Kayla Darnbrough

USC DPT student '21

[Kayla Darnbrough @KaylaDarnbrough]

Wrapped up an awesome semester of Neuropathology! Biggest takeaway point: do a thorough exam, follow the neuroanatomy affected and S/S and that can help narrow down the differential list for neuro dx and non-neuro dx! #Neuropath2020wk13 @juliehershberg

[Kayla Darnbrough @KaylaDarnbrough]

When in doubt about what is affected in a neoplasm? Do a thorough cranial nerve screen to assess what may be impacted and what may be the next system to be impacted
#Neuropath2020wk12 @juliehershberg

[Kayla Darnbrough @KaylaDarnbrough]

Pt reporting a headache? Need to rule out a possible concussion or TBI. Look at MOI and patient symptoms, but also perform a SCAT-5 to help with prognostics
#Neuropath2020wk11 @juliehershberg @manjiridahdul

[Kayla Darnbrough @KaylaDarnbrough]

Pt coming in with reports of headache? Screen for Snoopy!
S = systemic factors; N = neuro S/S; onset or older; previous HA, pattern, postural, precipitation, or papilledema
#Neuropath2020wk10 @juliehershberg

[Kayla Darnbrough @KaylaDarnbrough]

Pt coming in with dx of stroke? Perform a thorough neuro exam to find out what exactly is affected. But most common will have the MCA involved
#Neuropath2020wk9 @juliehershberg

[Kayla Darnbrough @KaylaDarnbrough]

Child is toe walking?
under 2 yrs = ✅ normal!
over 2 yrs + UMN S/S, spasticity, hypertonicity, delayed milestones = screen for CP
over 2 yrs + repetitive behavior, delayed social interaction, no eye contact = screen for ASD
#Neuropath2020wk8 @juliehershberg @bmendonca_usc

[Kayla Darnbrough @KaylaDarnbrough]

What’s the difference in neuro images?
CT = white skull hugging the brain
MRI T1 = looks like wet brain examples, dark CSF
MRI T2 = inverse of T1 with bright CSF

#Neuropath2020wk7 @juliehershberg

[Kayla Darnbrough @KaylaDarnbrough]

Initial S/S of PD? Bradykinesia, small steps and flexed posture ✅
But... S/S of early falls, hyperreflexia, cerebellar dysfunction (dysmetria) and autonomic dysfunction = MSA and not typical idiopathic PD
#Neuropath2020wk6 @juliehershberg @NoraDarak

[Kayla Darnbrough @KaylaDarnbrough]

Key to separate central vs peripheral reason for nystagmus:
direction fixed w/ mixed torsion and c/o of vertigo = peripheral
direction changing w/ vertical and no c/o of vertigo = central #Neuropath2020wk5 @juliehershberg @NoraDarak

[Kayla Darnbrough @KaylaDarnbrough]

Figured out how to correctly use the ASIA scale when understanding the potential motor & sensory levels of spinal cord injury. If it is complete, they are lvl A. If incomplete, then follow the steps for lvl B, C, or D. @juliehershberg @manjiridahdul #Neuropath2020wk4

[Kayla Darnbrough @KaylaDarnbrough]

Pt comes in with a 14 mo hx of progressive worsening from initial weakness in L LE to both LE and both UE with sensory disturbances. What’s rare is the inclusion of diplopia (CN III and VI involvement). Patient dx with CIDP and got back to ADLs! #Neuropath2020wk3 @juliehershberg

[Kayla Darnbrough @KaylaDarnbrough]

Interesting case today - initial dx of ALS, but with signs of head drop and excessive fatigue along with timeline being episodic rather than continuous. Still functioning on the farm 2 years after start - turns out it was MG and not ALS. #Neuropath2020wk2 @juliehershberg

[Kayla Darnbrough @KaylaDarnbrough]

When in doubt follow the timeline for neuro disorders - what may look like MS may be CIDP
@juliehershberg
#Neuropath2020wk1