instability. Non-motor symptoms are also common. While there is no cure for Parkinson's disease, treatment aims to manage the motor symptoms and other associated issues through medications and other therapies.
Presentation1.pptx, radiological imaging of parkinsonism.
This document discusses Parkinson's disease and parkinsonism. It covers the pathogenesis, classification, clinical features, investigations and imaging findings of Parkinson's disease and other conditions that can cause parkinsonian symptoms. Imaging plays an important role in the diagnosis and differential diagnosis of parkinsonism. Techniques like DAT imaging and MRI can help differentiate Parkinson's disease from other neurodegenerative diseases and conditions.
Ataxia&vertigo
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Diagnostic methods
The document discusses various topics related to neurology including:
1. Common neurological disorders such as headache, low back pain, and stroke.
2. Components of a neurological examination including signs, reflexes, and tests of sensory and motor function.
3. Diagnostic tools used in neurology such as CT, MRI, angiography, EEG, lumbar puncture, and PET.
4. Types of disturbances of consciousness including those caused by brainstem or cortical damage.
5. Criteria for determining brain death.
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Medicine 5th year, 1st & 2nd lectures (Dr. Mohammad Shaikhani)
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Anaesthesia Management of Posterior cranial fossa surgeries
posterior cranial fossa anatomy,physiology,tumours,various positions,complications, treatment ,anaesthetic management
Parkinsonism
Parkinsonism refers to a group of conditions characterized by motor symptoms like bradykinesia, tremor, and rigidity that result from basal ganglia dysfunction. Parkinson's disease is the most common cause of parkinsonism. It is characterized by degeneration of dopaminergic neurons in the substantia nigra. Atypical parkinsonism syndromes like multiple system atrophy and progressive supranuclear palsy are associated with more widespread neurodegeneration. Management focuses on improving motor symptoms through dopamine replacement therapy and other drugs, as well as non-pharmacological approaches like physiotherapy.
dizziness, vertigo, balance, migraine
differentiation of dizziness types impoves the effectiveness of treatment to 80%, miraine might be cured with toral relief of symptoms
Occulomotor nerves
This document summarizes the anatomy and clinical presentations of various cranial nerve palsies involving the third, fourth, and sixth cranial nerves. It describes the motor supply and nuclei of these nerves, along with common etiologies of palsies such as infarction, hemorrhage, tumors, and trauma. Clinical signs of individual and combined nerve palsies are provided. The document also reviews pupillary anatomy and reflexes, along with causes of anisocoria such as Horner's syndrome and Adie's pupil. Localization of cranial nerve lesions is discussed based on associated neurological findings.
Cns Neuropathy Davidson07.
This document summarizes different types of neuropathies including focal neuropathies, generalized neuropathies, cranial neuropathies, and hereditary neuropathies. It discusses various causes of neuropathies including metabolic, toxic, inflammatory, and genetic factors. Specific conditions summarized include Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, Charcot-Marie-Tooth disease, and entrapment neuropathies. Diagnostic testing and management of some common neuropathies are also briefly mentioned.
Radiological evaluation of Dementia
1. Structural imaging such as CT and MRI are useful in evaluating dementia by identifying structural abnormalities and patterns of atrophy that help differentiate between neurodegenerative and vascular causes.
2. Specific scales have been developed to assess atrophy on MRI in regions implicated in different dementias, such as the medial temporal lobe atrophy scale for Alzheimer's disease.
3. Functional imaging with PET, SPECT and fMRI can provide additional metabolic and neural activity information, especially in distinguishing Alzheimer's from other dementias, but are not widely used due to limited availability.
Chronic progressive external ophthalmoplegia
Chronic progressive external ophthalmoplegia (CPEO) is a descriptive term for a heterogeneous group of disorders characterized by chronic, progressive, bilateral, and usually symmetric ocular motility deficit and ptosis, without pain, proptosis and pupil involvement. Commonly a syndrome of Mitochondrial Cytopathy.
Similar to Fornal2 (20)
Presentation1.pptx, radiological imaging of parkinsonism.
Presentation1.pptx, radiological imaging of parkinsonism.
Medicine 5th year, 1st & 2nd lectures (Dr. Mohammad Shaikhani)
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Fornal
This document describes a case study of a rare cause of dementia in a 62-year old male patient. The patient had been experiencing memory, thinking, speaking, swallowing, and balance difficulties for two years. A neurological examination revealed dysarthria, opthalmoplegia, dysphagia, rigidity, and weight loss. MRI scans showed diffuse ischemic focuses and midbrain atrophy characteristic of Progressive Supranuclear Palsy (PSP), an uncommon cause of dementia. Based on the clinical symptoms and MRI findings, PSP was diagnosed as the cause of the patient's dementia.
Fornal
This document discusses seasonal influenza in Poland from 2010-2016. It finds that total influenza incidence increased over this period, with the exception of a small decrease in 2014. Influenza incidence is about 2.9-3.25 times higher among children compared to the total population. While influenza incidence and cases increased from 2010-2014, the number of deaths due to influenza did not show an upward trend. The Pomorskie Voivodeship generally had the highest influenza incidence, while Podkarpackie and Lubuskie Voivodeships tended to have the lowest. Influenza follows a typical seasonal pattern with the highest cases in March and lowest in August. Poland has a very low influenza vaccination rate of 3.7% among the general population
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This case report describes a 76-year-old male patient diagnosed with Marine-Lenhart syndrome. The patient had a history of Graves' disease treated with antithyroid drugs. Tests showed suppressed TSH levels and the patient was referred to an endocrinology department. Exams including ultrasound and scintigraphy revealed the patient had Graves' disease along with a hyperactive nodule in the thyroid, consistent with Marine-Lenhart syndrome. The patient was treated with antithyroid drugs followed by radioactive iodine therapy. Follow up showed improvement of hyperthyroidism symptoms. Marine-Lenhart syndrome is a rare cause of hyperthyroidism where a patient has Graves' disease concurrently with a hyperfunctional thyroid nodule.
