Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord. Causes, incidence, and risk factors Multiple sclerosis (MS) affects women more than men. The disorder is most commonly diagnosed between ages 20 and 40, but can be seen at any age. MS is caused by damage to the myelin sheath. The nerve [...]

A subarachnoid hemorrhage presents as: Sudden Severe Headache (occasionally there we be a sentinal headache at the initiation of the bleed) Nausea and/or vomiting Symptoms of meningeal irritation (ie: neck stiffness, low back pain, bilateral leg pain): These are seen in more than 75% of cases of subarachnoid hemorrhage Photophobia and visual changes Loss of [...]

Painless loss of monocular vision is the usual presenting symptom of retinal artery occlusion. Ocular stroke commonly is caused by embolism of the retinal artery. Retinal artery occlusion represents an ophthalmologic emergency, and delay in treatment may result in permanent loss of vision. Immediate intervention improves chances of visual recovery, but, even then, prognosis is [...]

Here are the normal parameters : Pressure          = 50-180 mmH2O Color                = clear RBC count       = 0-4 x 10^6/L WBC count      = 0-4 x 10^6/L Glucose            = >60% of the serum level Protein             = < 0.45 g/L Microbiology   = sterile//no growth Subarachnoid haemorrhage : Pressure increased, bloody, RBC count increased, WBC = normal/increased, glucose = normal, protein = increased, [...]

Exclusion of other treatable diseases is imperative (parasagittal foramen magnum tumors, spinal AV malformation, cervical spondylosis, etc.). Neurodegenerative disorder involving lower motor neurons (anterior horn cells and their brain stem homologues) and upper motor neurons (layer 5 of motor cortex). Involvement of both motor neurons types is characteristic (although disease may start with either type [...]

Von Hippel-Lindau syndrome – Retinal angiomas, cerebellar hemangioblastomas Li-Fraumeni syndrome  - Glial tumors, medulloblastoma Werner syndrome (MEN-1)  - Pituitary adenomas, malignant schwannomas Von Recklinghausen’s disease type 1 – Neuroma, schwannoma, meningioma, optic glioma Neurofibromatosis type 2 – Glial tumors Retinoblastoma – Retinoblastoma, pinealoblastoma Tuberous sclerosis – Astrocytoma Turcot syndrome – Astrocytoma, medulloblastoma

Autosomal dominant inheritance Consists of retinal angiomas and cerebellar hemangioblastomas (slowly growing cystic tumors occurring at any age) Hemangiomas of spinal cord, hypernephroma, pheochromocytoma and cysts of the kidney, pancreas, liver and epididymis also occur. Polycytemia due to erythropoetin production in cerebellar hemangioblastomas may also be seen.

It is inherited as autosomal dominant trait. It is characterized by cutaneous lesions, seizure, and mental retardation (hydrocephalus is also seen). Cutaneous lesions include adenoma sebaceum, leaf-shaped hypopigmented macules (best seen under the Wood’s lamp), shagreen patches (yellowish thickening of the skin over lumbosacral area), and depigmented nevi. Rhabdomyomas of the myocardium, angiomyomas of the [...]

Neurofibromatosis type 1 (NF1) – (Von Recklinghausen disease) is characterized by multiple neurofibromas (benign tumors of peripheral nerves), café au lait spots (six of them bigger than 1.5 cm in diameter is enough for diagnosis), hamartomas of the iris (Lisch nodules). Other features include axillary freckling, pseudoarthrosis of the tibia, hydrocephalus (due to aqueductal stenosis), [...]

It is the most common cause of intracerebral mass in patients with AIDS. About a third of patients present with confusional state that lasts for days or weeks. Other clinical features include fever, focal neurologic abnormalities (cranial nerve palsies, hemiparesis, seizures, headache, and signs of meningeal irritation). Serologic tests for toxoplasmosis are unreliable in patents [...]

It is thought to be caused by rapid removal of urea and other molecules from blood, leading to relative hypo-osmolality of extracellular fluid and shift of water into the brain. Rapid correction of acidosis may also contribute by aggravation of cerebrospinal fluid (CSF) acidosis (as CO2 diffuses to CSF). It is most common after patient’s [...]

Astereognosis – Inability to recognize objects by touching with hand. Agraphesthesia – Inability to identify a number written on the hand. Allesthesia – phenomenon in which patient wrongly perceives location of tactile stimulus. Extinction – A visual or tactile stimulus is perceived when applied alone to side contralateral to lesion, but not when stimulus is [...]

Myasthenia gravis is a relatively rare autoimmune disorder of peripheral nerves in which antibodies form against acetylcholine (ACh) nicotinic postsynaptic receptors at the myoneural junction. A reduction in the number of ACh receptors results in a characteristic pattern of progressively reduced muscle strength with repeated use of the muscle and recovery of muscle strength following [...]

Sporadic degenerative disorder with neuronal loss, gliosis, and neurofibrillary tangles in the midbrain, pons, basal ganglia, and dentate nuclei of the cerebellum  It is a neurodegenerative disease that affects cognition, eye movements, and posture. Marked impairment of voluntary downward and horizontal gaze distinguishes disorder from Parkinson’s disease (also extended, rather than flexed dystonic posturing of [...]

This is a simultaneous or sequential involvement of noncontiguous nerve trunks.  Mononeuritis multiplex is a painful asymmetric asynchronous sensory and motor peripheral neuropathy involving isolated damage to at least 2 separate nerve areas. Multiple nerves in random areas of the body can be affected. As the condition worsens, it becomes less multifocal and more symmetric. [...]