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What's the characteristic clinical pattern of symptoms in MS?
Waxing and waning unilateral visual impiarment (diplopia/optin neuritis) and facial numbness
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What's the etiology of MS?
Immune mediated demyelination via CD4 against myelin antigens
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What's the genetic association of MS?
- HLA DR2
- 15x higher prevelence in first-degree relatives
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What's the location of MS involvement?
Angles of lateral ventricle, (50%) optic neves, brainstem, cerebellum
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What are histological features of active MS disease?
- PAS-Positive macrophages
- perivascular cuffs
- Axonal preservation
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What's the charcterisitc lab finding of MS?
Oligoclonal bands in CSF electrophoresis
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What are clinical symptoms of severe Poliovirus infection?
- Fever/neck rigidity
- cramping, muscle pain, fasiculations
- Respiratory paralysis
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What are gross features of polio encephalomyelitis?
- Congestions/edema of cord
- Hemorrhage within cord gray matter
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Where's the primary spinal cord involvement in polio encephalomyelitis?
- Anterior horn MN destruction
- Progression to cranial nerve nuclei (bulbar polio)
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What are the common clinical symptoms of poliovirus infection?
mild gastroenteritis
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What's the most common demographic for polio infection?
Rural disadvantaged areas with lack of immunization
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What's the most common area of involvement of medulloblastoma/PNET?
85% cerebellum
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What's the common histological pattern of medulloblastoma?
- Anaplastic cells with hyperchromatic nuclei
- Small blue cell
- Mitosis
- Homer Wright Rosettes
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What are the most common areas of involvement for cysticercosis?
brain, muscles, skin, heart
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What is the most common clincial symptom of neurocysticercosis?
- Seizures (active cystic lesions) -> Antigenic Hydrocephalus -> Demise
- Calcifications
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What's the best method for detection of cysticercosis?
- EITB
- Poor in single/calcified involvement
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What's the species of infection in cysticercosis?
Taenia solium
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What are clinical findings of meningitis?
- Fever, headache, stiff neck, stupor
- Kernig sign, Brudinski sign
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What's the Kernig sign?
with thigh flexed, the leg cannot be extended
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What's the Brudzinski signs
With flexion of neck there is reflex flexion of ankle, knee and hip
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What's normal ICP?
Less than 200 mm H2O
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What are CSF signs of bacterial meningitis?
- cloudy or purulent fluid
- increased pressure
- numerous neutrophils
- increased protein
- decreased glucose
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What are CSF signs of viral meningitis?
- elevated lymphocytes
- mild protein elevation
- normal glucose
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What are CSF signs of TB meningitis?
- elevated lymphocytes
- marked protein elevation
- very low glucose
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What histological finding is present in bacterial meningitis?
Neutrophilig infiltrate in subarachnoid space without extension into parenchyma
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What's the cause of bacterial meiningitis in neonates?
Group B streptococci, E. coli
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What's the cause of bacterial meiningitis in Infants and children?
Staph pneumoniae
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What's the cause of bacterial meiningitis in adolescents nad young adults with petichiae/purpuric skin lesions?
N. meningitidis
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What's the cause of bacterial meiningitis in the very young/old?
Listeria monocytogenes
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What are gross findings in Rabies Encephalitis
Edema and vascular congestion of brain/brain stem
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What are histological findings in Rabies Encephalitis?
Neuronal degeneration, chronic inflamation, negri bodies
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What's the location of involvement of chronic inflamation in Rabies Encephalitis?
Mid-brain, basal ganglia, floor of 4th ventricle
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Whats the etiology/pathogenesis of Rabies Encephalitis?
- Ascending through peripheral nerves to CNS
- 1-3 month 'lag time' depending on location of bite
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What are clinical symptoms of Rabies Encephalitis?
- CNS Excitability
- Painful, violent motor response/convulsions
- Hydrophobia
- Respiratory failure
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