19 years old-emirati - student

19 years old-emirati - student

1. present with

   • cordination symptoms
     • clumsiness
   • motor symptoms
     • difficulty walking
   • sensory symptoms
     • numbness

2. Differential Diagnosis

   • Upper motor neuron lesions
     • encephalitis
       • capsular hemiplegia
         • trauma
           • Neurosyphyllis
   • lower motor neuron lesion
     • Poliomyelitis
       • Guillain–Barré
         • Spinal root lesions
           • cauda equina syndrome
   • physical examination
     • grading muscle power
       • gaits
         • spastic gait
           • Dragging stiff leg due to spasticity
             • causes
               • cerebral palsy (CP)
               • birth trauma
               • brain abscess
               • brain tumor
         • ataxic
           • Myopathy
         • parkinosian
         • steppage
   • investigations
     • MRI
       • CT
     • CBC
     • CSF analysis
     • each have indications
   • syringiomyelia
     • The normal
       • physiology of muscles
         • muscle sensors
           • muscle spindles
             • Ia + II
           • golgi tendon
             • Ib
         • muscle fibers
           • Extrafusal fibers
             • a-motorneuron
           • Intrafusal fibers
             • g-motorneuron
         • intrafusal fibers
           • Nuclear bag
             • Dynamic changes
               • Ia
           • Nuclear chain
             • static changes
               • II
       • physiology of spinal cord
         • pathway of pain and temperature
           • dermatomes
         • reflex
       • anatomy
     • causes
       • tumor
       • trauma
       • infection
       • arnold chiari malformation
         • posterior fossa deformity
           • tonsilar herination
             • CSF trapping and syrinx formation
               • syrinx expansion and compression of spinal cord structure
     • management
       • surgery
         • posterior fossa decompression
           • +aspiration
             • +/- shunting
               • complications
                 • hemorrhage
                   • spinal cord tethering
                 • infection
                   • shunt failure
                 • follow up
                   • psychological counselling
                     • to help the patient regain his life
                   • monitoring complications
                     • of both surgery and the disease
                   • prognosis
                     • progressive disease
                       • sooner intervention
                         • better outcome
                       • can lead to permenant nerve damage
                         • numbness
                           • weekness

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