-Precipitated by sudden voluntary movement
-Most common paroxysmal movement disorders
-Multiple attacks, frequency up to 100/day
-Attacks are brief, seconds
-Antiepileptic drug responsiveness
- Precipitated by a prolonged or sustained exercise
- Onset childhood
- Attacks: 2-5 min (up to 2 hours), stop within 10 min after stopping exercise
- Most common presentation dystonia
- Relationship: Young-onset PD, GLUT1 def, DYT 9& 18
- Restrict exercise
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- Is this a real paroxysmal movement disorder?
- Attacks occur during Non-REM sleep
- Many attacks < 1 min, can be indistinguishable from frontal lobe epilepsy
- Dystonic posturing, ballistic or choreic movements, without ictal EEG abnormalities
- ADCY-5 mutation!
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The cavity of the diencephalon is ----- the 3rd ventricle
All of the structures of the diencephalon are around the 3rd ventricle, so the cavity of the diencephalon is the 3rd ventricle.
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Parts
a. level of consciousness
b. vital signs (BP & breathing pattern)
c. cranial nerves (fundoscopy + vision + brainstem)
d. motor & sensory
e. reflex
f. meningeal signs
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Level of consciousness
Normal
Clouding of consciousness
Confusion/delirium
Lethargy
Obtundation
Stupor
Coma
Meningitis
-inflammation of leptomeninges & underlying subarachnoid CSF
Meningismus
-morbid state characterized by meningitic syndrome (triad: headache, photophobia, nuchal rigidity)
Meningism
-synonymous of meningismus
-neck stiffness w/o meningeal inflammation
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Mechanism
“maneuvers used to elicit meningeal signs produce tension on inflamed and hypersensitive spinal nerve roots, and the resulting signs are postures, protective muscle contractions, or other movements that minimize the stretch and distortion of the meninges and roots”
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