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Right Horner’s Syndrome-Where can the lesion(s) be? - PowerPoint PPT Presentation


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Right Horner’s Syndrome-Where can the lesion(s) be? . Representative of Case History #2 Guillain-Barré Syndrome (GBS) acute inflammatory demyelinating polyneuropathy disorder of the peripheral nerves attack of the myelin sheath of nerves by antibodies or white blood cells

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Presentation Transcript
slide2

Representative of Case History #2

  • Guillain-Barré Syndrome (GBS)
  • acute inflammatory demyelinating polyneuropathy
  • disorder of the peripheral nerves
  • attack of the myelin sheath of nerves by antibodies or white blood cells
  • rapid onset of ascending paralysis
  • begins with weakness and/or abnormal sensations of the legs and arms
  • breathing muscles may be so weakened
  • following gastrointestinal or respiratory viral infections
  • palpitations (sensation of feeling heartbeat), difficulty beginning to urinate, incomplete bladder emptying, incontinence (leaking of urine), constipation, and muscle contractions
slide3

Representative of Case History #1

DUCHENNES MUSCULAR DYSTROPHY

  • marked enlargement of calves
  • hyperlordosois
  • decreased tendon reflexes
  • normal sensation

Gower’s Sign

slide4

in A, patient is attempting to raise eyelids as high as possible

  • In B, same patient has had an iv injection of Tensilon, an acetylcholinsterase inhibitor. Eyelids go higher for a while

Representative of Case History #2

MYASTHENIA GRAVIS

B

A

slide5

Note relationships of

cranial nerves to major vessels and think about the effects of aneurisms!!!!

slide6

Lateral Medullary

Syndrome (Wallenberg’s)

Think of the neurological deficits!! This is one of your Case Vignettes!!!

What side is the lesion on?

Remember, the lesion is bigger than the white area.

slide7

Representative of Case History #5

Amytropic Lateral Sclerosis

Why are the spinal nerves smaller (shrunken) on the right cord??? Is there both upper and lower motor neuron disease? Is this also called Lou Gehrig Disease? Are there fasciculations?

slide8

Schwannoma of right CN VIII-You have a similar Case Vignette

What are some of the neurological deficits?

slide9

Parkinson’s Disease! Which brain has the least number of nigra cells containing melanin pigment?

slide10

What are the big white bundles

surrounding the 4th ventricle?

The melanin containing “black spots” is/are the locus coeruleus (contains nor-epi cells). We cover it in the third module.

What pathways are affected by the lesion? Does it looks like level 7 without the myelin stained??

slide11

Schwannoma of CN VIII. What problem(s) will this person have? This is similar to one of your Case Vignettes!!

What side is the lesion one??

slide12

Bells Palsey. What side is affected?

Can she wrinkle her forehead on the right?

slide13

Central VII

Peripheral VII

slide14

Ectropion-drooping lower lid

Lagophthalmos-inability to close upper lid

What CNs are involved in the corneal reflex?

slide17

Where could the lesion be??

Medulla?

Pons?

Midbrain?

Cortex?

Which side??

slide18

Inability to abduct the left eye!

Where could the lesion be???

slide19

Lid down and eye rotated down and out!

Where could the lesion be??

slide20

Left head tilt (not rotation!!)!

Where could the lesion be??

slide21

Right eye can’t go all the way down (ventral) and in (adduction); look at right eye in lower right frame)!!