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NeurologicalSyndromesJolantaStrzelecka
KlinikaNeurologiiDziecięcejWUM
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Pyramidalsyndrome
• paralysis,paresiso=enmassive(mulAplemusclegroups)• monoplegia,monopareza• hemipareza,hemiplegia• tatrapareza,tetraplegia• parapareza,paraplegia• enhanceofmusculartension-typepocketknife• hyperreflexiadeepreflexeswithJacobsonreflex,patella
shakeandfootshake• eliminaAonorweakeningoftheskinreflexes(abdominal,
plantar)• pathologicalreflexes(Babiński,Rossolimo,Oppenhaim,
Gordon,Chedock)
arisesfromdamagetothepyramidaltract
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Thetypesofsyndromesspas8cparalysis,dependingontheloca8onoflesions
• monopareza-damagetothecerebralcortex• paralysisoftheshoulder-faceorbothlegs
onthesameside-subcorAcalwhitemaQerdamage
• par8alparalysisonthesidecontrarytothesidewherenervesaredamaged,parAalydamagedfeelings,hemianopsiahomonyma,hearingdamage-capsulainternadamage,
• alterna8ngsyndrome-damagetothebrainstematdifferentlevels(paralysisofthecranialnervesatthesidewherethebraindamageisandhemiparesisontheoppositeside)
• tetraplegiatetrapareza–damageinthespinalsteminthecervicalspine
• paraplegia(parapareza)damageinthespinalsteminthethoracicspine
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Flaccidsyndromedamagetoperipheralneu(ron)alpathwayi.e.
inthecaseofdamageofganglioncellsofanteriorhorncellsofthespinalcordorthesamemotornucleusofthecranialnerve,anteriorrootsandperipheralnerves
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• paralysisorparesisofmuscleswithnervesbydamagedbyperipheralneuron(limitedparalysis
• decreaseinmusclestension• decreaseordisapperanceofdeepreflexes• muscularatrophy• electricalreacAondegeneraAonorneurogenicrecordinEMG
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Sensoryirrita8onsyndromes
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Scia8ca(Ischialgia)syndrome
• Spontaneouspainalongthenerve`slength• Painfulcompressionalongthenerve• Stretchablepain
arisesasaresultofirrita8onofrootofperipheralnerves
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Sensibledeficitsyndromes
Theyareformedasaresultofdamagetothesensorypathways
• Symptomes:reducAon(hypaesthesia)ordisappearance(anesthesia)ofsensaAon
Sensorydeficitperipheralsyndrome
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Syndromaradiculare
• sensorydisturbancescorrespondtotherootinnervaAon
• superficialsensorydisturbancesapplytoallkindsofsensiAvity
• therecanalsooccurdeepsensorydisturbances
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Mixedsyndromes
Hemiparaplegic
syndrome–causedbydamagetoonehalfof
thespinalcord
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Transversusspinalcordrupturesyndrome
• damageofspinalcordindorsalpart-paralysisoflegs(lowerlimbs)
• damageofspinalcordincervicalpart–paralysisofallthelimbs
• disappearanceofallkindsofsensoryofcord-typebelowtheinjurysiteinthespinalcord
• disappearanceofbodylocaAonsensors• appearanceofadefensereflexasasignofspinalautomaAsm
• analsphinctersdysfuncAonusuallyofastopnature• erecAledysfuncAon
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Cerebellarsyndrome• ataxia-incoordinaAon,incoherence• dismetria-lackofadequatemeasures
inthemovements• adiadochokinesia-inabilitytomake
rapidalternaAngmovement• decreasedneuromusculartone• nystagmus• imbalance,posiAveRomberg`stest–
paAentfallswhenstandingwithfeettogether,openorclosedeyesandhandsinfront.
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Cerebellopon8neanglesyndrome
symptomscausedbyatumorintheareapon8neangle-cerebellar
• symptomsofnervedamageVIII:hearingdisorders,uncomfortableAnnitus,verAgo
• symptomsofnervedamageV:decreaseorlackofcornealreflex,hypoesthesiaoftheface
• symptomsofnervedamageVII:peripheralparesis
• symptomsofdamagetothenervesIX,XandXII
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Bulbarpalsy
• dysphagia(difficultyinswallowing)• difficultyinchewing• nasalregurgitaAon• slurringofspeech• difficultyinhandlingsecreAons• chokingonliquids• dysphonia(defecAveuseofthevoice,inabilitytoproducesoundduetolaryngealweakness)
• dysarthria(difficultyinarAculaAngwordsduetoaCNSproblem)
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Extrapyramidalsyndrome
• movementsslowbutgoodmusclestrength
• abnormalpostureandmuscletone
• abnormalphysiologicaladdiAonalmovements-nobalancinglimbswhenwalking
• disordersintheareaofcomplexuncondiAonedreflexes-protecAngheadagainsthi_ng,runningaway
• abnormalfacialexpressions,gesAculaAon,voicemodulaAon
arisesfromdamagetothebasalganglia
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Parkinsonsyndrome
damagetotheglobuspallidus,the
substanAanigra
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Choreasyndrome
damagetothestriatum(caudatenucleus)
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Intracranialhipertensionsyndrome(raisedICP)
It’seleva8onofthepressureinthecranium.Itarisesfromtherela8onbetweenthecapacityandthecontentsoftheskull.
• Headaches• ProjecAlevomiAngwithoutnausea,usuallyinthefasAngstate• Dizziness• Bradycardia-lowheartrate• Generalizedseizures• AlteredmentalfuncAoningintheformofaslowdown,apathy• PapilloedemaattheboQomoftheeye• EdemaintheEEG
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Meningealsyndrome
Meningismarisesfrominflamma8on,hemorrhage,tumor
• meningialsigns-Kernig`s,Brudziński`ssigns• Opistothonus• hyperaesthesiatotacAlesAmuli,sound,light–increasedsensiAvitytosAmulaAon
• headaches,vomiAng
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Thankyou