introduction to neuropathology

8/18/2019 introduction to neuropathology

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INTRODUCTION

to NEUROPATHOLOGY


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NEUROPATHY, Inflammatory

• Guillain-Barré

–Pr!"!#!# $y %influ!n&a'-

li(!, or )iral li(!, illn!** – NO a"tual *+!"ifi" !tioloi" a!nt i*olat!#,

autoimmun! #i*!a*! to my!lin anlio*i#!* mo*tli(!ly

– Inflammation of a +!ri+!ral n!r)! – DE.YELINATION

– %A/CENDING' +araly*i* 0LO1ER !2tr!miti!*$!for! UPPER !2tr!miti!*3

– INCREA/ED PROTEIN IN C/4


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NEUROPATHY,

To2i"5.!ta$oli"

Dia$!t!* .!llitu*0*6oll!n a2on*3

7itamin D!fi"i!n"i!* 0many B*, E3

H!a)y .!tal*, P$, A*, !t"8

Orani" Com+oun#*

CHE.O


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DE.YELINATIONA diabetic ulcer is JUST AS MUCHrelated toNEUROPATHY asISCHEMIA!!!


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1at (in# of +i"tur!6oul# you *!! in a

y#ro"!+alu* "au*!#

$y a9u!#u"tal

*t!no*i*:


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IN4ECTION/• .!niniti* 0!n!rally $a"t!rial3

– E8 "oli, /tr!+ B 0n!onat!*3 – H8 influ!n&a! 0"il#r!n3

– N!i**!ria m!niniti#i* 0a#ult*3

– /tr!+8 +n!umonia!, Li*t!ria 0!l#!rly3

– NUCHAL RIGIDITY,P.N* in C/4, INCREA/ED+rot!in, REDUCED lu"o*! only in BACTERIALm!niniti*, NOT )iral

• En"!+aliti* 0!n!rally )iral3 – Ar$o)iru*!*, H/7, C.7, 75;, +olio, ra$i!*, HI7 – Lym+* an# ma"ro+a!* in +!ri)a*"ular %7ir"o6-

Ro$$in*' *+a"!*

• .!nino!n"!+aliti*

* viral, chemical, tumoral


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ACUTE 4OCAL /UPPURATI7E

CN/ IN4ECTION/

• CEREBRAL AB/CE//E/ – Lo"al 0ma*toi#iti*, *inu*iti*3

–H!mato!nou* 0toot !2tra"tion, *!+*i*3 – /ta+, /tr!+

– Oft!n fi$rou* "a+*ul!, li9ui# "!nt!r

• /UBDURAL E.PYE.A 0IN /INU/ITI/3

• E


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CHRONIC BACTERIAL

.!nino-!n"!+alit*• TB, $rain an# m!nin!*• /YPHILI/, umma* in $rain,

+o*t!rior "olumn#!!n!ration, "au*in lo** of

$alan"! 6it !y!* "lo*!#

0Rom$!r *in3 an# +ro*titut!

+u+il*

• LY.E DI/EA/E 0N!uro-Borr!lio*i*3


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PERI7A/CULAR

GIANT CELL/ in

1HITE .ATTER

In HI7

ENCEPHALITI/

*** ***


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OTHER/• .ALARIA

• TO


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./ > AUTOI..UNE• Cau*!? :

• U/A +r!)al!n"!? @?@• 4., A!*? *, *• Immun! r!*+on*! +rimarily aain*t CN/ my!lin 06it!

matt!r3, .BP 0.y!lin Ba*i" Prot!in3

• R!ional ar!a of 6it! matt!r olio#!n#ro"yt!#!my!lination i* "all!# %PLAFUE'

• In"r!a*!# C/4 amma lo$ulin, i8!8, olio"lonal $an#*

• Oft!n +r!*!nt* "la**i"ally 6it 7I/UAL +ro$l!m*

/COTO.ATA, an#+ar!*t!*ia*CCPP:

• E


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CN/ DEGENERATI7E DI/EA/E/

• CORTE< 0#!m!ntia*3, DUH

• BA/AL GANGLIA an# BRAIN

/TE. 0+ar(in*onian3• /PINOCEREBELLAR 0ata2ia*3

• .OTOR NEURON/ 0mu*"l!atro+y3


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• CORTE< 0#!m!ntia*3, 6y i*ti* r!#un#ant:

–AL;HEI.ER DI/EA/E TAU/ – 4rontot!m+oral

– Pi"( Di*!a*! 0al*o +rimarily frontal3

–Pror!**i)! /u+ranu"l!ar Pal*y 0P/P3

–Corti"oBa*al D!!n!ration 0CBD3

– 7a*"ular D!m!ntia* 0.ID3


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AL;HEI.ER DI/EA/E

• Commonest cause of dementias (majority)• Sporadic, 5-1! familial

• CORTICAL 0r!y matt!r3 ATROPHY

• NEURITIC PLAFUE/0!2tran!uronal3

• NEURO4IBRILLARY TANGLE/0intran!uronal3

• A.YLOID 0i8!8, %BETA' amyloi#3


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HUNTINGTON DI/EA/E• Cla**i"al

familial,!n!ti" #i*!a*!

• Pror!**i)! motorlo** an# #!m!ntia

• %"or!a', i8!8%6ritin,

!r(y'mo)!m!nt*

• Pror!**i)!, fatal

• Atro+y of $a*alanlia, i8!8, "or+u**triatum Corti"al 0$a*al anlia3 atro+y

7!ntri"ular !nlar!m!nt


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• /PINOCEREBELLAR

DEGENERATION/ 0ATA


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Amyotro+i" Lat!ral /"l!ro*i*

• Un(no6n !tioloy

• Pror!**i)! mu*"l! atro+y atro+y an#

6!a(n!** #u! to motor n!uron lo** 0lo6!r,

u++!r3• J-@K familial

• Lou G!ri a# it, *o #o!* /t!)!n Ha6(in

• CCPP? Han# 6!a(n!**, an# mu*"l! atro+y ri*in %a*"!n#in' to #ia+ram

• Ant!rior orn "!ll* r!#u"!# an# lioti"


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ACFUIRED TO


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15= .A.ILLARY BODIE/




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1"# $%

/CD >

DOR/AL

COLU.N

DI/EA/E > HIGH

.C7:::


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%PARA'-NEOPLA/TIC /YNDRO.E/

•/.ALL

CELL,LUNG

• LY.PHO.A/• BREA/T CA

• Pur(in! C!ll

D!!n!ration

• En"!+aliti*, Lim$i"

/y*t!m

• /!n*ory N!uron

D!!n!ration, DRG, #u!

to auto-A$*, #!"r!a*!#PAIN

• Ey! .o)!m!nt

Di*or#!r*

Documents

introduction to neuropathology