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This document discusses radiation protection for patients and medical staff during treatment of thyroid conditions with radioactive iodine (I-131). It provides guidelines for ensuring safety, including justifying every administered dose, calculating appropriate individual doses, and choosing radionuclides that deliver lower activities. It also addresses protecting medical staff by minimizing time spent near patients, maximizing distance and barriers, and using personal dosimeters. The conclusion is that radioiodine treatment can be relatively safe when proper safety procedures, training, and nuclear medicine laboratory organization are followed.
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A 55-year-old woman experienced her first syncope incident while on holiday abroad. Tests including CT scans of her chest, abdomen, and mammography did not reveal any abnormalities. An MRI of her head showed a lesion with edema in her left frontal lobe, which was later confirmed to be a brain tumor after she returned to Poland. She underwent a craniotomy to resect the tumor, and a biopsy revealed glioblastoma multiforme (GBM). After the operation, she received chemotherapy with Temodal and radiotherapy. Follow-up MRIs did not show any new metastases. GBM remains a significant cause of morbidity and mortality from brain tumors, but interdisciplinary therapy can prolong survival time after surgery.
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This study evaluated Polish medical students' attitudes towards simulation-based training. 204 fourth and fifth year medical students completed a survey on their satisfaction with and views on simulation-based learning. Results showed students found simulation-based learning a useful strategy that improved skills and helped apply knowledge, with 86% finding it developed clinical decision-making. Students reported being more stressed during initial simulations but less so in later ones. Most felt the debriefing component was most important and preferred playing the role of doctor during simulations. Students believed mistakes made during simulations would help them avoid similar errors in the future.Ріга А.,Бойко В.В.-Різні підходи до застосування антибактеріальної терапії пр...
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Fornal2
- 1. Natalia Fornal, Dominik Grzebyk, Ewelina Bracik, Tomasz Chromiec Students’ Scientific Society, Departament of Neurology, Medical University of Lublin, Poland Scientific supervisor: dr n. med. Joanna Bielewicz Case of patient with progressive supranuclear palsy with untypical fast progression, after ganglia stroke
- 2. Atypical Parkinsonism corticobasal degeneration progressive supranuclear palsy multiple system atrophy Lewy body dementia
- 3. Progressive supranuclear palsy - called Steele-Richardson- Olszewski Syndrome neurodegenerative diesease, from group of tauopathies, with slowly progress, shorter life expectancy 5-10 cases/100.000 population neuronal loss, tau protein deposits in neurons etiolology is unknown, there are several hypotheses, uknown treatment manifesting clinically about 6th decade of life, progresses to death within a decade
- 4. PSP manifestations supranuclear ophthalmoplegia in vertical movement pseudobulbar palsy – dysarthria, dysphagia, early falls and postural instability atypical Parkinsonism – bradykinesia, axial rigidity, dementia, cognitive impairments retrocollis without recovery after L-dopa treatment
- 5. Case report A 67 year old female, admitted to Neurological Departament in 2012 AILMENTS speech disorders signs of extrapiramidal syndrome, bradykinesia rigidity MRI indicated basal ganglia stroke: right hemisphere subcortical, in caudate nucleus and putamen Doppler USG without any impairments in vessels
- 6. Focus of stroke in basal ganglia
- 7. Case report Patient presented also other, unconected with stroke symptom dysartria, intensifing during a day Additional examination: EMG, cervical spine MRI was insufficient to exact diagnosis Then, in 2012 atypical Parkinson sydrome
- 8. Case report Recommendations: -Regular check-up in neurological clinic -Medicines: -Acard -Bisocard -Simvastatin -Madopar (L-dopa)
- 9. Case report 2017 - extension of last disorders Neurological examination - bradykineesia, without tremor -rigidity in all muscle groups -dysartria - inability in vertical movement of eyes - falls and instability of posture
- 10. Case report atrophy of the midbrain, especially in tegmentum increase of interpeduncular fossa length normal diameter of pons MRI and all neurologial symtoms leaded to PSP diagnosis
- 11. Radiographic features in PSP midbrain atrophy- reduced area ratio on the sagittal plane mickey mouse sign- reduced anteroposterior diameter of midbrain morning glory sign: tegmentum - loss of the lateral convex margin hummingbird sign / penguin sign- is referring to the axial MRI, showing atrophy of the midbrain tegmentum, with reduction of the midbrain tectum and cerebral peduncles
- 13. flattening outline of the midbrain („hummingbir d sign” or „penguin sign” )
- 14. Conclusions Diagnosis od PSP, which is a rare diesease, still constitutes a challange PSP can be undiagnosed or misdiagnosed as a more common, neurodegenerative brain dieseases, because of simmilar symptoms: Parkinson’s disease (due the balance and movement difficulties and rigidity) Alzheimer’s (due to the cognitive disturbances), and other. It is important, to take into consideration some symtoms more characteristic for PSP, than other atypical parkinsonism:
- 15. Conclusions In PSP a slowly progression is typical, however in this case a fast intensificaton of symptoms along with stroke may lead to obstacles, during diagnosis, which was notably difficult due to rare diesease’s occurence.
- 16. Thank You for Your attention!