NMS System Exam 3 Cumulative Quizlet

bacterial meningitis spinal fluid sample

A spinal fluid sample for someone with this type of meningitis would show lots of PMNs, a low sugar level, and a high protein level.

aseptic meningitis spinal fluid sample

A spinal fluid sample for someone with this type of meningitis would show lots of lymphocytes, a normal sugar level, and a normal protein level.

levetiracetam

Along with brivaracetam, this broad spectrum antiepileptic is a SV2A inhibitor. We give it orally and through IV. Side effects include somnolence and behavioral changes.

eosinophilic neurons

Also called red neurons or ischemic neurons, these are injured neurons due to things like hypoxia or ischemia. They show as shrunken, angular, and eosinophilic with shriveled, pyknotic, hyperchromatic nuclei.

acute disseminated encephalomyelitis

Also known as ADEM, this multiple sclerosis variant occurs after a viral infection. It leads to rapid, progressive, and diffuse demyelination seen around veins.

acute necrotizing hemorrhagic encephalomyelitis

Also known as ANHE, this multiple sclerosis variant is similar to ADEM, but more severe. It occurs after a upper respiratory infection, and is seen mostly in children and young adults.

asymptomatic neurocognitive impairment

Also known as ANI, this is one of the three types of HAND. This type usually shows as mild to moderate impairment, with someone being diagnosed if they've shown cognitive impairment for more than 1 month and it isn't explained by a comorbid illness. However, the impairment does not meet criteria for dementia or delirium.

amyloid beta

Also known as Aß, this protein is formed from the cleavage of amyloid precursor protein. When this precursor cleaved by beta-secretase and gamma-secretase, we get the insoluble form of this protein, which clumps up and inhibits proteins which fold Tau. The end result is Alzheimer's disease.

corticobasal degeneration

Also known as CBD, this condition results in asymmetric rigidity, where the rigid side shows dystonia, or "alien limb".

Creutzfeldt-Jakob disease

Also known as CJD, this transmissible spongiform encephalopathy is a prion disease. It occurs due to the conversion of PrP to PrPSc, which is toxic. It causes dementia, startle myoclonus, mood disorders, and hallucinations.

chronic traumatic encephalopathy

Also known as CTE, this neurodegenerative disease occurs due to recurrent concussions in people like athletes. We can mark it due to hyper-phosphorylated Tau in the brain (so sort of like Alzheimer's disease). Symptoms include cognitive changes, chronic headaches, and motor issues.

dihydroergotamine

Also known as DHE, this abortive medication is used to treat migraines. It's a non-selective serotonin agonist, so it works to stop dorsal Raphe nuclei from stimulating the trigeminal nerve.

dementia with Lew bodies

Also known as DLB, this neurodegenerative disease shows with Lewy bodies in cognitive areas, then progresses to motor areas.

neuromyelitis optica

Also known as Devic disease, this multiple sclerosis variant results in both optic neuritis AND spinal cord demyelination.

glial fibrillary acidic protein

Also known as GFAP, this protein can be stained to identify where astrocytes are in a tissue sample.

HIV-associated dementia

Also known as HAD, this is one of the three types of HAND. This type is the most severe, since it shows with large cognitive impairments. Usually, we'll see it in HIV patients who have a very low CD4 nadir.

HIV-Associated Neurocognitive Disorders

Also known as HAND, these are a group of disorders that occur in patients with HIV due to how the virus affects subcortical structures. Overall, these disorders affect cognitive, behavioral, and motor functioning parts of the brain. There are three types: asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia.

mild neurocognitive disorder

Also known as MND, this is one of the three types of HAND. This type is identical to ANI but is a bit more severe, since it disrupts daily living.

non-rapid eye movement sleep

Also known as NREM sleep, this is one of the two main stages of sleep. This stage is actually divided into three stages: N1, N2, and N3. In these stages, the body can move and the brain is less active than in REM sleep.

progressive multifocal leukoencephalopathy

Also known as PML, this CNS disease is caused by the JC virus (human papovavirus). In patients with HIV, it is the second-leading cause of lesions, specifically multiple ring-enhancing lesions.

progressive multifocal leukoencephalopathy

Also known as PML, this condition occurs in people with the JC virus who see it get reactivated due to immunosuppression (CD4 < 200). It leads to demyelination of subcortical structures around the periventricular areas of the brain, and this leads to progressive cognitive impairment, seizures, and cranial nerve issues. To treat, we can use HAART to help the immunosuppression.

primary CNS lymphoma

Also known as PNCSL, this is the second-leading cause of intracranial lesions in patients with AIDS. It is related to Epstein-Barr virus infection and shows in patients with very low CD4 counts (less than 50). Symptoms include altered consciousness, impaired cognitive function, seizures, and focal neurological deficits. We can diagnose it with MRI or CT of the supratentorial region (corpus callosum and periventricular area), since it forms single, couple ring-enhancing lesions about 2 centimeters or greater in size with edema.

rapid eye movement sleep

Also known as REM sleep or Stage R, this is one of the two main stages of sleep (and taken altogether, one of five stages). In this stage, the body is paralyzed, but the brain is active. The only things that can move are the eyes (hence the name of this stage).

return to play

Also known as RTP, this is a procedure used to help ease athletes back into their sports. It occurs in 6 steps: baseline, light aerobic exercise, moderate exercise, non-contact exercise, practice, and then play.

second impact syndrome

Also known as SIS, this syndrome occurs when a second concussion occurs BEFORE recovering from a prior one. This can lead to coma and death, since it may cause cerebral edema, then cerebral herniations.

striatonigral degeneration

Also known as SND, this is a variant of multiple system atrophy. In this case, the main symptoms are Parkinsonisms that are unresponsive to levodopa.

olivopontocerebellar atrophy

Also known as SND, this is a variant of multiple system atrophy. In this case, the main symptoms are cerebellar issues.

Shy-Drager syndrome

Also known as SND, this is a variant of multiple system atrophy. In this case, the main symptoms are severe autonomic issues with orthostatic hypotension.

multiple sleep latency test

Also known as a MSLT, this test is used to assess a person's daytime sleepiness. In this case, we measure the time it takes for a person to fall asleep for a nap.

subarachnoid hemorrhage

Also known as a SAH, this occurs due to hemorrhaging of cerebral arteries in the subarachnoid space. It can occur due to nontraumatic and traumatic reasons. A unique characteristic about this is the thunderclap headache that people experience.

transient ischemic attack

Also known as a TIA, this is sort of like a mini stroke. When it happens, blood flow is only stopped for a brief period of time (like a day or so), but will get better in minutes to an hour.

saccular aneurysm

Also known as a berry aneurysm, this is a ballooning of an artery that looks like a berry. When these are located on cerebral arteries and rupture, we get a nontraumatic subarachnoid hemorrhage.

tonic clonic seizure

Also known as a grand mal seizure, this type of generalized seizure leads to stiffening, then shaking.

absence seizure

Also known as a petit mal seizure, this seizure is pediatric, but resolves by adolescence. These seizures last 5 to 15 seconds, where the child will stare-off for a bit then act like nothing happened. There is no postictal state, and these are triggered by hyperventilation.

low pressure headache

Also known as a post lumbar puncture headache, this headache occurs due to a low CSF pressure that occurs after a lumbar puncture. It feels diffuse and throbbing, and really occurs when you stand-up. Treatment includes rest and hydration, although we can give a epidural blood patch to help ease symptoms.

cingulate gyrus herniation

Also known as a subfalcine herniation, this occurs when the cingulate gyrus herniates beneath the falx cerebri. As a result, we'll see compression of the anterior cerebral artery, which may lead to loss of lower limb sensation (since the medial portion of the somatosensory cortex is losing blood flow).

uncal herniation

Also known as a transtentorial herniation, this occurs when the uncus herniates below the tentorium cerebelli. As a result, the uncus pushes on structures in the posterior cranial fossa, such as the oculomotor nerve, cerebral peduncles, reticular formation, posterior cerebral artery, diencephalon, and brainstem.

viral meningitis

Also known as aseptic meningitis, this is the inflammation of the leptomeninges caused by a virus. Often, the virus is an Enterovirus (like echovirus, coxsackie viruses, and polioviruses). Symptoms include nuchal rigidity, phonophobia, photophobia, fever, and progressively worsening headaches. If we were to analyze the CSF, it would show lymphocytes with normal protein and normal sugar levels.

Pick's disease

Also known as frontotemporal dementia and frontotemporal lobar dementia, this type of dementia accounts for 10-20% of all dementia cases. Characteristics of this are knife-blade gyri in the frontal and temporal lobes, reactive gliosis, and cytoplasmic inclusions of Tau, TPD43, and FUS. It may occur due to inherited mutations in C9ORF72.

orexin

Also known as hypocretin, this hormone is made in the posterior hypothalamic nucleus to cause hunger. It also plays a role in sleep, where it activates the norepinephrine projection system in the locus ceruleus of the pons. As a result, we get wakefulness. We these levels are low, we get narcolepsy.

nasal continuous positive airway pressure

Also known as nasal CPAP, this is a treatment for sleep apnea. A patient wears a mask which helps maintain pressure in the oropharynx, so that they can continually breathe and not awaken due to apnea.

idiopathic intracranial hypertension

Also known as pseudotumor cerebri, this condition is seen mainly in obese females of childbearing age. Symptoms include secondary headaches and papilledema due to increased ICP. Also, there's abducens nerve dysfunction. Risk factors include Lyme's disease, Vitamin A medications, oral contraceptives, and endocrine and metabolic disorders. To treat, we use drugs like acetazolamide to lower ICP, which we hope prevents vision loss. We may also put a lumbo-peritoneal shunt in to drain CSF.

giant cell arteritis

Also known as temporal arteritis, this condition involves the inflammation of the vessels of the head and neck (especially the temporal artery). Symptoms include headache, jaw claudication, loss of appetite, and flu-like symptoms. At the worst, we may see vision loss if not corrected. We can diagnose this by looking for elevated erythrocyte sedimentation rate and by doing a temporal artery biopsy. To treat, we give corticosteroids for at least a year.

Glasgow Coma Scale

Also known as the GCS, this is the objective test used to assess patients for coma. It is scored with three parameters: best eye response, best motor response, and best verbal response. The total score ranges between 3 to 15, with 3 being braindead and 15 being normal.

apneustic respirations

Also known as top hat breathing or inspiratory cramp, these respirations occur due to damage to the pons. When patients have this, they will inhale, hold it, exhale, stop breathing for a little, then repeat.

meningoencephalitis

Also known as viral encephalitis, this is the inflammation of the meninges AND brain tissue. It occurs usually because of the hematogenous spread of a virus to the brain. It always results in necrosis, and can show a range of things like perivascular cuffing, microglial nodules, and Negri bodies (based on the virus present). Viruses that cause this are usually echoviruses, HIV, polio, rabies, and herpes simplex.

presenilin 1 and 2

Autosomal dominant mutations in these proteins leads to too much amyloid beta, which shows with a higher likelihood of developing Alzheimer's disease.

concussion imaging

For concussion, this is typically normal.

age over 70

For this age range affected by Parkinson's disease, the best type of treatment is either dopamine agonists or carbidopa with levodopa.

ages 50 to 70

For this age range affected by Parkinson's disease, the best type of treatment is with carbidopa and levodopa.

age less than 50

For this age range affected by Parkinson's disease, the best type of treatment is with dopamine agonists.

30 to 35%

In 2 years olds, this is the percentage of REM sleep they undergo.

trigeminal nerve

In a migraine, stimulation of this cranial nerve by the dorsal Raphe nuclei leads to release of substance P and calcitonin gene related peptide.

substance P

In a migraine, this protein, along with calcitonin gene related peptide, is released due to trigeminal nerve stimulation. As a result, it causes vessel dilation (which leads to pain).

calcitonin gene related peptide

In a migraine, this protein, along with substance P, is released due to trigeminal nerve stimulation. As a result, it causes vessel dilation (which leads to pain).

posterior cerebral artery

In an uncal herniation, this artery may get compressed. As a result, the visual cortex is impacted, which leads to a homonymous hemianopia with macular sparing.

tyrosine

In dopaminergic neurons, this amino acid is converted to L-DOPA by tyrosine hydroxylase.

DOPA-decarboxylase

In dopaminergic neurons, this enzyme converts L-DOPA to dopamine.

tyrosine hydroxylase

In dopaminergic neurons, this enzyme converts tyrosine to L-DOPA.

vesicular monoamine transporter

In dopaminergic neurons, this enzyme takes dopamine and puts it into vesicles for exocytosis into the synaptic cleft. It is also known as VMAT.

catechol-O-methyltransferase

In dopaminergic neurons, this is one of the two enzymes which metabolizes dopamine to homovanillic acid. It is also known as COMT.

monoamine oxidase B

In dopaminergic neurons, this is one of the two enzymes which metabolizes dopamine to homovanillic acid. It is also known as MAO-B.

