What's the characteristic clinical pattern of symptoms in MS?
Waxing and waning unilateral visual impiarment (diplopia/optin neuritis) and facial numbness
What's the etiology of MS?
Immune mediated demyelination via CD4 against myelin antigens
What's the genetic association of MS?
- HLA DR2
- 15x higher prevelence in first-degree relatives
What's the location of MS involvement?
Angles of lateral ventricle, (50%) optic neves, brainstem, cerebellum
What are histological features of active MS disease?
- PAS-Positive macrophages
- perivascular cuffs
- Axonal preservation
What's the charcterisitc lab finding of MS?
Oligoclonal bands in CSF electrophoresis
What are clinical symptoms of severe Poliovirus infection?
- Fever/neck rigidity
- cramping, muscle pain, fasiculations
- Respiratory paralysis
What are gross features of polio encephalomyelitis?
- Congestions/edema of cord
- Hemorrhage within cord gray matter
Where's the primary spinal cord involvement in polio encephalomyelitis?
- Anterior horn MN destruction
- Progression to cranial nerve nuclei (bulbar polio)
What are the common clinical symptoms of poliovirus infection?
What's the most common demographic for polio infection?
Rural disadvantaged areas with lack of immunization
What's the most common area of involvement of medulloblastoma/PNET?
What's the common histological pattern of medulloblastoma?
- Anaplastic cells with hyperchromatic nuclei
- Small blue cell
- Homer Wright Rosettes
What are the most common areas of involvement for cysticercosis?
brain, muscles, skin, heart
What is the most common clincial symptom of neurocysticercosis?
- Seizures (active cystic lesions) -> Antigenic Hydrocephalus -> Demise
What's the best method for detection of cysticercosis?
- Poor in single/calcified involvement
What's the species of infection in cysticercosis?
What are clinical findings of meningitis?
- Fever, headache, stiff neck, stupor
- Kernig sign, Brudinski sign
What's the Kernig sign?
with thigh flexed, the leg cannot be extended
What's the Brudzinski signs
With flexion of neck there is reflex flexion of ankle, knee and hip
What's normal ICP?
Less than 200 mm H2O
What are CSF signs of bacterial meningitis?
- cloudy or purulent fluid
- increased pressure
- numerous neutrophils
- increased protein
- decreased glucose
What are CSF signs of viral meningitis?
- elevated lymphocytes
- mild protein elevation
- normal glucose
What are CSF signs of TB meningitis?
- elevated lymphocytes
- marked protein elevation
- very low glucose
What histological finding is present in bacterial meningitis?
Neutrophilig infiltrate in subarachnoid space without extension into parenchyma
What's the cause of bacterial meiningitis in neonates?
Group B streptococci, E. coli
What's the cause of bacterial meiningitis in Infants and children?
What's the cause of bacterial meiningitis in adolescents nad young adults with petichiae/purpuric skin lesions?
What's the cause of bacterial meiningitis in the very young/old?
What are gross findings in Rabies Encephalitis
Edema and vascular congestion of brain/brain stem
What are histological findings in Rabies Encephalitis?
Neuronal degeneration, chronic inflamation, negri bodies
What's the location of involvement of chronic inflamation in Rabies Encephalitis?
Mid-brain, basal ganglia, floor of 4th ventricle
Whats the etiology/pathogenesis of Rabies Encephalitis?
- Ascending through peripheral nerves to CNS
- 1-3 month 'lag time' depending on location of bite
What are clinical symptoms of Rabies Encephalitis?
- CNS Excitability
- Painful, violent motor response/convulsions
- Respiratory failure