PCA Syndrome

Weber's syndrome
= oculomotor palsy (CN III) + contralateral hemiplegia

Claude's syndrome
= oculomotor palsy (CN III) + contralateral ataxia

학교를 다닐땐 그렇게 공부하기가 싫었다. 어른들은 줄 곳 한살이라도 젊을 때 하나라도 더 배우라고 하셨는데, 요즘은 그 말이 진심이셨구나라고 느끼며 하루하루를 보낸다.
요즘은 외우는 것도 힘들어 졌음은 물론 배운것도 쉽게 잊곤 하니 말이다...

한살이라도 더 젊을 때 하나라도 더 배우기...

Wallenberg's syndrome

aka "lateral medullary syndrome"

2' to occlusion of PICA or VBA (located laterally to medulla oblongata)
ipsilateral L/O pain & temp of face (trigeminal nucleus)
contralateral L/O pain & temp of body (lateral spinothalamic)
dysphasia (difficulty swallowing & speech 2' to vagus & hypoglossal CN9), decreased gag reflex
if vestibular system involved = pt. may c/o vertigo, N/V, (+) nystagmus
if descending SNS involved = pt. may present c/ (+) ipsilateral Horner's syndrome

Circle of Will

1. ACA = LE>UE
2. MCA = mess, UE>LE, BG - sensory ataxia, (+) Romberg (L/O standing balance c/ eyes closed), speech (wernicke's), HH

3. PCA = Weber's Syndrome (ocular motor palsy c/contralateral hemiplegia/hemiparesis)
4. Basilar a. = brainstem s/s ("locked-in syndrome")
5. PICA = Wallenberg syndrome (ipsi tongue + contra para/paresth.)
6. VBA = Horner's sign (ptosis, miosis, anhydrosis)

REYE'S SYNDROME

[Ralph DK Reye, Australian pathologist]

Reye's syndrome is a combination of acute encephalopathy and fatty infiltration of the internal organs that may follow acute viral infection. This syndrome has been associated with influenza B, chickenpox (varicella), the enteroviruses, and the Epstein-Barr virus.

It usually affects people under 18 years of age, characteristically causing an exanthematous rash, vomiting, and confusion about 1 week after the onset of a viral illness. In the late stage there may be extreme disorientation followed by coma, sz, and respiratory arrest.

Lab test reveal greater than normal amounts of SGOT and SGPT, bilirubin, and ammonia in the blood. A specimen obtained by liver biopsy shows fatty degeneration and confirms the Dx.

Mortality varies between 20-80%, depending on the severity of sx.

The cause of Reye's syndrome is unknown; however, there appears to be an association with the administration of aspirin (ASA). Therefore aspirin is given only if prescribed by a physician for any condition in infants or children. Aspirin should not be given in cases of chickenpox or suspected influenza.

No specific tx is available. Insulin, antibiotics, and mannitol may be given.
Blood gases, blood pH, and BP are monitored frequently. Intensive supportive nrsg care with meticulous monitoring of all vital functions and prompt correction of any imbalance are extreme significance in the outcome of this syndrome.

SOURCE: Mosby's medical, nursing, & allied health dictionary. 6th ed. St. Louis, MO: Mosby; 2002.

REITER'S SYNDROME

[Hans Reiter, German physician, 1881-1969]

Reiter's syndrome is an arthritic disorder predominantly of adult males, resulting from infection with Shigella flexneri, Salmonella, Yersinia, or Chlamydia or from enterocolitis.

It most often affects the ankles, feet, and sacroiliac joints and is usually associated with conjunctivitis and urethritis.

The onset may be marked by unexplained diarrhea and low grade fever, followed in 2 to 4 weeks by conjunctivitis. Superficial ulcers may form lesions on the palms and the soles. Arthritis usually persists after the conjunctivitis and urethritis subside, but it may become episodic.

Tx includes a short course of tetracycline to tx the infection and phenylbutazone to relieve pain and inflammation in the joint. Sexual partners should also be tested. Recovery is expected, but recurrent arthritic symptoms may continue for several years.

See also dactylitis, reactive arthritis.

SOURCE: Mosby's medical, nursing, & allied health dictionary. 6th ed. St. Louis, MO: Mosby; 2002.