Myoclonus
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This document discusses myoclonus, which are sudden, brief involuntary muscle jerks. It describes the different types of myoclonus including positive vs negative and cortical vs subcortical. Various potential causes are outlined such as neurological disorders, metabolic conditions, infections, and medications. Treatment options mentioned include anticonvulsant medications and deep brain stimulation.
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Myoclonus
Myoclonus is characterized by brief, involuntary muscle contractions or inhibitions. It can be classified anatomically based on its physiological origin in the cortex, subcortex, or periphery. Clinically, myoclonus is classified as physiological, essential, epileptic, or secondary. Treatment involves addressing the underlying cause, with anti-seizure medications often used for cortical or cortical-subcortical myoclonus, and benzodiazepines or botulinum toxin injections for other types.
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2. Ballismus involves proximal, flinging, violent involuntary movements. Both chorea and ballismus are associated with basal ganglia dysfunction and abnormal neurotransmitter levels like decreased GABA and increased dopamine.
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Myoclonus is characterized by brief, involuntary muscle contractions or inhibitions. It can be classified anatomically based on its physiological origin in the cortex, subcortex, or periphery. Clinically, myoclonus is classified as physiological, essential, epileptic, or secondary. Treatment involves addressing the underlying cause, with anti-seizure medications often used for cortical or cortical-subcortical myoclonus, and benzodiazepines or botulinum toxin injections for other types.
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Syringomyelia is a condition where a cyst, called a syrinx, develops in the spinal cord. It most commonly affects the lower cervical spine. It is often associated with abnormalities of the skull or spinal column. The majority of cases are linked to Chiari malformation type 1, where the cerebellar tonsils are displaced into the spinal canal. Symptoms vary depending on the location of the syrinx but can include pain, loss of sensation, muscle weakness or atrophy, and autonomic dysfunction. Diagnosis is made using imaging like MRI. Treatment involves surgery to decompress pressure on the spinal cord like laminectomy with the goal of resolving the syrinx.
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The document discusses cerebellar ataxia, a disorder caused by damage to the cerebellum that controls coordination. It causes loss of coordination, balance problems, and slurred speech. The cerebellum coordinates muscle movement and is located in the hindbrain. Causes include viruses, alcohol, tumors, and toxins. Symptoms are diagnosed through neurological exams, imaging scans, and lab tests. Treatment focuses on physical therapy, assistive devices, and treating any underlying causes to ease symptoms and improve quality of life. Prevention involves vaccinations to reduce risk of viral infections that can lead to cerebellar ataxia.
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The document discusses various movement disorders, classifying them as either hypokinetic-hypertonic (such as Parkinson's disease) or hyperkinetic-hypotonic (including tremors, chorea, dystonia, tics, myoclonus, and ballism). Parkinson's disease is primarily caused by dopamine loss in the basal ganglia. Its treatment involves levodopa drugs and dopamine agonists. Tremors can be essential, physiological, or pathological, and are treated with beta-blockers or anti-epileptics. Dystonia causes abnormal muscle contractions and is treated with medications, botulinum toxin, or surgery. Chorea involves irregular movements and its causes include Huntington's disease and
Late Responses (F-wave and H.Reflex)
This document provides information about late responses in nerve conduction studies, including F-waves, H-reflexes, and axon reflexes. It discusses the mechanisms, characteristics, and clinical applications of each response. The F-wave results from antidromic stimulation of motor neurons and evaluates more proximal nerve segments. The H-reflex is a monosynaptic stretch reflex that is reliably measured in the lower limbs. Axon reflexes occur due to terminal nerve branching and suggest reinnervation. Late responses provide valuable information about radiculopathies and plexopathies that cannot be observed with distal nerve studies alone.
Polyneuropathy
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- Challenges in diagnosing and managing dominant psychiatric presentations of Wilson's disease.
- The role of various specialists like speech therapists and counselors in addressing issues related to speech, behavior, rehabilitation and quality of life in patients with Wilson's
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Peripheral neuropathy in systemic disease children
This document discusses peripheral neuropathies that can occur in children due to systemic diseases. It notes that the overall prevalence of peripheral neuropathies is estimated to be 2-4% in children, with around 20-50% of cases remaining undiagnosed. It then lists and describes 12 systemic diseases that can be associated with peripheral neuropathies in children, including liver diseases, endocrinopathies, renal failure, amyloidosis, and connective tissue disorders. The document concludes by discussing some specific neuropathies in more detail, such as those related to diabetes, thyroid disease, amyloidosis, vasculitis, and critical illness.
Nervous system
Course title: Medical Microbiology
Course code: MBIO-210
Group members name: 1)Sumaia. 2)Ayesha Akter. 3)MD.Anwar Hossen. 4)Shanta islam. 5)Mst.Nasrin akter. 6)MD.Asadujjaman. 7)MD.Azizul Haque.