L-DOPA

In dopaminergic neurons, this is the precursor of dopamine. It is converted to dopamine by DOPA-decarboxylase. Clinically, we can give patients this as a drug to help treat Parkinson's disease.

dopamine active transporter

In dopaminergic neurons, this protein is found on the presynaptic terminal. It reuptakes dopamine from the synaptic cleft for metabolism via monoamine oxidase B and catechol-O-methyltransferase. It is also known as DAT.

50%

In full-term neonates, this is the percentage of REM sleep they undergo.

80%

In infants born 10 weeks prematurely, this is the percentage of REM sleep they undergo.

neurofibrils

In neurons, these fibers make-up the cytoskeleton and are used in axonal transport. There are three: microtubules, neurofilaments, and microfilaments.

medial longitudinal fasciculus

In patients with multiple sclerosis, this band of fibers may get demyelinated, which leads to impaired conjugate eye movements (since the oculomotor and abducens nuclei can't communicate with one-another).

non-Parkinson's disease Parkinsonisms

In people with Parkinsonisms, these are red flags to indicate that they don't have Parkinson's disease, but just some other issue that presents like it. Some of these red flags include that they have early falls, supranuclear gaze palsy, dementia, autonomic issues (like orthostatic hypotension, ladder issues, erectile dysfunction), the onset is too early, and they respond poorly to levodopa.

mass effect

In terms of the brain, this is when a space-occupying lesion causes abnormal brain shape or symmetry.

crossing of BBB

In this neurotropic stage, the pathogen is now ready to cross the BBB. It's able to do this with its adhesive pili.

intravascular survival

In this neurotropic stage, the pathogen is now within our vasculature. It wants to try and survive here, and does so by having a polysaccharide capsule which prevents complement (specifically the alternative pathway) from opsonizing the pathogen for destruction.

colonization or mucosal invasion

In this neurotropic stage, the pathogen's main goal is to invade our tissue. It will do this by secreting IgA proteases to help get rid of our inborn secretory IgA defense system, use adhesive pili to attach to our mucosa, and even cause ciliostasis.

20 to 25%

In young adults, this is the percentage of REM sleep they undergo.

equine encephalitides

Infection of this arbovirus leads to acute encephalitis.

dengue virus

Infection of this arbovirus leads to arthralgia and a rash.

yellow fever virus

Infection of this arbovirus leads to hemorrhagic fever, hepatitis, and nephritis.

Marburg virus

Infection of this arbovirus leads to hemorrhagic fever.

anterior circulation ischemia

Ischemia of this circulation of the brain will show symptoms like amaurosis fugax, dysphasia, contralateral weakness, contralateral numbness, and neglect.

posterior circulation ischemia

Ischemia of this circulation of the brain will show symptoms like dizziness, diplopia, dysarthria, dysphagia, ataxia, and crossed signs of weakness and numbness.

mild brain injury

On the Glasgow Coma Scale, this is rated a 13 or higher.

moderate brain injury

On the Glasgow Coma Scale, this is rated between 9 to 12.

severe brain injury

On the Glasgow Coma Scale, this is rated less than 8.

group B streptococci

These Gram-positive cocci are a main cause of bacterial meningitis in neonates.

nonpolio enteroviruses

These RNA viruses fall within Picornaviridae. They cause aseptic meningitis, encephalitis, motor paralysis, and are the leading cause of CNS infection in children. They spread through fecal-oral, respiratory, and mother-child peripartum routes. Examples include coxsackie virus.

Triptans

These abortive medications are used to treat migraines. They cause vessel constriction and decrease substance P and CGRP release. They include sumatriptan, almotriptan, rizatriptan, eletriptan, and frovatriptan.

GABA-A receptor anticonvulsive drugs

These anticonvulsive drugs work specifically on GABA-A receptors. The main two are phenobarbital and valproate.

T-type calcium channel anticonvulsive drugs

These anticonvulsive drugs work specifically on T-type calcium channels. The main one is ethosuximide.

non-NMDA glutamate receptor anticonvulsive drugs

These anticonvulsive drugs work specifically on non-NMDA glutamate receptors. The main one is topiramate.

SV2A anticonvulsive drugs

These anticonvulsive drugs work specifically on the SV2A protein to block neurotransmitter release. They include levetiracetam and brivaracetam.

voltage-sensitive calcium channel anticonvulsive drugs

These anticonvulsive drugs work specifically on voltage-sensitive calcium channels. They include oxcarbazepine, topiramate, and gabapentin.

voltage-sensitive sodium channel anticonvulsive drugs

These anticonvulsive drugs work specifically on voltage-sensitive sodium channels. They include carbamazepine, oxcarbazepine, lamotrigine, topiramate, zonisamide, lacosamide, and phenytoin.

neurofibrillary tangles

These are accumulations or abnormal neurofilaments in the cytoplasm of neurons. They're seen with Alzheimer's disease.

chorea

These are brief, dance-like movements seen with people who have conditions like Huntington's disease, systemic lupus, hyperthyroidism, dopamine antagonists, and polycythemia vera. To treat this, we can give dopamine antagonists, too.

Lewy bodies

These are clumps of alpha-synuclein found in dopaminergic neurons. They are an indicator of Parkinson's disease.

stroke mimics

These are conditions or problems in the brain which show symptoms that seem like a stroke, but aren't. We can divide them into structural and non-structural ones.

idiopathic hypersomnia disorders

These are disorders which seem like narcolepsy, but aren't.

boxcar ventricles

These are enlarged lateral ventricles seen in patients with Huntington's disease. They occur because of atrophy of the caudate nuclei. Since they atrophy, the lateral ventricles take-up the empty space by enlarging.

gemistocytic astrocytes

These are enlarged, eosinophilic astrocytes. They appear in response to CNS damage and help form glial scars.

acquired demyelinating diseases

These are one of the two types of diseases associated with oligodendrocytes. These diseases are acquired through the lifespan, and include ones like multiple sclerosis.

leukodystrophies

These are one of the two types of diseases associated with oligodendrocytes. These occur due to inherited disorders of myelin metabolism.

CD4+ Th1 helper cells

These are one of the two types of lymphocytes active in multiple sclerosis. When activated, these release IFN-γ to recruit macrophages.

CD4+ Th17 helper cells

These are one of the two types of lymphocytes active in multiple sclerosis. When they activated, they go on to recruit leukocytes, which end-up destroying oligodendrocytes and myelin on axons.

antigen-nonselective immunomodulators

These are one of the two types of medications used to treat multiple sclerosis. These medications inhibit IFN-γ. Examples include IFN-beta 1a (Avonex) and IFN-beta 1b (Betaseron).

antigen-selective immunomodulators

These are one of the two types of medications used to treat multiple sclerosis. These medications inhibit the immune response to myelin basic protein. However, they make sure to maintain typical immune system functioning, since we still need an immune response. The main drug used is Cop1 (Copaxone).

generalized epileptic drugs

These are one of the two types of narrow spectrum anticonvulsive drugs. The main one is this category is ethosuximide, which treats absence epilepsy.

focal epileptic drugs

These are one of the two types of narrow spectrum anticonvulsive drugs. These include carbamazepine, gabapentin, and oxcarbazepine.

non-structural stroke mimics

These are one of the two types of stroke mimics. These are health conditions, such as hypoglycemia, infection, drug toxicity, and Bell's palsy. In any case, the problem isn't literally a physical issue, but some issue with a bodily process that's causing there to be stroke-like symptoms.

structural stroke mimics

These are one of the two types of stroke mimics. These are physical issues in the brain, such as tumors, abscesses, epidural hematomas, and subdural hematomas. In any case, these physical abnormalities may cause stroke-like symptoms, but the patient isn't actually having one.

myoclonus

These are rapid, "lightning-like" muscle contractions that lead to irregular jerking. They can be caused by toxic-metabolic encephalopathies, CNS infections, epilepsy, or are just hereditary.

tics

These are repetitive, stereotypic, semi-involuntary behaviors that can be motor or vocal. We see this with Tourette's syndrome. Usually, people can suppress them, but only for a short period of time. After, they have even more movements.

Kayser-Fleischer rings

These are rings of copper seen in the iris. They're a symptom of Wilson's disease.

third-generation cephalosporins

These are the main antibiotics we use to treat bacterial meningitis.

acetylcholinesterase inhibitors

These are the main drug used to treat dementia.

periodic leg movements

These are the type of movement that we see in restless leg syndrome.

thiamine and dextrose

These are two of the three medications given to patients in a coma. These two are given to account for any nutritional deficiencies that may be causing the coma.

psammoma bodies

These are whorls or sheets of meningothelial cells. We see these in meningiomas.

Nissl bodies

These basophilic clumps of granules are found in motor neurons. They represent endoplasmic reticulum.

Lewy bodies

These clumps of alpha-synuclein are seen in people with dementia, Parkinson's disease, and Parkinson's disease dementia.

ependymal cells

These cuboidal-columnar cells are found in the ventricular system and central canal of the spinal cord. Their job is to help push CSF through these areas with their cilia. They are also found in the choroid plexus of the lateral ventricles, where they produce and secrete CSF.

demyelinating disorders

These disorders occur due to destruction of oligodendrocytes in the CNS. As a result, we see less myelination, which leads to many problems. The most common type of this disorder is multiple sclerosis.

anticholinergics

These drugs are used to treat Parkinson's disease. Specifically, we use them to help treat tremors (since they are acetylcholine blockers).

COMT inhibitors

These drugs are used to treat Parkinson's disease. They are used to inhibit L-DOPA and dopamine metabolism. Examples include tolcapone and entacapone.

dopamine agonists

These drugs are used to treat Parkinson's disease. This type acts as a replacement for dopamine and binds to mainly D2 receptors to cause movement. Examples include drugs like pramipexole, ropinirole, and rotigotine. These drugs may cause orthostatic hypotension, hallucinations, dyskinesias, nausea, and sleepiness. However, a good advantage of them is that they show offer a reduced-risk of long-term motor issues, since they mainly bind to D2 receptors (so we're only getting half the effect).

IV benzodiazepines

These drugs are used to treat status epilepticus. They include lorazepam and diazepam.

IV anticonvulsants

These drugs are used to treat status epilepticus. They include phenytoin, valproic acid, and levitiracetam.

MAO-B inhibitors

These drugs used to treat Parkinson's disease. This type stops dopamine metabolism. Examples include rasagiline and selegiline.

arboviruses

These enveloped, RNA viruses get their name since they are "arthropod-borne" (so they are transmitted from insects). A notable example of these viruses is West Nile virus, which falls within the family Togaviridae. Altogether, symptoms of infection from these viruses include CNS lesions involving basal brain structures, the cerebral cortex, and the spinal cord.

Negri bodies

These eosinophilic cytoplasmic inclusions are unique to a rabies infection. We find them in the CNS.

Negri bodies

These eosinophilic inclusion bodies are seen histologically with viral encephalitis caused by rabies. We find them in pyramidal neurons.

meningiomas

These extra-axial tumors come from arachnoid cells, where we see them on the sides of the brain, attached to dura. They don't invade brain tissue, and their cells show psammoma bodies.

Rosenthal fibers

These fibers are seen in areas where there's long-standing gliosis. They are long, eosinophilic structures found within astrocytic processes.

astrocytes

These glial cells are found around the brain, where they help form the BBB with their little feets. Aside from this, they also form tripartite synapses between neurons, regulate energy metabolism, give insulation for unmyelinated neurons, and form glial scars when there's damage. Histologically, we can identify them by staining for glial fibrillary acidic protein (GFAP).

oligodendrocytes

These glial cells are found in the CNS. They have low cytoplasm with rounded nuclei, and only a few short processes. We see them surround gray matter and form myelin in white matter. When forming myelin, they can add many segments to an axon. They may swell when responding to toxic or metabolic changes, and are affected by leukodystrophies and acquired demyelinating diseases.

Schwann cells

These glial cells are found in the PNS. They add myelin to neurons. Unlike oligodendrocytes, they can only add myelin to one segment on an axon.

microglia

These glial cells are unique in that they're made from mesoderm, NOT ectoderm. They're really just little macrophages which sit in the CNS to help clean-up debris and pathogens coming in.

unformed visual hallucinations

These hallucinations occur due to a occipital lobe seizure. Examples of these include seeing spots, zig zags, and colors.

formed visual hallucinations

These hallucinations occur due to a temporal lobe seizure.

