WILTIMS #244: Neuro strikes back!

Today we transitioned from respiratory diseases to neurological ones. Didn't you take an entire class on neuro last year? you might reasonably ask. Yes. And though that class was much more centered on the anatomy, we sure did an awful lot of pathology too. The same goes with learning neuro drugs in our behavioral science class last year, which we are duplicating in pharmacology now. There will be lots of overlap, but that neuro/behavioral block was brutal and we could use a refresher as we approach boards. I will, however, try not to repeat things from last year's blog posts.

TIL: Gerstmann's syndrome is a disorder caused by a lesion in the inferior parietal lobule of the dominant hemisphere of the brain. It has a very specific constellation of symptoms:
 • Dysgraphia/agraphia (inability to write)
 • Dyscalculia/acalculia (unusual difficulty with math)
 • Finger agnosia (inability to distinguish the fingers on the hand)
 • Left-right disorientation

Remember, just because you're bad at math or remembering your left from your right, doesn't mean you have a neurological disorder. All of these symptoms are compared with your baseline. 

One interesting symptom you can test to detect optic neuritis (inflammation of the optic nerve) is red desaturation. This is when a part of the vision in one or both eyes is damaged in such a way that red doesn't look as red as red should look. Parts of the field of vision will look more pink or orange when viewing a true, rich red.

Hoffmann's sign is used to demonstrate heightened reflexes in the muscles of the hands. This is the upper limb version of the Babinski sign, which looks at the curling of the toes when you scratch from the heel to the toes of the foot. With Hoffmann's, you grasp the patient's middle finger and sorta flick the nail. If the thumb twitches significantly, that's a positive sign and indicates heightened reflexivity.

Radiculopathy, unfortunately, does not mean an excellent disease. Instead, it refers to any neuropathy centered specifically around dysfunction of the nerve roots. The "radic-" part of the word actually shares a root with radish: radix, latin for root. Yep, that's the root of root.