اليوم بلليل ادزلكم المحاضرات سويتلها نوتات او شرحتها🤝 لعل وعسى تستفادون منها
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هواي قنوات شارحه المادة واجرهم عند الله عظيم وبوركت جهودهم
ف الي حكدر اسوي ان جانت اكو فكرة بمكان معين لكيتها حدزها اهنا واشرحها ان شاء الله👍🏻
ف الي حكدر اسوي ان جانت اكو فكرة بمكان معين لكيتها حدزها اهنا واشرحها ان شاء الله👍🏻
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Marcus gunn pupil
تصير بلMS
هو انه وحدة من العينين بل swinging light test
تستجيب عكس الاستجابة طبيعية🤝
تصير بلMS
هو انه وحدة من العينين بل swinging light test
تستجيب عكس الاستجابة طبيعية🤝
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اذا شخص شااااااب اجاك bilateral trigeminal nerve palsy
وخاصة مضروب عده
Bilateral opthalmic nerve division(V1)
اول شيء نفكر بي ندزه
MRI
نشوف عنده MS لا‼️
وخاصة مضروب عده
Bilateral opthalmic nerve division(V1)
اول شيء نفكر بي ندزه
MRI
نشوف عنده MS لا‼️
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Lesion occurs in MLF (Medial longitudinal fascicules) Pt present with diplopia, when Dr examined pt he see one eye is diverged outward (in primary position), no ptosis, and pupil is normally, Do H maneuver, you see that one of they eyes not adducted & and the adducted eye have nystagmus So there loss of adduction on line eye (e.g. left eye) and nystagmus of abducted eye (right eye) The site of INO is at the side eye that lost adduction (lesion in the left MLF in this case)
• If bilateral in young female this pathognomonic for MS
• Id unilateral could be MS, or if unilateral in Elderly patient = could be stroke in the Pons
• If bilateral in young female this pathognomonic for MS
• Id unilateral could be MS, or if unilateral in Elderly patient = could be stroke in the Pons
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Study room 808
Lesion occurs in MLF (Medial longitudinal fascicules) Pt present with diplopia, when Dr examined pt he see one eye is diverged outward (in primary position), no ptosis, and pupil is normally, Do H maneuver, you see that one of they eyes not adducted & and…
What is next step?MRI to exclude MS
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(Uhthoff phenomenon).
Means, one with old deficits like paraparesis, but recovered and there is usually only simple effect, when exposed to high temperatures or severe stress = deteriorated (in this case leg weakness) - in Hx taking, ask him do you have old attack, and if the same symptoms, he will tell you yes I have old attack it is the same one (Fixed), ask him about high temperature exposure ( he answers yes either hot water or exposure to sun), ask him how long weaknesses prolonged ? It must be less than 24 hr ( this is not true attack, this is uhthofs phenomenon) and this occurred due to decrease in the conduction velocity in the de-myelinated axons and could be treated or prevented ? By Thiamine B1 daily pill - while if prolonged more than 24 hr this is new attack “relapse” so investigation and examination is needed and treat as new relapse ( Steroids )
Means, one with old deficits like paraparesis, but recovered and there is usually only simple effect, when exposed to high temperatures or severe stress = deteriorated (in this case leg weakness) - in Hx taking, ask him do you have old attack, and if the same symptoms, he will tell you yes I have old attack it is the same one (Fixed), ask him about high temperature exposure ( he answers yes either hot water or exposure to sun), ask him how long weaknesses prolonged ? It must be less than 24 hr ( this is not true attack, this is uhthofs phenomenon) and this occurred due to decrease in the conduction velocity in the de-myelinated axons and could be treated or prevented ? By Thiamine B1 daily pill - while if prolonged more than 24 hr this is new attack “relapse” so investigation and examination is needed and treat as new relapse ( Steroids )
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شوكت تحلف هل شخص عده MS من تسوي CSF electrophoresis وتلكه عده oligoclonal band
وراها تسوي MRI
وراها تسوي MRI
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Study room 808
شوكت تحلف هل شخص عده MS من تسوي CSF electrophoresis وتلكه عده oligoclonal band وراها تسوي MRI
اما بقية تحاليل كلها to exclude بس للأسف هل تيست موجود بس ب٩٠٪ اما ال١٠% نطبق عليهم الMcDonald criteria ولهذا شافوا هل كرايتيريا احسن👍🏻
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