Lewy bodies

These intraneuronal inclusions are large and spherical. They're seen with Parkinson's disease.

cortical lesions

These lesions cause aphasia, neglect, homonymous visual field issues, and cortical sensory loss (like extinction and agraphesthesia).

subcortical lesions

These lesions cause purely motor and purely sensory issues.

cerebral peduncles

These make-up one of the three structures affected by an uncal herniation. When impacted, we get hemiplegia on the contralateral side (since we're pushing on fibers of the lateral corticospinal tract). However, if the herniation is severe, we may see Kernohan's notch.

broad spectrum agents

These make-up one of the two types of anticonvulsive medications. These drugs are used for really any type of seizure, so they can help focal epilepsies or generalized epilepsies. Examples include brivaracetam, lacosamide, lamotrigine, levetiracetam, phenobarbital, phenytoin, topiramate, valproate, and zonisamide.

narrow spectrum agents

These make-up one of the two types of anticonvulsive medications. We can further divide this group into two types based on what they treat: focal epilepsies and generalized epilepsies.

CNS effects of lead poisoning

These make-up one of the two types of effects caused by lead poisoning. They involve the cerebral cortex and cerebellar cortex, which leads to edema, white matter necrosis, vascular proliferation, glial cell proliferation, and neuron damage. More specifically, it causes encephalopathy.

PNS effects of lead poisoning

These make-up one of the two types of effects caused by lead poisoning. They involve the motor nerves, which leads to demyelination of axon segments at first, then full axon degeneration over time. This will show as weakness in the muscles (more-so distally, like with wrist drop).

abortive medications

These medications are given to help stop a migraine. They include many things, but Triptans and dihydroergotamine are the main two.

hypokinetic movement disorders

These movement disorders involve too little movement. They include Parkinson's Disease and akinetic-rigid syndromes.

hyperkinetic movement disorders

These movement disorders involve too much movement. They include tremors, dystonia, myoclonus, chorea, hemiballismus, and tics.

ballooned neurons

These neurons get their characteristic look due to the accumulation of unmetabolized stuff from malfunctioning lysozymes.

dorsal Raphe nuclei

These nuclei are found in the brainstem. In a migraine, these are activated, which leads to the stimulation of the trigeminal nerve.

gliomas

These primary neoplasms come from glial cells. Examples include astrocytomas, oligodendrogliomas, and ependymomas.

protective factors for Parkinson's disease

These protective factors include estrogen, caffeine, smoking, heavy alcohol use, NSAIDs, calcium channel blockers, and exercise.

Cheyne-Stokes respirations

These respirations occur due to damage to the diencephalon. When a patient breathes this way, they alternate between hypoventilation and hyperventilation. We see this often with patients who have diabetic ketoacidosis.

ataxic respirations

These respirations occur due to damage to the medulla. When patients breathe this way, they will breathe once, not breathe for a bit, then hyperventilate and repeat. Usually, these respirations are a sign of end-of-life.

HAND risk factors

These risk factors include insulin resistance, vascular disease, anemia, low CD4 nadir, Hepatitis C virus, and CD14/CD16 monocyte activity.

risk factors for Parkinson's disease

These risk factors include severe head trauma, genetic link in families, pesticides, well water, rural living, manganese poisoning, Von Economo's encephalitis, MPTP, and low uric acid.

reactive seizures

These seizures are secondary to some other biological issue, like hypoglycemia, alcohol withdrawal, trauma, and infection.

NREM parasomnias

These sleep disorders include night terrors and sleepwalking. They are most common in children,

primary headache syndromes

These syndromes are headaches caused by a biological issue. They include transformed migraine, medication overuse headache, chronic tension type headache, and hemicrania continua.

secondary headache syndromes

These syndromes are headaches that are secondary to some issue. They include cerebral venous thrombosis, giant cell arteritis, increased ICP, low ICP, space-occupying masses, sleep apnea, and cervical spine disorders.

sinusitis, otitis media, and mastoiditis

These three infections can become starting points for meningitis (if prolonged and not treated well).

delta waves

These waves are found on the EEG of a person who is in Stage N3 of NREM sleep (or in other words, deep sleep). They have a high amplitude, but are slow.

neuritis

This CNS inflammation occurs when there's an infection in of the nerves.

encephalitis

This CNS inflammation occurs when there's an infection in the brain proper. Usually, it's caused by herpes simplex virus.

radiculitis

This CNS inflammation occurs when there's an infection in the dorsal nerve root.

meningitis

This CNS inflammation occurs when there's an infection in the leptomeninges.

myelitis

This CNS inflammation occurs when there's an infection in the spinal cord.

Guillain-Barre syndrome

This CNS syndrome leads to muscle pain and symmetric, ascending paralysis with barely any sensory issues. It's mainly caused by Campylobacter, but also by some viruses (like herpes simplex virus). In either case, we should check history for URI and GI illnesses, since Campylobacter is a food-borne pathogen.

diffuse astrocytoma

This Grade II astrocytoma shows a network of GFAP-positive astrocytic processes.

anaplastic astrocytoma

This Grade III astrocytoma shows greater nuclear changes and gemistocytic astrocytes.

glioblastoma

This Grade IV astrocytoma is the most common type of primary tumor seen in adults. It's found in the cerebral hemispheres, where it can cross-over between them. The tumor contains many mitoses and endothelial proliferation.

Neisseria meningitidis

This Gram-negative diplococcus is a main cause of bacterial meningitis in adolescents and young adults (since it's seen in shared living spaces, like college dorms).

Escherichia coli

This Gram-negative rod is a main cause of bacterial meningitis in neonates.

Listeria monocytogenes

This Gram-positive bacillus is a main cause of bacterial meningitis in older adults and people with cell-mediate immunity issues.

Listeria monocytogenes

This Gram-positive bacillus is often found in pregnant females and people with cell-mediated immunodeficiencies. If untreated, it can lead to bacterial meningitis.

Streptococcus pneumoniae

This Gram-positive lancet-shaped bacteria is the largest cause of bacterial meningitis. It infects people of all ages.

night terrors

This NREM parasomnia is characterized by sudden and partial awakening from Stage N3 sleep, then screaming or frantic movement. It may be genetic, and occurs in the first 1/3 of sleep.

REM sleep behavior disorder

This REM parasomnia is characterized by a loss of atonia during REM sleep (so in other words, people with this can move while in REM sleep). It's likely due to pontine tegmental lesions from conditions like drug withdrawal (when acute) and Parkinson's disease or dementia (when chronic).

nightmare disorder

This REM parasomnia is characterized by repeatedly waking up from frightening dreams. In this case, you'll have perfect recall of them, and they occur in the second half of sleep.

West Nile virus

This RNA virus is an arbovirus within the family Flaviviridae. It is transmitted through a mosquito bite, but infection is usually asymptomatic. In the worst case, it can cause a neuroinvasive disease that leads to aseptic meningitis, encephalitis, seizures, LMN issues, and Guillain-Barre syndrome.

donepezil

This acetylcholinesterase inhibitor is reversible and selective. It causes cholinergic side effects, like nausea, diarrhea, and vomiting.

galantamine

This acetylcholinesterase inhibitor is reversible. It causes cholinergic side effects, like nausea, diarrhea, and vomiting, as well as vivid dreams.

multiple sclerosis

This acquired demyelinating disorder affects oligodendrocytes.

AEIOUTIPS

This acronym is used to help remember the causes of coma. A = alcohol E = endocrine I = insulin O = oxygen U = uremia T = trauma and temperature I = infection P = psychogenic S = space-occupying lesion, stroke, SAH

TRAP

This acronym stands for the motor issues seen with Parkinson's disease. It stands for Tremor, Rigidity, Akinesia, and Postural gait instability.

Guillain-Barre syndrome

This acute demyelinating polyradiculopathy affects the PNS. We see it occur after infection in young adults. Symptoms include rapidly-developing muscle weakness that starts low and ascends. The worst outcome is that the weakness moves to the diaphragm, which results in respiratory failure. The good news is that most people recover from this.

hemidystonia

This adult-onset dystonia affects only half the body.

blepharospasm

This adult-onset dystonia affects only the eyes.

truncal dystonia

This adult-onset dystonia affects only the trunk muscles.

Meige syndrome

This adult-onset dystonia affects only the upper face and neck.

Charcot-Bouchard aneurysm

This aneurysm is seen on the lenticulostriate arteries of the stem of the MCA. When it ruptures, it leads to an intracerebral hemorrhage affecting the basal ganglia and internal capsule, so movement is greatly affected.

Eastern equine encephalitis virus

This arbovirus is a part of the alphavirus genus within the family Togaviridae. Infection of this leads to Eastern equine encephalitis.

Western equine encephalitis virus

This arbovirus is a part of the alphavirus genus within the family Togaviridae. Infection of this leads to Western equine encephalitis.

California encephalitis group

This arbovirus is a part of the bunyavirus genus within the family Bunyaviridae. Infection of this leads to California encephalitis.

Colorado tick fever virus

This arbovirus is a part of the orbivirus genus within the family Reoviridae. Infection of this leads to Colorado tick fever.

locus ceruleus

This are of gray matter is found in the pons. It contains noradrenergic neurons that participate in the norepinephrine projection system. It gets excited by orexin A coming from the lateral hypothalamic nuclei, which leads to wakefulness.

oliogdendroglioma

This astrocytoma comes from oligodendrocytes. We see them in the cerebral hemispheres, where we see calcification and hemorrhage. However, these are slow-growing. The tumor itself shows cells with a "fried-egg appearance".

Streptococcus pneumoniae

This bacteria is found in our airways. It's a common cause of sinus infections and the like for really anyone. It can lead to bacterial meningitis if not treated properly, and is the leading cause of it.

Neisseria meningitidis

This bacteria is often found in community spaces, such as dorms in college. So, the most at-risk people tend to be young people. It likes to colonize the upper airways, and if not treat properly, can lead to bacterial meningitis.

phenobarbital

This broad spectrum antiepileptic is a GABA-A receptor enhancer (and it helps increase chloride channels). We give it orally and through IV. Side effects include sedation, pediatric paradoxical hyperactivity, and Dupuytren's contracture.

phenytoin

This broad spectrum antiepileptic is a voltage-sensitive sodium channel blocker. We can give it orally or through IV. Side effects include nystagmus, diplopia, aplastic anemia, drug-induced lupus, gingival hyperplasia, and purple glove syndrome.

lacosamide

This broad spectrum antiepileptic is a voltage-sensitive sodium channel enhancer during the inactive state. We give it orally and through IV. Side effects include dizziness, headache, nausea, diplopia, and PR prolongation.

valproate

This broad spectrum antiepileptic is mainly a GABA-A receptor enhancer. We give it orally and through IV. Side effects include dose-dependent nausea/vomiting, hair loss, pancreatitis, myelosuppression, hyperammonemia, and thrombocytopenia.

zonisamide

This broad spectrum antiepileptic works as a voltage-sensitive sodium channel blocker, T-type calcium channel blocker, and carbonic anhydrase inhibitor. We give it orally. Side effects include sulfa allergy reactions, pediatric anhidrosis, ataxia, somnolence, irritability, anorexia, and kidney stones.

topiramate

This broad spectrum antiepileptic works as a voltage-sensitive sodium channel blocker, non-NMDA glutamate receptor blocker, and carbonic anhydrase inhibitor. We give it orally. Side effects include concentration issues, aphasia, weight loss, taste aversion, paresthesia, non-anion gap metabolic acidosis, and kidney stones.

lamotrigine

This broad spectrum antiepileptic works as a voltage-sensitive sodium channel blocker, voltage-sensitive calcium channel blocker, and a glutamate release inhibitor. We give it orally and it's metabolized by the liver. Side effects include ataxia, fatigue, dizziness, nausea, somnolence, diplopia, headache, and Steven-Johnsons syndrome.

rabies virus

This bullet-shaped, enveloped, single-stranded RNA virus comes from the Rhabdovirus group. It infects all warm-blooded animals, and is unique in that it's envelope is studded with hemagglutinin and it contains a transcriptase. In a host, it goes from the muscle to the Schwann cells, then the CNS, then the peripheral nerves, and finally to salivary glands (where it gets transmitted through mainly bites). In terms of its effect on the host, it pretty much affects the entire CNS (brain, cerebellum, brainstem, you name it). Symptoms include hyperventilation, paralysis, hydrophobia, confusion, hyperactivity, and in the worst case, coma and death. When diagnosing someone with this, a unique feature is the presence of Negri bodies within lesions of the CNS.

acetazolamide

This carbonic anhydrase inhibitor is used with idiopathic intracranial hypertension to help reduce ICP.

voltage-sensitive calcium channel

This channel is located at the presynaptic cleft of a neuron. It allows the influx of calcium to cause vesicle fusion, which leads to neurotransmitter release into the synaptic cleft. For epilepsy, we can target this channel and block it to help reduce the amount of glutamate released to the other neuron. Drugs that do this include oxcarbazepine, topiramate, and gabapentin.

voltage-sensitive sodium channel

This channel is located at the presynaptic cleft of a neuron. It allows the influx of sodium into the neuron to help propagate action potentials. For epilepsy, we can target this channel and block it to help lengthen the repolarization stage, which may help control the excessive activity of a seizure. Drugs that do this include carbamazepine, oxcarbazepine, lamotrigine, topiramate, zonisamide, lacosamide, and phenytoin.

