6) Neurological Conditions and Stroke Flashcards
What are upper motor neuron lesion signs?
Increased tone
Reduced power
Hyperreflexia +/- clonus
Extensor plantar reflex
What are lower motor neuron lesion signs
Wasting and fasciculation
Hypotonia
Weakness
Reduced or absent reflexes
What are cerebellar signs?
Dysdiadokokinesia Ataxic gait Nystagmus Intention tremor Dysarthria Heel-shin ataxia
What is Romberg’s sign?
Test of sensory v cerebellar ataxia
Compare degree of unsteadiness with eyes closed v open
What are the signs of alcohol withdrawal?
Seizures
Halluncinosis
Tremulousness
Delirium tremens
What nutritional diseases are associated with alcohol?
Wernicke-Korsakoff syndrome
Polyneuropathy
Optic neuropathy
Pellagra
Describe the main features of alcoholic polyneuropathy:
Axonal degeneration of peripheral nerves
Slowly progressive neuropathy - superficial sensation (pain and burning) followed by muscle cramps and weakness
Symmetrical
How does alcoholic polyneuropathy differ from thiamine deficiency?
Thiamine deficiency causes a motor neuropathy and acute progressive pattern of impairment of superficial and deep sensation
What investigations may be done to diagnose alcoholic polyneuropathy?
MCV
Nerve conduction studies
What is a stroke and what are the two types?
Sudden onset of focal neurological deficit from a vascular cause
Ischaemic and haemorrhagic
What are some modifiable risk factors for stroke?
BP Diabetes Cholesterol Smoking Obesity AF
What are some unmodifiable risk factors for stroke?
Male
Increasing age
FH
Ethnicity
What are the causes of ischaemic stroke?
Thrombus or embolus
Describe the treatment thrombolysis:
Give a rTPA (e.g. Alteplase) within 4.5 hours of stroke
0.9mg/kg, 10% as bonus then rest as 60 min infusion
What are the causes of haemorrhagic stroke?
Primary bleed - HTN
Secondary to anticoagulation
Tumour
Vascular abnormality
