Title: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: adoma on Apr 23, 2013 The Mysterious Episodes of Mary: A Case Study on Neuroanatomy
Episode 1 Mary Lazarro, a 44-year-old mother of two, made an appointment with her physician after experiencing a prolonged episode of numbness in her chin and lower lip. Two days prior to her appointment, she felt a prickling sensation like “pins and needles” at the right corner of her mouth. The sensation extended to her lower lip and chin. The examination revealed only a superficial hypoesthesia of the chin and lower lip (numb chin syndrome). There was no clinical evidence of palpable regional lymph nodes or other systemic or neurologic abnormalities. Her physician scheduled her for a CT scan of the affected region. These tests showed no abnormalities in the jaw, neck, or pharynx. The numbness and hypoesthesia spontaneously disappeared gradually over a few weeks. Episode 2 Four months later, while eating dinner with her family, Mary felt a stabbing pain in her upper jaw and teeth that radiated out to the side of her nose. Over the next several days, she experienced several more episodes of this intense pain. A visit to the dentist revealed no abnormalities and she was referred to her physician for an evaluation. Prior to her appointment, she noticed that the symptoms were subsiding as they had previously. Her physician scheduled an appointment for a complete neurological exam the following week. Episode 3 Three nights prior to her scheduled visit to the neurologist, Mary stopped at an intersection and experienced intense double vision when looking to the right to check for traffic. The double vision was less intense when looking forward, and her vision when looking left was unaffected. Her husband noticed that her right eye appeared to be turned slightly inward when she looked straight ahead. A day later, Mary noticed that the vision in her left eye started to blur. The neurologist later suggested that the two visual problems she was experiencing were related. The double vision when looking right was found to be caused by cranial nerve palsy—a form of muscle paralysis caused by a dysfunction in one of the cranial nerves. The problem with the left eye was diagnosed as optic neuritis (inflammation). Both of these signs and symptoms, along with the previous episodes, pointed to a diagnosis of multiple sclerosis (MS). The neurologist prescribed oral steroids and ordered an MRI. As with her previous episodes, Mary’s visual symptoms began to diminish over time. Finale The results of the MRI, shown below, were consistent with a diagnosis of relapsingremitting multiple sclerosis (RRMS). Relapsing-remitting multiple sclerosis is a form of MS in which symptoms randomly flare up (Mary’s episodes) and then resolve on their own. The lesions seen on the MRI on the left were associated with another episode in which Mary experienced sensory and motor disjunction in her left lower extremity. A subsequent MRI (image on the right) appeared to show improvement after three months.Short answer questions 1. Related to Episode 1: What is hypoesthesia? How does it differ from paresthesia? 2. Related to Episode 1: Using the flowchart below, identify the part of the human nervous system that is usually associated with symptoms of hypoesthesia and paresthesia. 3. Related to Episode 1: Which of Mary’s cranial nerves is affected in this episode? 4. Related to Episode 2: Which of Mary’s cranial nerves is affected in this episode? 5. Related to Episode 3: Name all of the cranial nerves that are involved with eye movements. 6. Related to Episode 3: Which of Mary’s affected cranial nerves is responsible for her double vision when looking right? Why does she not experience double vision when looking left? 7. Related to Episode 3: Which of Mary’s affected cranial nerves is responsible for her blurred vision? 8. Related to Finale: In the MRI images shown in the case, you can see the lesions as bright “white spots” on the brain. Using what you know about the structure of a neuron, explain what is causing this spot to appear in the MRI. 9. Related to Finale: Three months later, you can see that the spots in the MRI appear to be smaller. Using what you know about the structure of a neuron, explain what is happening to the neurons in the area where the lesions are disappearing Title: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: royalblue08 on Apr 29, 2013 Did you find a solution for any of these? I need help too :s Please post something so that I have something to build on!
Title: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: adoma on Jun 10, 2013 Content hidden
Title: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: Questioning on Dec 12, 2013 How is #3 Trigeminal nerve?
Title: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: Jay11 on Jul 27, 2014 #3 is a trigeminal nerve because trigeminal nerves are located within the mouth and chin
Title: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: studyguide on Nov 26, 2014 Number 2 is Sensory Division not Somatic Nervous System
Title: Re: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: thecasinator on May 1, 2015 Number 2 is Sensory Division not Somatic Nervous System I don't think it would be the sensory division. Remember, the sensory division deals with AFFERENT signals to the peripheral nervous system. The somatic division deals with EFFERENT signals. Title: Re: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: Adriana Gutierrez on Apr 17, 2020 Interesting
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I wonder if in another 7 years people will still be looking this up because they didnt read over their work. Hey 2027, hows life? Title: Re: The Mysterious Episodes of Mary: A Case Study on Neuroanatomy Post by: Christina Mae Imbler on Nov 15, 2020 Thanks
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