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Neuropsychiatric aspects of epilepsy
This document provides an overview of the history, definitions, classification, epidemiology and psychiatric disorders associated with epilepsy. It discusses how epilepsy was viewed in ancient times as a supernatural condition and outlines key developments in understanding including Hippocrates' view of it as a brain disorder. It defines terms like seizure, aura and epilepsy and classifies seizure types. Statistics on prevalence and risk factors for psychopathology in epilepsy are presented. Specific psychiatric conditions like depression, anxiety and inter-ictal psychosis are also examined.
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approach to Dystonia and myoclonus movement disorders
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Myoclonus
- 1. Myoclonus AdeWijaya, MD – November 2019
- 2. Introduction • Sudden, brief, shock-like involuntary movements, associated with bursts of muscular activity (positive myoclonus) or silencing of muscular activity (negative myoclonus) • It may be present at rest, during voluntary movement (action- induced) or due to provoking stimuli such as sensory, visual, auditory or emotional cues • Typically, myoclonus presents as short (10–50 ms, rarely more than 100 ms), non-rhythmic jerks, often without any discernible pattern Caviness, J.N. Myoclonus. Mayo Clin. Proc. 1996, 71, 679–688. Shibasaki, H. Neurophysiological classification of myoclonus. Neurophysiol. Clin. 2006, 36, 267–269
- 3. Epidemiology • The average annual incidence: 1 per 100,000 person-years • Lifetime prevalence: less than 10 cases per 100,000 population • The rate increased with advancing age and was consistently higher in men • Neurodegenerative and dementing diseases were the most common cause of symptomatic myoclonus (about 70%) Caviness, J.N.; Alving, L.I.; Maraganore, D.M.; Black, R.A.; McDonnell, S.K.; Rocca, W.A. The incidence and prevalence of myoclonus in olmsted county, minnesota. Mayo Clin. Proc. 1999, 74, 565–569. Caviness, J.N.; Brown, P. Myoclonus: Current concepts and recent advances. Lancet Neurol. 2004, 3, 598–607.
- 4. Classification Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 5. Cortical Myoclonus • Myoclonus in the Context of Epilepsy • Neurodegenerative and Mitochondrial Disorders • Cerebrovascular Disease with Probable Cortical Sources • Acute post-hypoxic myoclonus Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 6. Subcortical Myoclonus • Myoclonus Dystonia • Orthostatic Myoclonus • Chronic Posthypoxic Myoclonus • Cerebrovascular Disease with Probable Subcortical Sources Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 7. Others • Segmental and Peripheral Myoclonus • Propriospinal Myoclonus • Negative Myoclonus Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 8. Metabolic Causes of Myoclonus • Uremic encephalopathy • Hepatic encephalopathy Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 9. Autoimmune Conditions with Myoclonus • Opsoclonus-Myoclonus Syndrome • Steroid-Responsive Encephalopathy with Autoimmune Thyroid Disease • Stiff-Person Syndrome and Progressive Encephalomyelitis with Rigidity • Limbic encephalitis Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 10. Infectious und Para-Infectious Causes of Myoclonus • HIV infection • Whipple disease • Viral (VZV, HSV-1, EBV, measles, mumps, WNV, St. Louis encephalitis, EEE (Eastern equine encephalitis) virus,WEE (Western equine encephalitis) virus, Dengue virus), bacterial (Leptospira, Mycoplasma pneumonia), parasitic (cerebral malaria) or slow virus infections (subacute sclerosing panencephalitis) Cardoso, F. Hiv-related movement disorders: Epidemiology, pathogenesis and management. CNS Drugs 2002, 16, 663–668. Louis, E.D.; Lynch, T.; Kaufmann, P.; Fahn, S.; Odel, J. Diagnostic guidelines in central nervous system whipple’s disease. Ann. Neurol. 1996, 40, 561–568. Zutt, R.; van Egmond, M.E.; Elting, J.W.; van Laar, P.J.; Brouwer, O.F.; Sival, D.A.; Kremer, H.P.; de Koning, T.J.; Tijssen, M.A. A novel diagnostic approach to patients with myoclonus. Nat. Rev. Neurol. 2015, 11, 687–697.
- 11. Medication andToxin-Induced Myoclonus • Opioids • Antidepressants • Classic or atypical antipsychotics • Antiepileptic drugs • Antibiotics Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 12. Treatment • Cortical myoclonus: levetiracetam, valproic acid, clonazepam or piracetam • Subcortical myoclonus: clonazepam • Deep brain stimulation Eberhardt O, Topka H. Myoclonic disorders. Brain sciences. 2017 Aug;7(8):103.
- 13. Summary • Sudden, brief, shock-like involuntary movements • Positive vs negative myoclonus • Cortical vs subcortical myoclonus • Various etiologies • Treatment: anticonvulsants; deep brain stimulation
- 14. THANKYOU