Articles on Medical Diseases and Conditions

Entries for the ‘Cerebrospinal Fluid Examination and Neurologic Disorders’ Category

Peripheral Nerve Sensory Syndromes

Sulfatide antibody syndrome (idiopathic sensory polyneuropathy). Sulfatide is a glycolipid found in greatest quantity in CNS and peripheral nerve myelin. Some patients develop antibodies against sulfatide, leading to destruction of peripheral nerve axon myelin sheaths. These changes are greater in sensory nerves than motor nerves, producing paresthesias with symptoms of numbness and burning as well […]

Idiopathic or Paraneoplastic Autoimmune Sensory, Motor, or Mixed Sensory-Motor Disorders

Primary motor or encephalitic syndromes Paraneoplastic cerebellar degeneration. This syndrome is caused by generalized loss of many cerebellar Purkinje cells, producing ataxia, which is also frequently accompanied by nystagmus and dysarthria. This is most commonly found in postmenopausal women with breast or ovarian carcinoma and less frequently with other adenocarcinomas. A few cases are associated […]

Myasthenia Gravis

Myasthenia gravis (MG) is manifested primarily by muscle weakness. Clinically, there is especially frequent involvement of cranial nerves, most commonly manifested by diplopia and ptosis. In more serious cases there is difficulty in swallowing. Peripheral nerve involvement tends to affect proximal muscles more severely than distal ones. In the most severe cases there is paralysis […]

Laboratory Tests in Neurology

Most laboratory tests concerned with diagnosis or function of the CNS are discussed earlier in this chapter. The major condition affecting the peripheral nervous system which involves the laboratory is myasthenia gravis.

Cerebrospinal Fluid Artifacts

During or after a lumbar puncture the question frequently arises whether blood has been introduced into the spinal fluid by the spinal needle, resulting in a traumatic tap. There are several useful differential points. Xanthochromia, if present, suggests previous bleeding. However, a nonxanthochromic supernatant fluid does not rule out the diagnosis, since xanthochromia may be […]

Lead Encephalopathy

Lead poisoning is discussed elsewhere. Lead encephalopathy occurs mainly in children (adults are more likely to develop peripheral neuropathy), and it is more common in acute than in chronic poisoning. Clinical signs and symptoms include visual disturbances, delirium, convulsions, severe headaches, hypertension, and sometimes papilledema. CSF usually displays increased pressure. The cell count varies from […]

Multiple Sclerosis (MS)

Multiple sclerosis is a chronic demyelinating disease that has a reputation for recurrent illness of unpredictable length and severity. A multifocal demyelinating process in cerebral hemisphere white matter results in various combinations of weakness, ataxia, vision difficulties, and parasthesias, frequently ending in paralysis. Thus, the clinical symptoms, especially early in the disease, can be mimicked […]

Intracerebral Hemorrhage

CSF findings depend on how close the hematoma is to the subarachnoid space. If penetration to the brain surface occurs, the CSF resembles that of subarachnoid hemorrhage; if situated relatively far from the brain surface, the CSF will be relatively normal. About 20% (literature range, 15%-25%) of cases are said to have clear CSF; the […]

Subarachnoid Hemorrhage

In hemorrhage involving the subarachnoid space, the findings depend on the time interval following hemorrhage when the patient is examined. It takes about 4 hours (literature range, 2-48 hours) to develop xanthochromia. Therefore, CSF obtained very early may have a colorless supernatant. Initially, the WBC count and protein level are proportional to the amount of […]

Cerebral Thrombosis

In one series of fatal cerebral thrombosis, 90% had clear CSF and most of the remaining 10% had xanthochromia. WBC counts were usually normal; about 15% had a small increase in cell count (usually < 50/mm3). CSF protein level was normal in 50% of cases and usually less than 100 mg/ 100 ml in the […]