tailieunhanh - Differential Diagnosis in Neurology and Neurosurgery - part 8

Nhức đầu hội chứng Cervicocephalic do kích thích bởi vị trí đứng đầu một số bị ảnh hưởng bởi những thay đổi trong thời gian ngắn vị trí đầu (vị trí phụ thuộc vào) Giới hạn Không có cải thiện chuyển động cột sống cổ tử cung | 232 Spinal Disorders Cervicocephalic Syndrome Versus Migraine Versus Meniere s Disease Cervicocephalic syndrome Migraine Meniere s disease Headaches Triggered by certain head positions Spontaneous Spontaneous Affected by changes in head position Not affected by changes in head position Not affected by changes in head position Short duration position-dependent Pain persists for hours Pain persists for hours Nausea vomiting None Nausea and vomiting Vomiting Spinal movements Limitation of cervical spine motion Cervical muscle spasm Free motion Not limited Treatment Improvement with cervical traction cervical collar Improvement with ergotamine alkaloids Improvement with 20 glucose infusion and dehydration with loop diuretics Lasix Tsementzis Differential Diagnosis in Neurology and Neurosurgery 2000 Thieme All rights reserved. Usage subject to terms and conditions of license. Differentiation between Spasticity and Rigidity 233 Differentiation between Spasticity and Rigidity Spasticity is a component of the pyramidal syndromes rigidity is a component of the extrapyramidal syndromes. Brain lesions can affect both the pyramidal and extrapyramidal neural pathways causing mixtures of spasticity and rigidity as in cerebral palsy. Spasticity Rigidity Clinical findings Hypertonicity characteristics Clasp-knife phenomenon a catch and yield sensation elicited by quick jerking of the resting extremity Clonus Muscle stretch reflexes hyperactive Extensor toe sign Hypertonicity distribution Monoplegic hemiplegic paraplegic tetraplegic Predominates in one set of muscles such as flexors of the upper extremity extensors of the knee and plantar flexors of the ankle Associated neurological signs No specific signs Electrophysiological findings EMG No muscle activity at complete rest Lead-pipe phenomenon lead-pipe resistance elicited by a slow movement of the patient s resting extremity No clonus Muscle stretch reflexes not necessarily altered Normal plantar reflexes Usually in all four .