T-type calcium channel

This channel is located on the postsynaptic neuron. It allows the influx of calcium into the neuron to help propagate action potentials to muscle. For generalized epilepsies, we can target this channel and block it to help reduce the hyper-synchronous activity of an seizure. The main drug that does this is ethosuximide.

AIDS-related cognitive-motor complex

This complex of symptoms is due to HIV infection that has now reached the brain. Symptoms include demyelination of subcortical regions, where macrophages, microglia, and multinucleated giant cells are primary targets. Also, people with this tend to have a higher chance of other infections and of developing progressive multifocal leukoencephalopathy.

dementia

This condition involves the progressive degeneration of the brain, which leads to many cognitive issues like aphasia, apraxia, agnosia and executive processing issues. The most common forms of this condition are Alzheimer's disease, Lewy body dementia, and vascular cognitive impairment.

communicating hydrocephalus

This condition is a possible side effect of bacterial meningitis. It occurs due to the pus formed in the subarachnoid space. As a result, the pus blocks arachnoid villi, so CSF can't get resorbed into the superior sagittal sinus.

progressive multifocal leukoencephalopathy

This condition is caused by reactivation of the JC virus in people with AIDS, which affects their oligodendrocytes (so we get demyelination). As a result, we get multiple ring-enhancing lesions in the brain, which leads to dementia and overall deterioration. Also, a unique finding is inclusion bodies in the nuclei of the oligodendrocytes.

epilepsy

This condition is characterized as recurring seizures that are NOT due to an acute neurological issue.

pernicious anemia

This condition occurs due to cobalamin deficiency. It can mimic dementia.

subacute sclerosing panencephalitis

This condition occurs due to infection from measles that has spread to the brain. The infection affects gray matter, which progressively gets worse and mostly leads to death in 3 to 4 years. Symptoms include intellectual decline, personality changes, and seizures.

pellegra

This condition occurs due to niacin deficiency. It can mimic dementia.

Wernicke's encephalopathy

This condition occurs due to thiamine deficiency. It can mimic dementia.

sleep apnea

This condition occurs when a person stops breathing while asleep. We can divide this into two types: central and obstructive.

tuberous sclerosis

This condition presents with adenoma sebaceum, which looks like a red rash over the nose, cheeks, and skin.

inflammatory demyelinating polyneuropathy

This disease is rare for patients with HIV. It causes rapidly ascending weakness that starts in the legs, however, sensation is spared.

Wilson's disease

This disease occurs due to an autosomal recessive mutation on Chromosome 13, specifically on the copper transporter gene. As a result, we get high levels of copper, which deposit and cause liver failure basal ganglia issues, psychiatric symptoms, and Kayser-Fleischer rings.

Huntington's disease

This disease occurs due to autosomal dominant mutations in Chromosome 4. Here, we see CAG repeats. The symptoms of this condition are chorea, dementia, depression, and cerebellum issues. A unique feature is boxcar ventricles, which occur due to atrophy of caudate nuclei.

Toxoplasmosis

This disease, along with primary CNS lymphoma, is the main cause of intracranial lesions in patients with AIDS.

multiple system atrophy

This disorder occurs due to too much α-synuclein (just like Parkinson's disease) but its in glial cells, NOT dopaminergic neurons. Symptoms include early dysautonomia, cerebellar issues, corticospinal issues, early falls, nocturnal stridor, and a poor response to levodopa.

cerebral amyloid angiopathy

This disorder occurs in patients with Alzheimer's disease, which leads to a buildup of amyloid beta in blood vessels.

pyridostigmine

This drug can be given to people who are dealing with post-polio syndrome. It helps them with their fatigue that's causing their dysphagia.

amantadine

This drug is used to treat Parkinson's disease. It blocks NMDA and is a weak inducer of dopamine release. We really see it effective for patients who have had Parkinson's disease for so long, and as a result, they easily develop dyskinesia due to levodopa use.

carbidopa

This drug is used to treat Parkinson's disease. It's given alongside levodopa to make sure it isn't converted to dopamine until it reaches the CNS. This is because this drug is a dopamine decarboxylase inhibitor, but it cannot pass the BBB, so it's useful in making sure our levodopa actually gets to the CNS (instead of turning into dopamine in the periphery).

levodopa

This drug is used to treat Parkinson's disease. This type is a dopamine precursor, and it's given alongside carbidopa. It's goal is to get past the BBB and into the dopaminergic neurons, where it'll get converted to dopamine via dopamine decarboxylase. Too much of this can lead to nausea, orthostatic hypotension, hallucinations, and dyskinesias. Also, we don't recommend it get taken with food, since this can impair it's ability to get to the brain.

valproic acid

This drug is used to treat juvenile myoclonic epilepsy.

acyclovir

This drug is used to viral encephalitis caused by herpes simplex virus type I.

herpes simplex virus

This enveloped, double-stranded DNA virus is the leading cause for encephalitis at all age groups.

GTP cyclohydrolase

This enzyme is used to reconvert dihydrobiopterin into tetrahydrobiopterin, which is a cofactor to tyrosine hydroxylase. When this enzyme is mutated, we get DOPA-responsive dystonia.

alpha-secretase

This enzyme will cleave amyloid precursor protein and form soluble amyloid beta.

gamma-secretase

This enzyme, along with beta-secretase, will cleave amyloid precursor protein and form insoluble amyloid beta (which, we think, leads to Alzheimer's disease).

beta-secretase

This enzyme, along with gamma-secretase, will cleave amyloid precursor protein and form insoluble amyloid beta (which, we think, leads to Alzheimer's disease).

ictal event

This event is when the actual seizure occurs.

central chromatolysis

This event occurs when a neuron has undergone damage. First, the cell body swells, which causes Nissl bodies and the nucleus to move to the cell's periphery. This allows there to be more protein synthesis so that the cell can start to heal.

seizure

This event occurs when there's an abnormal syncing-up of neurons in both hemispheres. In other words, we see lots of super in-sync brain activity occurring. Prior to this event, people may show stereotypical mood or behavior changes. We see this mainly in children and elderly.

mini mental status exam

This exam is used to assess mental status. It's a 19-point questionnaire that adds-up to 30 points.

complex partial seizure

This focal seizure leads to altered cognition and postictal confusion.

simple partial seizure

This focal seizure leads to unimpaired consciousness or awareness and no postictal state.

hospital-acquired meningitis

This form of bacterial meningitis is unique in that it usually occurs due to Gram-negative bacteria (like E. coli).

meningoencephalitis

This form of encephalitis is caused by Cryptococcal meningitis. It shows as a subacute fever with headache, altered mental status, and a CD4 count less than 100.

cytomegaloencephalitis

This form of encephalitis is caused by cytomegalovirus infection. It shows with fever, altered mental status, focal cranial nerve changes (like gaze palsy), and a CD4 count less than 50. We can diagnose it by doing a MRI of the subarachnoid space, and may see enlarged ventricles.

herpes simplex encephalitis

This form of encephalitis is due to infection from herpes simplex virus 1. Usually, the temporal lobe is affected, and the patient may experience Bell's palsy, pain syndromes, ascending myelitis, trigeminal neuralgia, post-infectious encephalomyelitis, Mollaret meningitis, fever, altered consciousness, seizures, and personality changes.

toxoplasma encephalitis

This form of encephalitis occurs due to infection from Toxoplasma gondii. Specifically, it occurs once cysts from this bacteria become reactivated. It is the most common cause of CNS mass lesions for patients with AIDS. We see it at its worst when patients have a CD4 count less than 100. To diagnose, we look for IgG antibodies and use CT or MRI to look for multiple less-than-2 cm ring-enhancing lesions in the gray matter of the brain.

intravenous mannitol

This form of mannitol can be given as therapy for cerebral edema once 2 to 4 days has passed.

memantine

This glutamate antagonist is noncompetitive for the NMDA receptor. It may cause vivid dreams.

reticular formation

This group of neurons is found in the pons. It is important in REM sleep for rapid eye movements and muscle atonia.

Parkinson's disease

This hypokinetic movement disorder is the second-most common neurodegenerative disease. It occurs due to destruction of the substantia nigra pars compacta. As a result, there's less dopamine that goes to the striatum, which means the direct pathway is not activated and the indirect pathway is not inhibited, so no movement. We also see Lewy bodies form within the dopaminergic neurons. Patients will show progressive motor issues, such as resting tremor, rigidity, akinesia, and postural gait instability. Outside of motor issues, they may experience smelling issues, constipation, sleep disorders, and mood disorders.

skull trauma

This injury predisposes patients to developing meningitis. This is because the trauma creates an area for infection to occur, especially from bacteria found on the skin (like Staphylococcus epidermidis and Staphylococcus aureus). These then have a direct pathway into the brain.

IFN-γ

This interferon is released by CD4+ Th1 helper cells to recruit macrophages.

baseline

This is Step 0 of the return to play protocol. In this step, we're just getting the athlete's baseline. We ask them to rest, and they don't progress until they're concussion symptom-free for 1 day.

light aerobic exercise

This is Step 1 of the return to play protocol. In this step, our goal is to increase the athlete's heart rate to see how they do. We can do this by having them do things like walk or jog for 5 to 10 minutes.

moderate exercise

This is Step 2 of the return to play protocol. In this step, we're increasing physical activity, but still trying to maintain limited body and head movement. We can do so with things like moderate jogging and moderate weightlifting.

non-contact exercise

This is Step 3 of the return to play protocol. In this step, our goal is to allow the athlete intense exercise, but with NO CONTACT. Here, we can have them do high-intensity workouts.

practice

This is Step 4 of the return to play protocol. In this step, the athlete can fully practice with contact.

play

This is Step 5 of the return to play protocol. In this step, the athlete is fully-cleared to play.

concussion

This is a change in momentum of the head which leads to short-lived neurological issues (like respiratory arrest, loss of consciousness, and amnesia). We don't see anything on CT scans, and it may lead to post-concussive syndrome.

empyema

This is a collection of pus in a space or potential space (like the epidural space of the meninges).

psychosis

This is a condition which results in difficulty knowing what's reality. It can be acute, subacute, and chronic, and shows with things like hallucinations and delusions.

sleep-onset delay

This is a delay in someone being able to fall asleep. Usually, this is due to life stressors or anxiety.

delirium

This is a disturbance in consciousness that leads to less ability to pay attention. The issue causing this is usually correctable.

pseudodementia

This is a false dementia. It's really memory problems that are due to a poorly controlled mental health disorder, like depression.

Todd's paralysis

This is a form of paralysis that we see in the postictal period of a seizure. It looks like a stroke occurred, but really, it's just a side effect from the seizure.

dyskinesia

This is a hyperkinetic disorder where there's excessive movement. We see this occur due to levodopa use, where it's too effective, that it's causing too much movement.

abscess

This is a localized collection of pus in tissue.

inflammation

This is a localized, protective cellular response due to an infectious agent.

intracerebral abscess

This is a newly-formed cavity in the brain that is filled with pus. It's caused by bacteria (Streptococcus pneumoniae, Staphylococcus aureus, and Staphylococcus epidermidis) and fungi (Candida and Cryptococcus neoformans). In terms of appearance, it has liquefactive necrosis surrounded by gliosis from astrocytes.

laminar necrosis

This is a special type of necrosis that's seen in acute carbon monoxide poisoning. It's necrosis of the cerebral cortex.

status epilepticus

This is a state of continuous seizures or frequent seizures. Essentially, we'll see a patient have a seizure, enter the postictal period, then have another one. The most common cause of this is missing a dose of anticonvulsants. We can treat it with IV doses with benzodiazepines and anticonvulsants.

cataplexy

This is a sudden loss of muscle tone. We see this with patients who have narcolepsy.

head drop

This is a symptom of atonic seizure. It occurs due to the loss of muscle tone in the nuchal muscles.

brain tumor

This is a tumor found within the CNS, specifically in the brain. Unlike typical tumors, this type doesn't metastasize to different parts of the body.

perivascular cuffing

This is a unique finding seen with viral encephalitis. Essentially, lymphocytes and plasma cells are seen surrounding blood vessels in the brain, causing inflammation.

contusion

This is an area of hemorrhagic necrosis in the brain. In other words, it's a brain bruise. They occur due to acceleration of the head, which causes the brain to bounce around in the skull and hit something (like the falx cerebri). We describe it as either occurring where trauma on the skull was (coup) or 180 degrees opposite to it (contrecoup). The main areas that get this are orbital gyri, the temporal pole, and the occipital pole, since these all are located near rough edges of the skull.

