19 years old-emirati - student

present with
1. cordination symptoms
  1. clumsiness
2. motor symptoms
  1. difficulty walking
3. sensory symptoms
  1. numbness
Differential Diagnosis
1. Upper motor neuron lesions
  1. encephalitis
    1. capsular hemiplegia
      1. trauma
        Neurosyphyllis
2. lower motor neuron lesion
  1. Poliomyelitis
    1. Guillain–Barré
      1. Spinal root lesions
        cauda equina syndrome
3. physical examination
  1. grading muscle power
    1. gaits
      1. spastic gait
        Dragging stiff leg due to spasticity
        causes
        cerebral palsy (CP)
        birth trauma
        brain abscess
        brain tumor
      2. ataxic
        Myopathy
      3. parkinosian
      4. steppage
4. investigations
  1. MRI
    1. CT
  2. CBC
  3. CSF analysis
  4. each have indications
5. syringiomyelia
  1. The normal
    1. physiology of muscles
      1. muscle sensors
        muscle spindles
        Ia + II
        golgi tendon
        Ib
      2. muscle fibers
        Extrafusal fibers
        a-motorneuron
        Intrafusal fibers
        g-motorneuron
      3. intrafusal fibers
        Nuclear bag
        Dynamic changes
        Ia
        Nuclear chain
        static changes
        II
    2. physiology of spinal cord
      1. pathway of pain and temperature
        dermatomes
      2. reflex
    3. anatomy
  2. causes
    1. tumor
    2. trauma
    3. infection
    4. arnold chiari malformation
      1. posterior fossa deformity
        tonsilar herination
        CSF trapping and syrinx formation
        syrinx expansion and compression of spinal cord structure
  3. management
    1. surgery
      1. 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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19 years old-emirati - student

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	Criado por yousaf alabrash mais de 6 anos atrás