cerebral edema

This is fluid-buildup within the brain. There are two types: vasogenic, cytotoxic, and hydrocephalic.

diffuse axonal injury

This is injury to white matter from acceleration of the head. It can lead to prolonged traumatic coma, and shows with axonal swellings and Wallerian degeneration.

hematogenous spread

This is just a fancy term for an infection that has spread through the blood.

watershed infarct

This is one of the causes of hypoperfusion in the brain. This occurs when there's a lack of blood flow that spans two or more vascular territories (like as if there was hypoperfusion between the vascular territories of the anterior and middle cerebral arteries).

space-occupying lesions of blood

This is one of the causes of increased intracranial pressure. This occurs when there's hemorrhaging, which leads to blood pushing on the brain.

space-occupying lesion of the brain

This is one of the causes of increased intracranial pressure. This occurs when there's something like a neoplasm or infection in the brain tissue itself. As a result, we see mass effect.

vessel dissection

This is one of the causes of ischemic stroke. In this case, there's a tear in an artery of the brain, like the carotid arteries or vertebral arteries (so the major ones that contribute to the circulations). It's usually caused by trauma, seen in young people mostly, and shows with neck pain.

hypoperfusion

This is one of the causes of ischemic stroke. It's essentially just less than normal blood flow to the brain, and can be due to low blood pressure, heart attack, irregular heart rhythm, or watershed infarcts.

locked-in syndrome

This is one of the conditions that gets mistaken for coma. In this condition, the culprit is a brainstem injury (due to issues with the basilar artery) or a neuromuscular disorder (like Lou Gehrig's disease). The patient cannot move, but can blink and has normal consciousness.

status epilepticus

This is one of the conditions that gets mistaken for coma. In this condition, the patient has non-convulsive seizures, which stops patients from responding.

catatonia

This is one of the conditions that gets mistaken for coma. In this condition, the source is primarily psychiatric.

akinetic mutism

This is one of the conditions that gets mistaken for coma. In this condition, there's large lesions to the frontal lobes, which causes minimal responsiveness. However, the patient can still track with their eyes and appears fully awake.

stupor

This is one of the five levels of consciousness. This level shows with decreased arousal, decreased retained content, needs a constant stimulus to perform tasks, and decreased attention span.

obtundation

This is one of the five levels of consciousness. This level shows with decreased arousal, decreased retained content, needs a stimulus to perform tasks, and decreased attention span.

coma

This is one of the five levels of consciousness. This level shows with decreased arousal, decreased retained content, no ability to perform tasks, and no attention span.

somnolent

This is one of the five levels of consciousness. This level shows with decreased arousal, retained content, an impaired ability to perform tasks, and decreased attention span.

lethargy

This is one of the five levels of consciousness. This level shows with decreased arousal, retained content, an impaired ability to perform tasks, and decreased attention span. It's a bit more severe form of somnolent.

no verbal response

This is one of the five ratings possible for measuring the verbal response in the Glasgow Coma Scale. This response gets a score of 1. In this case, we hear nothing from the patient.

incomprehensible sounds

This is one of the five ratings possible for measuring the verbal response in the Glasgow Coma Scale. This response gets a score of 2. In this case, the only sounds we hear from the patient are moaning or groaning.

inappropriate words

This is one of the five ratings possible for measuring the verbal response in the Glasgow Coma Scale. This response gets a score of 3. In this case, the patient may show with a fluent aphasia.

confused

This is one of the five ratings possible for measuring the verbal response in the Glasgow Coma Scale. This response gets a score of 4. In this case, the patient can't remember where they are.

oriented

This is one of the five ratings possible for measuring the verbal response in the Glasgow Coma Scale. This response gets a score of 5. In this case, the patient knows what's going on and can communicate it.

Stage N3

This is one of the five stages of sleep (and even more specifically, is one of the three stages within NREM sleep). In this stage, we are in deep sleep, which shows as delta waves on an EEG. It may last from minutes to an hour, and this is where we dream. Because of these waves, we also call this stage slow wave sleep or delta sleep.

Stage N1

This is one of the five stages of sleep (and even more specifically, is one of the three stages within NREM sleep). In this stage, we experience sleep drowsiness (so it's right when we're laying down to sleep).

Stage N2

This is one of the five stages of sleep (and even more specifically, is one of the three stages within NREM sleep). We usually go back to this stage from Stage N3 a few times throughout the night.

Stage W

This is one of the five stages of sleep. In this stage, we are awake, which shows as alpha waves on an EEG.

Stage R

This is one of the five stages of sleep. In this stage, we have now transition from NREM to REM sleep. We experience rapid eye movements, whole body paralysis, and our brain is very active. At first, this stage is quite short (about 15 to 20 minutes), but it gets longer throughout the night.

no eye opening

This is one of the four ratings possible for measuring the eye response in the Glasgow Coma Scale. This response gets a score of 1. In this case, we don't see a patient open their eyes.

eye opening to pain

This is one of the four ratings possible for measuring the eye response in the Glasgow Coma Scale. This response gets a score of 2. In this case, we see the patient open their eyes when we give them a painful stimulus.

eye opening to verbal command

This is one of the four ratings possible for measuring the eye response in the Glasgow Coma Scale. This response gets a score of 3. In this case, we see the patient open their eyes when we talk to them.

spontaneous eye opening

This is one of the four ratings possible for measuring the eye response in the Glasgow Coma Scale. This response gets a score of 4. In this case, we see the patient open their eyes with no problem.

cognitive symptoms of concussion

This is one of the four types of symptoms seen with a concussion. Symptoms of this type include confusion, anterograde amnesia, retrograde amnesia, loss of consciousness, mental fog, inattention, and aphasia.

sleep symptoms of concussion

This is one of the four types of symptoms seen with a concussion. Symptoms of this type include drowsiness, delayed-onset sleep, hypersomnia, and insomnia.

affective symptoms of concussion

This is one of the four types of symptoms seen with a concussion. Symptoms of this type include emotional lability, irritability, fatigue, anxiety, and depression.

somatic symptoms of concussion

This is one of the four types of symptoms seen with a concussion. Symptoms of this type include headache, dizziness, balance issues, nausea and vomiting, photophobia, double vision, and phonophobia.

reticulospinal tract

This is one of the medial motor pathways. This pathway is involved in helping regulate muscle contraction in the axial and proximal muscles; mainly to help maintain posture and muscle tone. It is involved with REM sleep, where it works with the magnocellular nucleus of the medulla to help inhibit motor neurons (so we get paralyzed).

abdominal migraine

This is one of the migraine equivalents seen in children. This shows as episodic abdominal pain.

elevated erythrocyte sedimentation rate

This is one of the signs of giant cell arteritis. It occurs due to inflammation of the arteries.

no motor response

This is one of the six ratings possible for measuring the motor response in the Glasgow Coma Scale. This response gets a score of 1. In this case, the patient does not show any movement.

extension to pain

This is one of the six ratings possible for measuring the motor response in the Glasgow Coma Scale. This response gets a score of 2. In this case, the patient will show decerebrate posturing in response to something painful.

flexion to pain

This is one of the six ratings possible for measuring the motor response in the Glasgow Coma Scale. This response gets a score of 3. In this case, the patient will show decorticate posturing in response to something painful.

withdrawal from pain

This is one of the six ratings possible for measuring the motor response in the Glasgow Coma Scale. This response gets a score of 4. In this case, the patient will move away from a painful stimulus.

localizes to pain

This is one of the six ratings possible for measuring the motor response in the Glasgow Coma Scale. This response gets a score of 5. In this case, the patient will move toward a painful stimulus to stop it (like if we pinch a part of their body).

obeys commands

This is one of the six ratings possible for measuring the motor response in the Glasgow Coma Scale. This response gets a score of 6. In this case, the patient can follow directions about doing a motor movement, like "Hold your hands up in the air".

midbrain

This is one of the structures affected by a central herniation. When impacted, we get eyes that are in midposition with fixed pupils, since both sympathetics and parasympathetics are affected.

diencephalon

This is one of the structures affected by a central herniation. When impacted, we get small, reactive pupils, since the herniation caused damage to the sympathetic nuclei for the eye.

amaurosis fugax

This is one of the symptoms that occurs due to anterior circulation ischemia. This is just a fancy term for blindness in an eye. It occurs usually because the ipsilateral carotid artery is affected, which means the ophthalmic artery isn't able to get blood flow to the eye.

dysphasia

This is one of the symptoms that occurs due to anterior circulation ischemia. This occurs because of lack of blood flow to Broca's area.

naloxone

This is one of the three medications given to patients in a coma. This medication is given to account for any drug overdose that may be causing the coma.

pilocytic astrocytoma

This is one of the three most common tumors in children. This Grade I astrocytoma occurs in the cerebellar hemispheres, which leads to ipsilateral limb ataxia. It's a cystic lesion that has a mural nodule, and is made of astrocytes with pilocytic fibers. The prognosis is good.

medulloblastoma

This is one of the three most common tumors in children. This malignant, poorly-differentiated neoplasm occurs in the vermis, and may even go into the fourth ventricle or brainstem. It leads to truncal ataxia and increased ICP with non-communicating hydrocephalus. It's solid and may be soft to granular. The prognosis is poor, but radiotherapy is quite effective.

ependymoma

This is one of the three most common tumors in children. This tumor is made of ependymal cells of the fourth ventricle. Due to its location, it leads to increased ICP, which causes headache, nausea, vomiting, and papilledema. It's solid, but friable and granular, and has rosettes. The prognosis is poor.

best eye response

This is one of the three responses measured on the Glasgow Coma Scale. This response is rated from 1 to 4. Here, we're measuring the patient's ability to voluntarily open their eyes.

best verbal response

This is one of the three responses measured on the Glasgow Coma Scale. This response is rated from 1 to 5. Here, we're measuring the patient's ability to voluntarily speak.

best motor response

This is one of the three responses measured on the Glasgow Coma Scale. This response is rated from 1 to 6. Here, we're measuring the patient's ability to voluntarily move. Of the three, this response is the most predictive of recovery.

oculomotor nerve

This is one of the three structures affected by an uncal herniation. When impacted, we get a blown pupil (since the outer layer of this nerve containing parasympathetics is primarily affected).

reticular formation

This is one of the three structures affected by an uncal herniation. When impacted, we get coma, since this structure cannot properly regulate sleep and arousal anymore.

contrecoup lesion

This is one of the three types of cerebral contusions. This type occurs 180 degrees away from the site of injury on the skull.

coup lesion

This is one of the three types of cerebral contusions. This type occurs at the site of injury on the skull.

intermediary coup lesion

This is one of the three types of cerebral contusions. This type occurs somewhere away from the site of injury.

cytotoxic cerebral edema

This is one of the three types of cerebral edema. This results from an increased permeability of cell membranes due to cell damage from ischemia or metabolic poisons. The main thing affected is gray matter.

vasogenic cerebral edema

This is one of the three types of cerebral edema. This type is the most common, and results from an increased permeability of small vessels. The end result is a loss of BBB, which mainly affects white matter.

bacterial meningitis

This is one of the three types of meningitis. Also known as acute pyogenic meningitis, this type shows with pus in the SAH and necrosis in brain tissue. In the CSF, we'll see PMNs, high protein levels, and low sugar levels. This type can lead to other issues, such as hydrocephalus, increased ICP, cranial nerve palsies, and abscesses.

viral meningitis

This is one of the three types of meningitis. Also known as aseptic meningitis or acute lymphocytic meningitis, this type will have lymphocytes, normal protein levels, and normal sugar levels in the CSF.

fungal meningitis

This is one of the three types of meningitis. Also known as chronic meningitis, this type shows with granulomatous inflammation. In the CSF, we'll see lymphocytes, high protein levels, and low sugar levels.

behavioral areas

This is one of the three types of subcortical areas affected by HAND. When affected, the patient may show apathy, depression, and agitation.

cognitive areas

This is one of the three types of subcortical areas affected by HAND. When affected, the patient may show issues with memory, concentration, mental processing, and comprehension.

motor functioning areas

This is one of the three types of subcortical areas affected by HAND. When affected, the patient may show unsteady gait, poor coordination, abnormal tone, and tremors.

meningovasculitis

This is one of the three types of tertiary neurosyphilis. This type affects arteries in the brain, which leads to white matter infarcts. So in other words, it looks and presents like a stroke.

general paresis

This is one of the three types of tertiary neurosyphilis. This type involves UMN lesion-type weakness.

tabes dorsalis

This is one of the three types of tertiary neurosyphilis. This type involves dorsal roots and the dorsal column of the spinal cord in the lumbosacral region.

alcoholic polyneuropathy

This is one of the two conditions caused by thiamine deficiency. This condition leads to numbness, paresthesia, weakness that affects distal regions first.

Wernicke-Korsakoff syndrome

This is one of the two conditions caused by thiamine deficiency. This syndrome is a combination of Wernicke's encephalopathy and Korsakoff's psychosis. The major issues result from lesions to the mamillary bodies, medial dorsal thalamic nucleus, paraventricular regions around the third ventricle, cerebral aqueduct, and 4th ventricle, and oculomotor, trochlear, abducens, and vestibular nuclei.

Korsakoff's psychosis

This is one of the two conditions which makes-up Wernicke-Korsakoff syndrome. This condition results from prolonged Wernicke's encephalopathy. What happens is the mamillary bodies become impacted, which leads to confabulations.

Wernicke's encephalopathy

This is one of the two conditions which makes-up Wernicke-Korsakoff syndrome. This condition results in a triad of symptoms (confusion, ophthalmoplegia, and ataxia).

ischemic stroke

This is one of the two major types of stroke. This type is the most common, and is caused by a clot in the brain. It can be divided into two types: thrombotic and embolic.

remote tumor effects

This is one of the two types of effects caused by tumors. Also known as paraneoplastic effects, these are effects on the CNS and PNS that are caused by a non-nervous system tumor. So in other words, a tumor in some other part of the body is causing nervous system issues (probably because of proximity to one-another). The most common type of tumor to cause these issues is a small cell lung carcinoma. This is because in the area of the lungs, we have spinal roots, DRGs, peripheral nerves, and other CNS and PNS structures. The tumor may impact all of these. Also, we may see our body produce autoantibodies from the tumor, which target our nervous system.

direct tumor effects

This is one of the two types of effects caused by tumors. This type occurs with a brain tumor itself. This tumor can cause localized neuron destruction or space-occupying effects (like if a tumor was in Broca's area, we'd see nonfluent aphasia, and the tumor may cause a midline shift).

open-head injury

This is one of the two types of head injury. This injury involves the breaching of the dura, so we're getting into the brain. It occurs due to penetrating injuries from things like stab wounds or gunshots.

closed-head injury

This is one of the two types of head injury. This injury is involves the dura NOT being breached. Commonly, it's from blunt injuries, or from linear acceleration or deceleration of the head.

embolic stroke

This is one of the two types of ischemic stroke. This type occurs due to a clot which formed somewhere else, but made its way to the brain. As a result, symptoms have an abrupt onset. It can be caused by atrial fibrillation, septic emboli, cholesterol emboli, pulmonary emboli, and many more.

thrombotic stroke

This is one of the two types of ischemic stroke. This type occurs due to a clot which has formed within the brain over time. As a result, symptoms have a gradual onset. Most ischemic strokes are of this kind. It's usually due to atherosclerosis of the arteries in the brain, which takes time to build-up. When a patient has one, they may show stuttering.

acute lead encephalopathy

This is one of the two types of lead encephalopathy. This type shows with increased ICP, seizures, ataxia, and even coma.

chronic lead encephalopathy

This is one of the two types of lead encephalopathy. This type shows with seizures, attention deficits, motor skill loss, mental deficits, weakness, and anemia.

narcolepsy-cataplexy

This is one of the two types of narcolepsy. In this case, a person has narcolepsy in combination with loss of muscle tone. For people with this, the sleepiness occurs for 5 to 30 minutes, and usually occurs after experiencing strong emotions, like laughter. We can diagnose it with multiple sleep latency test, where they're diagnosed if they enter REM sleep in the first 15 minutes of sleep. Usually, the issue is a orexin deficiency.

narcolepsy without cataplexy

This is one of the two types of narcolepsy. This type is just narcolepsy but there is NO sudden loss of muscle tone. Also, people with this have multiple sleep-onset REM periods when assessed through the multiple sleep latency test.

obstructive sleep apnea

This is one of the two types of sleep apnea. This is the most common type. With this type, there's a temporary obstruction in the upper airway, which leads to apnea, then a slight arousal to breathe. As a result, patients with this get hypersomnia, since their sleep is constantly disrupted. We can diagnose it with polysomnography, and treat it with a nasal CPAP machine.

traumatic subarachnoid hemorrhage

This is one of the two types of subarachnoid hemorrhage. This one occurs due to accumulation of blood in the subarachnoid space nearby brain contusions, which occurred mainly from a skull fracture.

nontraumatic subarachnoid hemorrhage

This is one of the two types of subarachnoid hemorrhage. This one occurs due to rupturing of saccular aneurysms, specifically located on the cerebral arteries of the Circle of Willis.

episodic tension type headache

This is one of the two types of tension type headaches. This type occurs less than 15 days a month.

chronic tension type headache

This is one of the two types of tension type headaches. This type occurs more than 15 days a month.

jaw claudication

This is pain when chewing. It's a symptom of giant cell arteritis.

hemiballismus

This is rapid, large amplitude, unilateral, flinging movements. It usually occurs due to damage to the subthalamic nucleus. This can occur via a stroke in the middle cerebral artery, which impacts the lenticulostriate arteries that serve this nucleus.

acute disseminated encephalomyelitis

This is the damage of the myelin sheath in the brain and spinal cord due to a viral infection. It seems a lot like encephalitis, so similar symptoms (headache, fever, altered consciousness, etc.). We see this in children mostly, in which we can use T2 MRI to find the areas of demyelination.

hyper-metabolic state

This is the first metabolic state that occurs with a concussion. It occurs due to glutamate release, which goes to NMDA receptors. This leads to lots of depolarization, which stresses the Na-K pump to work harder (since it's goal is to renormalize ion concentrations in between depolarizations). Because this pump needs to work harder, we see more glucose use, which leads to this state.

viral encephalitis

This is the inflammation of the brain due to viral infection (usually from herpes simplex virus). Symptoms include fever, headache, altered consciousness, behavior and speech changes, disorientation, hemiparesis, cranial nerve palsies, and seizures.

poliomyelitis

This is the inflammation of the spinal cord due to infection from Polio virus, specifically the 1, 2, and 3 serotypes. There are two types of this disease: paralytic and nonparalytic. In most cases, there aren't any symptoms. However, some people may develop aseptic meningitis and LMN issues from it.

infection

This is the invasion of tissues with microorganisms that multiply and cause damage.

aura

This is the main symptom that occurs prior to a seizure. Examples include abnormal smells, abnormal tastes, deja vu, and rising abdominal sensations.

multiple sclerosis

This is the most common CNS demyelinating disorder. It occurs in mostly Caucasian women between the ages of 20 to 50. We also notice it's common in higher altitudes. It occurs due to the activation of CD4+ Th1 and Th17 helper cells, which recruit macrophages and leukocytes, respectively. The leukocytes then destroy oligodendrocytes and myelin on axons, so we lose our myelin-forming glial cells of the CNS and white matter. As a result, we get lesions of white matter, specifically of the periventricular areas.

migraine

This is the most common acute headache syndrome. It occurs due to activation of the dorsal Raphe nuclei, which causes stimulation of the trigeminal nerve. This nerve causes release of substance P and calcitonin gene related peptide, which causes vessel dilation and pain. Symptoms include photophobia, phonophobia, nausea, auras, and frontal lobe pain. Things like MSG, processed meat and cheese, red wine, and stress can lead to them. We can treat this with putting a patient in a dark room and by giving abortive medications like Triptans and dihydroergotamine. We can prevent these with medications like topiramate and valproate.

thunderclap headache

This is the most common acute headache. It occurs due to a subarachnoid hemorrhage. Symptoms include nausea, vomiting, photophobia, phonophobia, scotomas, zigzag hallucinations, and focal numbness or weakness.

Alzheimer's disease

This is the most common form of dementia. It's seen more in females. It has both late-onset and early-onset forms.

juvenile myoclonic epilepsy

This is the most common inherited epilepsy syndrome in juveniles. It shows with myoclonic and staring spell seizures in early age, then with generalized tonic-clonic seizures in early adulthood.

optic neuritis

This is the most common initial symptom of multiple sclerosis.

distal symmetric polyneuropathy

This is the most common neurological condition for patients with HIV. Most of the time, it is undetectable and CD4 counts are greater than 350. Symptoms show as symmetric numbness and burning in the legs that may spread to the arms when advanced.

herpes simplex virus type I encephalitis

This is the most common non-epidemic form of encephalitis. It's caused by herpes simplex virus type I, and leads to lesions involving the temporal lobe and orbital gyrus of the frontal lobe. These lesions cause problems in mood, memory, and behavior. Something unique to this encephalitis is hemorrhagic necrosis, which will show in the CSF as lots of RBCs.

glioma

This is the most common type of primary brain tumor. It comes from glial cells.

Alzheimer's disease

This is the most major neurodegenerative disease. It accounts for 60-70% of all dementia cases. We think this occurs because of the cleavage of amyloid precursor protein by beta-secretase, then gamma-secretase. As a result, we get the insoluble form of amyloid beta. If this stuff isn't cleared quickly enough, it will form oligomers, or plaques, on the synapses (which damages them). This damage leads to loss of synapses, and as a result, we lose the ability to properly fold Tau protein. This protein becomes hyperphosphorylated, which inhibits axonal transport via microtubules (so the neurons die). Specifically, we see this occur in the entorhinal cortex, which causes massive degradation of the hippocampus. We also see degradation of the nucleus basalis of Meynert and cerebral amyloid angiopathy.

rivastigmine

This is the only drug approved to treat Parkinson's disease dementia.

arousal

This is the overall level of responsiveness to environmental stimuli.

postictal period

This is the period of time that comes after a seizure. Usually, symptoms include fatigue, headache, combative behavior, or mental status changes.

neurodegeneration

This is the progressive decline in brain functioning that affects specific areas of the brain (like how Parkinson's affects the substantia nigra pars compacta), which can lead to cognitive, motor, and emotional disorders.

ciliostasis

This is the reduction or stoppage of cilia movement caused by pathogens.

concussion

This is the rough shaking of the brain due to external forces (like a car accident). As a result, the brain undergoes trauma either at the site of impact, or away from it. Due to the trauma, we see somatic, cognitive, affective, and sleep symptoms. After this occurs, we see lots of glutamate bind to NMDA receptors, which leads to a hyper-metabolic state (especially when there's reduced cerebral blood flow). After, the brain goes into a hypo-metabolic state.

facial hypomimia

This is the slowing of facial movements. We see this in patients with Parkinson's disease.

level of consciousness

This is the specific state of alertness someone is showing. There are five states: somnolent, lethargy, obtundation, stupor, and coma.

dystonia

This is the sustained contraction of agonist and antagonist muscles AT THE SAME TIME. In other words, both muscles are working against each other, so there's really no net movement. Two types of this that are childhood-onset are generalized torsion dystonia and DOPA-responsive dystonia.

papilledema

This is the swelling around the optic disc. It occurs when there's an increased intracranial pressure, since the pressure pushes on the optic nerve.

somnambulism

This is the technical term for sleepwalking. This NREM parasomnia usually occurs in the first 1/3 of sleep for about 10 minutes.

MRI with gadolinium

This is the test of choice for diagnosing a brain tumor.

intracranial pressure

This is the total pressure within the skull. It is made-up of the pressures coming from brain tissue, CSF, and blood. Normally, it's less than 20 mm of water when checked through a lumbar puncture.

liquefactive necrosis

This is the type of necrosis seen in brain. It occurs due to the release of lysozymes.

coma

This is what results from profound impairment of the cerebral cortex and reticular formation.

primary CNS lymphoma

This lymphoma comes from B cells in the deep cerebral hemispheres. We see this mainly in immunocompromised patients (like those with AIDS), where it shows as single, multiple ring enhancing lesions.

anticonvulsive medication

This medication is used to treat epilepsy. It helps decrease the frequency and severity of seizures. We can divide this type of medication into two types: broad spectrum agents and narrow spectrum agents.

Parkinson's disease

This movement disorder shows with Lew bodies in the brainstem and limbic regions.

central pontine myelinolysis

This multiple sclerosis variant involves specific demyelination of the basis pontis and pontine tegmentum. We usually see this occur when hyponatremia is rapidly corrected.

gabapentin

This narrow spectrum anti-focal epileptic is a voltage-sensitive calcium channel blocker. We give it orally. Side effects include sedation, edema, tremor, and weight gain.

carbamazepine

This narrow spectrum anti-focal epileptic is a voltage-sensitive sodium channel blocker that we give orally. Side effects include ataxia, nystagmus, thrombocytopenia, hyponatremia, Steven Johnsons syndrome, and it can make generalized epilepsies worse.

oxcarbazepine

This narrow spectrum anti-focal epileptic is a voltage-sensitive sodium channel blocker. It's the prodrug version of carbamazepine, and we give it orally. Side effects include ataxia, fatigue, Steven-Johnson's syndrome, nausea, somnolence, diplopia, and it can make generalized epilepsies worse.

ethosuximide

This narrow spectrum anti-generalized epileptic is a T-type calcium channel blocker. We give it orally, and we specifically use it for absence epilepsy. Side effects include nausea, drowsiness, dizziness, headache, and dose-dependent granulocytopenia.

Fahr disease

This neurodegenerative disease occurs due to deposits of calcium in the basal ganglia.

lipofuscin

This neuronal inclusion is a combination of lipids, proteins, and carbohydrates. It appears to be a normal result of aging.

polio virus

This non-enveloped, single-stranded RNA virus comes from the Enterovirus subgroup of the Picornavirus group. It infects mainly humans, specifically young people in areas where there's poor hygiene. It spreads from person-to-person through the fecal-oral and respiratory routes, and can cause both paralytic and nonparalytic disease.

altered mental state

This nonspecific term refers to any chance in mentation. It can be acute, subacute, or chronic.

suprachiasmastic nucleus

This nucleus is found in the hypothalamus. It's in charge of circadian rhythms.

magnocellular nucleus

This nucleus is found in the medulla. It's active when we're in REM sleep to paralyze our body. It works closely with the reticulospinal tract to make sure motor neurons are inhibited (so all-in-all, we don't get any trunk movement or limb movement).

nucleus basalis of Meynert

This nucleus is responsible for directing our attention to something. It's degraded in people with Alzheimer's disease.

brain death

This occurs when a patient shows no activity in either their cerebral hemispheres or brainstem. However, their spinal reflexes may be intact, since their spinal cord is unaffected. To test for this, we can do the caloric test and apnea test.

stroke

This occurs when blood flow is impaired to the brain. It can be ischemic (due to a clot) or hemorrhagic (due to bleeding). If not treated properly, the end result is brain tissue death.

midline shift

This occurs when the midline of the brain is shifted laterally. More specifically, the diencephalon (thalamus and hypothalamus) shifts laterally. As a result, we may have decreased consciousness.

increased intracranial pressure

This occurs when there's either too much blood (due to hemorrhaging), too much brain tissue (due to a tumor), or too much CSF (due to infection or hydrocephalus). Symptoms include headache, nausea and vomiting, decreased consciousness, papilledema (may occur), and diplopia due to 6th nerve palsy.

progressive supranuclear palsy

This palsy occurs due to too much hyper-phosphorylated Tau protein in neurons. As a result, we get a loss of voluntary extraocular motor movements. However, reflexes like the vestibulo-ocular reflex are intact (so their eyes can move, but they just don't have the ability to voluntarily do it). Other symptoms include axial rigidity and a wide-eyed, unblinking face.

supranuclear gaze palsy

This palsy shows when a patient cannot voluntary move their eyes. However, vestibulo-ocular reflexes are intact, so it isn't an extraocular cranial nerve issue.

blueprinting

This phenomenon is seen in Creutzfeldt-Jakob disease. Here, PrP is exposed to a tiny amount of PrPSc, which causes it is convert to this toxic form.

dreaming

This phenomenon occurs during REM sleep. Here, we see a combination of activity between the superior colliculus and limbic system, which allows this event to occur. However, unlike when we're awake, these the superior colliculus and limbic system aren't connected to the frontal lobe, hence why this event can be so bizarre.

Kernohan's notch

This phenomenon occurs when an uncal herniation is so severe, that it actually pushes on the cerebral peduncles on the OPPOSITE side of the where the herniation is occurring. As a result, we get motor deficits that are ipsilateral to the herniation. This can lead to false localization, because when we see motor deficits due to problems in the brainstem and above, we usually think "Ah, the issue must be on the opposite side". But in this case, that's not what's happening.

medication overuse headache

This primary headache syndrome occurs due to taking abortive medications too often (such as Triptans). It feels like a constant, dull headache. To treat, we reduce dosages.

transformed migraine

This primary headache syndrome occurs in people who have an increase in migraine episodes, as well as due to analgesic overuse. Symptoms include episodic migraines with less symptoms (like photophobia, phonophobia, and nausea). We can treat it by reducing medication dosages.

deep brain stimulation

This procedure involves stimulating the striatum to help modulate movement in patients with Parkinson's disease.

neuronophagia

This process involves microglia surrounding cell bodies of dying neurons.

sleep

This process is needed by humans to help consolidate memories, regulate metabolism, and get rid of wastes with increased CSF flow. We can divide it into two main stages: REM and nonREM.

gliosis

This process occurs when astrocytes respond to CNS damage. They become gemistocytic and then form many glial processes to help repair damage.

apoptosis

This programmed cell death occurs in four steps: 1. Signaling pathways 2. Control and integration through Bcl-2 family 3. Execution phase with caspases 4. Removal of dead stuff by phagocytosis

histamine projection system

This projection system begins with neurons in the hypothalamus. It's responsible for wakefulness.

APOE4

This protein is responsible for clearing amyloid beta, but it's bad at it. So, if you have two copies of the gene for it, then you have a higher chance of developing Alzheimer's disease.

SCAT 2

This protocol is used to test athletes for concussion.

purple glove syndrome

This rare condition occurs due to IV phenytoin. What happens is the drug leaks from the IV site and causes pain, edema, and discoloration around the hand.

Steven-Johnsons syndrome

This rare rash occurs due to carbamazepine, oxcarbazepine, or lamotrigine use.

non-NMDA glutamate receptor

This receptor is located on postsynaptic neurons. It receives glutamate from presynaptic neurons. For epilepsies, we can target this receptor and block it to help reduce activation of postsynaptic neurons. The main drug that does this is topiramate.

bacterial neurotropism

This refers to the ways in which certain bacteria are able to penetrate the BBB and cause meningitis.

triple flexion

This reflex is tested on patients who are in a coma. It involves flexion at the thigh, flexion at the knee, and dorsiflexion of the foot (so altogether, it looks like when someone raises their leg to take a step). It's important to know this reflex for spinal functioning, since it does NOT need the brainstem. So, we may see this occur in braindead patients.

oculocephalic response

This response is checked for patients in a coma. We turn their head and look to see how their eyes move. If their eyes stay forward to keep line of sight, then this means their brainstem is intact. However, if their eyes move with their head and do not correct, then this means their brainstem is NOT intact.

restless leg syndrome

This sensorimotor disorder leads to insomnia. It shows as a strong urge to move the legs (periodic leg movements) which interferes with sleep mainly in the evening.

parasomnia

This sleep disorder is characterized as having abnormal sensations or behaviors while asleep.

insomina

This sleep disorder is characterized as sleeping too little.

hypersomnia

This sleep disorder is characterized as sleeping too much. It's caused by many things, like insufficient sleep, medication, sleep apnea, and narcolepsy.

narcolepsy

This sleep disorder is characterized by hypersomnia and disordered REM sleep. Essentially, people with this get random bouts of severe, irresistible sleepiness. There are two types: one with cataplexy, and one without it.

pallidotomy

This surgery involves causing a lesion in the globus pallidus internus.

stuttering

This symptom is commonly seen with thrombotic strokes.

post-concussive syndrome

This syndrome involves headaches, lethargy, and mental dullness. It may occur after a concussion.

Tourette's syndrome

This syndrome is characterized as having motor and vocal tics. It occurs mainly in males before the age of 20. We can treat it with α2 adrenergic agonists, dopamine antagonists, and botulinum toxin.

"talk and die" syndrome

This syndrome is seen with epidural hematomas. Essentially, the patient will first be unconscious, then seem fine for hours only to relapse into unconsciousness and a coma.

post-polio syndrome

This syndrome occurs about 30 to 40 years after someone has poliomyelitis. Symptoms include a slow onset of muscle pain and increased muscle weakness, as well as muscle atrophy. To treat this, we can help the patient through physical therapy, exercise, encouraging them to rest, and giving pyridostigmine for their fatigue (which causes dysphagia).

cholinergic activating system

This system in the brain is important for waking and REM sleep. It projects to the thalamus, where it activates REM neurons.

Parkinsonism

This term is used to describe patients who show at least 2 of the 4 cardinal features of Parkinson's disease.

viral tropism

This term refers to how a virus can have the ability to infect a specific type of cell. For example, HIV infects only CD4 helper T cells.

Jacksonian march

This term refers to how there's a marching of symptoms when people are about to have a seizure. In other words, it begins with focal neurological signs (like loss of movement), then progresses to a generalized tonic clonic seizure.

polysomnogram

This test is used to assess a person's sleep. It's an all-night recording of EEG, EKG, EMG, ear oximetry, nose airflow, mouth airflow, and thoracic and abdominal wall motion.

apnea test

This test is used to determine if a patient is brain dead. It's done by causing changes in pH and pCO2 in the patient, then looking to see if they spontaneously respire (since this is an involuntary mechanism for when we need to breathe). If they don't do this, then they're brain dead.

precursor loading

This treatment refers to giving lots of choline to help makes lots of acetylcholine in patients with dementia.

pituitary adenoma

This tumor is found in the anterior pituitary. It can compress the optic nerves, optic chiasm, optic tracts, hypothalamus, and oculomotor nerve. It's usually benign.

retinoblastoma

This tumor is found in the eye. The prognosis is good if we catch it when it's small.

Schwannoma

This tumor is found in the peripheral nerves, specifically in the vestibulocochlear nerve. Symptoms include tinnitus, hearing loss, and vertigo. Usually, this tumor is benign.

craniopharyngioma

This tumor is the most common supratentorial tumor in childhood. It comes from the anterior pituitary embryonic tissue. It's usually benign.

neuroblastoma

This tumor occurs in the PNS, specifically with the adrenal glands. The prognosis is poor, unless the child is young (less than 1 year old).

early-onset Alzheimer's disease

This type of Alzheimer's disease is not very heritable. It occurs due to autosomal dominant mutations in genes for amyloid precursor protein, presenilin 1, and presenilin 2.

late-onset Alzheimer's disease

This type of Alzheimer's disease is very heritable, with a strong risk factor being having two alleles of the APOE4 gene, which leads to APOE4 that is not good at cleaning-up amyloid beta (so more plaques form).

Group B Streptococcus

This type of Streptococcus is one of the two most common causes of neonatal meningitis.

Alzheimer type II astrocytes

This type of astrocyte is seen in the gray matter of people who have liver disease or have issues with their urea cycle. They have a very large nucleus, prominent nuclear membrane, and are NOT related to Alzheimer's disease.

secondary brain tumor

This type of brain tumor comes from outside the CNS. In other words, it started somewhere else, and has metastasized to the brain.

primary brain tumor

This type of brain tumor comes from the brain itself. In other words, it comes from CNS cells (like glial cells) or from the meninges. Most brain tumors are this type, and of this type, gliomas are the most common.

benign brain tumor

This type of brain tumor has symptoms that show with a gradual onset and are slowly progressive.

extra-axial brain tumor

This type of brain tumor is found outside of the brain. In other words, this tumor comes from the meninges, skull, cranial nerves, or brain structures (like the pituitary gland, which isn't technically part of the brain proper). The most common type is a meningioma.

intra-axial brain tumor

This type of brain tumor is found within the brain tissue or spinal cord. The most common type is a glioma, specifically a glioblastoma.

central neurogenic hyperventilation

This type of breathing occurs due to damage to the midbrain.

acute carbon monoxide poisoning

This type of carbon monoxide poisoning leads to laminar necrosis, as well as necrosis of the hippocampus, cerebellum, and globus pallidus.

generalized torsion dystonia

This type of childhood-onset dystonia occurs due to a mutation in DYT-1. To treat this, we can directly stimulate the globus pallidus internus.

DOPA-responsive dystonia

This type of childhood-onset dystonia occurs due to a mutation in GTP cyclohydrolase. As a result, this enzyme cannot reconvert dihydrobiopterin into tetrahydrobiopterin, which is a cofactor to tyrosine hydroxylase. Without this cofactor, tyrosine hydroxylase cannot form L-DOPA from tyrosine, so all-in-all, we don't get any dopamine. To treat this, we can just give levodopa.

prolonged traumatic coma

This type of coma occurs due to diffuse axonal injury.

Wallerian degeneration

This type of degeneration is seen when axons are damaged/severed. Essentially, it shows as distal degeneration of the axon. In other words, the piece of axon not attached to the soma will die (which makes sense, since it can't get nourished and the microtubule system supplying neurotransmitters is severed). For ascending tracts, we see this occur above where the spinal cord lesion occurred. For descending tracts, it's the opposite.

Wallerian degeneration

This type of degradation occurs after there's damage to a neuron's axon. The degradation occurs distal to where the damage happened.

frontotemporal dementia

This type of dementia has an early-onset. It leads to degeneration of the frontal and temporal lobes. It's due to mutations in tau or progranulin genes on Chromosome 17 or the C9ORF72 gene on Chromosome 9. Symptoms include a personality change, which leads to impaired social awareness and making inappropriate comments.

Parkinson's disease dementia

This type of dementia shows with Lewy bodies in association cortices. Specifically, it goes from motor areas, then to cognitive areas.

biphasic chorea dyskinesia

This type of dyskinesia occurs when levodopa is either beginning its effect or starting to wear off.

peak dose chorea dyskinesia

This type of dyskinesia occurs when levodopa is working very well, but almost too well to the point where it's causing excessive movement.

dystonia

This type of dyskinesia occurs when levodopa wears off, which leads to muscle cramps and posture issues.

post-infectious encephalomyelitis

This type of encephalomyelitis occurs AFTER a measles infection.

hepatic encephalopathy

This type of encephalopathy is due to liver damage, which causes lots of ammonia to concentrate in the brain. As a result, we get impaired neurons and brain edema.

pinpoint reactive pupils

This type of eye behavior is seen in a patient with a pontine lesion or opiate overdose. However, for a patient with an opiate overdose, this may be the only intact reflex (so we should also do a drug screening).

unilateral pupil fixed and dilated

This type of eye behavior is seen in a patient with a transtentorial herniation.

normally reactive pupils

This type of eye behavior is seen with a patient in a toxic metabolic coma.

midposition and fixed

This type of eye behavior is seen with a patient who's in a coma due to midbrain damage.

atonic seizure

This type of generalized seizure leads to a brief muscle tone loss, which can affect the entire body or just the nuchal muscles.

clonic seizure

This type of generalized seizure leads to shaking.

tonic seizure

This type of generalized seizure leads to stiffness of the body.

pediatric headache

This type of headache is mostly a migraine, but with shorter duration. We treat it with avoiding caffeine, maintaining normal BMI, and getting proper sleep (since most migraine medications aren't approved for this age group).

chronic daily headache

This type of headache is really a group of headache disorders that occur most days. It includes primary headache syndromes and secondary headache syndromes.

acute headache

This type of headache is secondary to primary or secondary headache syndromes. They get severe in seconds to minutes. The most common type is a thunderclap headache.

cluster headache

This type of headache is thought to occur due to serotonin or histamine release issues and hypothalamic dysfunction. It feels like a sharp, burning, steady pain that can be felt around or in the eye. Symptoms include tearing, swelling under the eye, scleral injection, a runny nose, and facial flushing. We can treat it with abortive treatments like 100% oxygen and also prevent it by avoiding tobacco and alcohol, high elevations, and by taking valproate.

thunderclap headache

This type of headache occurs due to a subarachnoid hemorrhage. Patient's usually describe it as the "worst headache I've ever had".

tension type headache

This type of headache occurs mainly in people aged 20 to 50. It feels dull and can show as a band around the head mainly affecting the frontal lobes and occipital lobes. Interestingly, it shows no typical headache symptoms (like photophobia or phonophobia). We can treat this with abortive medications like NSAIDs and aspirin, and prevent it with topiramate, valproate, and SSRIs.

subdural hematoma

This type of hematoma occurs between the arachnoid mater and dura mater. It usually occurs due to the tearing of bridging veins connecting the two layers. These are the more common hematoma, and can be divided into acute, sub-acute, and chronic types.

epidural hematoma

This type of hematoma occurs between the periosteal dura and skull. It usually occurs due to trauma to the temporal lobe, which results in rupturing of the middle meningeal artery. As a result, bleeding occurs, which can cause increased ICP (and then an uncal herniation).

Duret hemorrhage

This type of hemorrhage occurs due to an uncal herniation.

intracerebral hemorrhage

This type of hemorrhage occurs within brain tissue. The main cause is systemic hypertension.

central herniation

This type of herniation occurs due to a midline mass or uncal herniation. In either case, there's direct downward compression of the brainstem. As a result, we get a progressive neurological decline in consciousness, respiration, postural reflexes, and pupil contraction. Ultimately, it can lead to death.

cerebellar tonsillar herniation

This type of herniation occurs when the cerebellar tonsils herniate through the foramen magnum. As a result, they push on the respiratory center in the medulla oblongata.

hydrocephalus en vacuo

This type of hydrocephalus is NOT due to atrophy of cortex.

normal pressure hydrocephalus

This type of hydrocephalus is just communicating hydrocephalus that occurs over time, so the pressure remains normal. Symptoms include "wet" (urinary incontinence), "wobbly" (gait instability), and "wacky" (dementia).

CT with no contrast

This type of imaging is used to assess a patient in a coma. This is done because acute bleeding appears white, so the contrast could hide the bleeding.

polio immunity

This type of immunity is permanent, but monotypic (which just means it can differ a bit based on the type of polio someone has been infected with). Also, removing tonsils can lower this immunity.

Negri body

This type of inclusion body is seen with rabies infections. It itself is made-up of the rabies virus.

blunt injury

This type of injury can cause either open-head injuries or closed-head injuries. It occurs due to things like a car accident or getting hit in the head with a ball. As a result, we may also see depressed or non-depressed skull fractures.

penetrating injury

This type of injury is the primary cause of an open-head injury. It occurs due to things like a gunshot wound or stab wound. As a result, we also see depressed skull fractures.

aseptic meningitis

This type of meningitis gets its name because it is NOT caused by bacteria. Instead, it's caused by viruses. As a result, the main part of our immune system causing the response to the virus are our lymphocytes (unlike how neutrophils are the major responder for bacterial meningitis). Compared to bacterial meningitis, it is usually less severe with less symptoms, and does not show an increased CSF pressure. It also shows with normal protein and normal glucose levels.

acute meningitis

This type of meningitis occurs in the subarachnoid space.

reactive meningitis

This type of meningitis occurs when we see markers of infection in a lumbar puncture, but we don't actually find any pathogens. This is because the infection is NOT in the CSF, but somewhere else. We're just seeing the immune response in the CSF.

microglial nodules

This type of microglia form in response to injury. They are seen forming aggregates around necrosis.

rod cells

This type of microglia form in response to injury. They get their name for their elongated nuclei.

acute multiple sclerosis lesion

This type of multiple sclerosis lesion shows as a large loss of myelin and less oligodendrocytes, but most axons are preserved (so we get some re-myelination). We also see perivascular inflammation.

chronic multiple sclerosis lesion

This type of multiple sclerosis lesion shows as significant axon loss and lots of gliosis, with no re-myelination.

adult myoclonic seizure

This type of myoclonic seizure is occurs due to brain injuries from a lack of oxygen.

Purkinje cell death

This type of neuronal cell death occurs from acute carbon monoxide poisoning. It occurs in the cerebellum.

mercury poisoning

This type of poisoning affects the cerebellum and causes mental fatigue and polyneuropathy.

lead poisoning

This type of poisoning is especially dangerous for fetuses (since it can cross the placenta) and children (since they may ingest paint chips or dust). It affects both the CNS and PNS.

carbon monoxide poisoning

This type of poisoning is quite common. It occurs when people are around faulty furnaces, heating sources, or engine exhaust with no ventilation from the fumes. A result of this poisoning is hypoxia, due to carbon dioxide binding to hemoglobin, which causes hemoglobin to not release oxygen. This leads to confusion, loss of consciousness, necrosis, and even death.

chronic arsenic poisoning

This type of poisoning leads mainly to sensation issues.

nonparalytic poliomyelitis

This type of poliomyelitis will NOT cause paralysis. For this type, the incubation period is quite long: 7 to 21 days.

paralytic poliomyelitis

This type of poliomyelitis will cause paralysis. For this type, the incubation period is 3 to 6 days. We see it mostly in people who already have an acute motor neuron disease.

enhanced physiological tremor

This type of postural tremor occurs due to some biological reason, like you're feeling nervous or consumed too much caffeine.

essential tremor

This type of postural tremor occurs due to unknown reasons, so it's not pathological. It shows bilaterally in the hands and forearms, and usually does not show at rest. Interestingly, it gets better with alcohol use.

rest tremor

This type of postural tremor occurs when the body is at rest. It's seen with people who have Parkinson's disease.

short duration response

This type of response is seen in patients with Parkinson's disease. This response occurs because a drug's efficacy is starting to decrease. In other words, the drug is not as effective, so the patient sees shorter and shorter periods of time where their symptoms are fixed. To fix this, we adjust the dosing to match this window of time. So, if a 6 hour dose is now only effective for 3 hours, then we start giving it every 3 hours now.

early-onset restless leg syndrome

This type of restless leg syndrome is usually due to abnormal iron metabolism, which leads to brain iron insufficiency. As a result of low iron, the body enters a hyperdopaminergic state, which leads to these movements (probably because we get activation of the direct pathway and inactivation of the indirect pathway).

generalized seizure

This type of seizure affects the entire brain. It will show with no aura, postictal confusion, incontinence, and side of tongue trauma.

myoclonic seizure

This type of seizure is seen in infants, juveniles, and adults. It leads to muscle stiffening.

febrile seizure

This type of seizure occurs only in children between the ages of 6 months to 6 years old. They're secondary to a fever, so to fix them, we treat the fever.

sensory seizure

This type of seizure usually occurs because of a tumor.

non-depressed skull fracture

This type of skull fracture occurs due to blunt trauma. However, the skull remains intact (no shards in the brain).

depressed skull fracture

This type of skull fracture occurs due to either penetrating or blunt trauma. As a result, we see fragments of skull in the brain.

acute subdural hematoma

This type of subdural hematoma occurs due to rapid bleeding from a severe head injury. It shows with subarachnoid hemorrhaging. Symptoms develop pretty quickly (about two days later) and include loss of consciousness, headache, confusion, drowsiness, vomiting, and focal neurological signs. Between the three types of subdural hematomas, this one has the worst prognosis. On CT, this shows as a hyperdense crescent.

chronic subdural hematoma

This type of subdural hematoma occurs due to slow bleeding from frequent, yet mild trauma. It is seen mainly in infants and elderly, since for both, their vasculature are weak. Symptoms are quite delayed, so they don't develop for several weeks to months. They include headaches, drowsiness, unsteady gait, and focal neurological signs. On CT, this shows as a hypodense crescent.

terminal tremor

This type of tremor occurs due to cerebellar disease. We may see it occur with dysmetria, dysarthria, and nystagmus.

small cell lung carcinoma

This type of tumor is the most common cause of paraneoplastic syndromes.

supratentorial brain tumor

This type of tumor is what we typically see in adults.

primary infratentorial cerebellar brain tumor

This type of tumor is what we typically see in children. It appears like a posterior fossa space-occupying lesion, so it leads to headaches upon waking-up, nausea, vomiting, papilledema, and other cerebellar issues.

thiamine deficiency

This type of vitamin deficiency can lead to alcoholic polyneuropathy and Wernicke-Korsakoff syndrome.

cobalamin deficiency

This type of vitamin deficiency causes megaloblastic anemia (where our RBCs get really big because they're having an issue making nucleotides, due to issues with the one-carbon cycle). In the CNS, it causes subacute combined degeneration, where we see myelin degeneration of the white matter of the dorsal and lateral columns of the spinal cord. As a result, we get MVP deficits and UMN-type issues, respectively.

measles

This virus causes post-infectious encephalomyelitis and subacute sclerosing panencephalitis.

herpes simplex virus type II

This virus causes viral encephalitis mainly in neonates (since it's passed from the mother during birth).

cytomegalovirus

This virus causes viral encephalitis mainly in people with AIDS.

multiple sclerosis diagnosis

To diagnose this condition, we can do two things: MRI and a lumbar puncture. The MRI is done to look for lesions in the periventricular areas, brainstem, cerebellum, and spinal cord. Specifically, we may also use gadolinium to show us where any active lesions are. The lumbar puncture is done for us to analyze the CSF. We can look for low lymphocyte counts and oligoclonal gamma globulin bands.

mild traumatic brain injury

We call this type of brain injury the "silent pandemic", since it may lead to long-term cognitive issues, but not really show any symptoms at first.

last time known well

When assessing a stroke patient, this is the time when they were last normal. This is important for us to better understand how long the stroke's been going on, and based on that, what kind of damage has occurred. If the time is not long ago, then this could mean the stroke came from an embolism or hemorrhage (since it was so quick).

blink to threat

When conducting a neurological exam on a patient in a coma, this test is used to assess the optic nerve. Here, we bring our fingers close to the patient's eye to see if they blink.

emergent hospital evaluation

With a concussion, this should only occur if there's symptoms like loss of consciousness for more than 30 seconds, increased headache, repeated vomiting, aphasia, increased confusion, abnormal behavior, irritability, seizures, sensory and motor deficits, and bad neck pain. With these symptoms, we'd want to image the brain.