9 Neuro Flashcards
CN 3:
what signs you expect to see for compressive vs ischemic mech
compression (eg uncal herniation)–down and out, dilated
ischemia– down and out, pupil spared
CN 4 and 6 palsies
-what signs/hx
4: superior oblique. vertical diplopia. can’t read, can’t go downstairs
6: lateral rectus. can’t look one direction left/right
wernicke’s encephalopathy, compared with NPH
-sxs/signs
triad: opthalmoplegia, encephalopathy, gait abnormality
NPH triad: wet wacky wobbly
intraparenchymal hemorrhagic stroke and lacunar strokes:
where in the brain is most commonly affected
sxs
think: basal ganglia, thalamus
all motor or all sensory, should not have cortical findings like aphasia or neglect or LOC
Subarachnoid hemorrhage:
At What time of onset does CT sensitivity fall?
What on LP are you looking for, and timing of that
Sensitivity is near 100% <6hours, then decreases after that
LP: xanthrochromia (at least 2h after bleed to develop)
-also look for incomplete clearing of RBCs from tube 1 to 4
ED pt with stroke like sxs, but in b/l or nonvascular distribution
-what is someting to consider
cerebral venous thrombosis
If you have pt with SAH story, but CT and LP neg, think what?
Possible cervical artery dissection (can be headache with no neck pain)
Reflex spine levels:
biceps, triceps,
patellar, ankle,
C6
C7
L3,4
S1, 2
conus medullaris syndrome
cauda equina, but above L1
cauda equina is technically below L1
Guillan barre vs tick paralysis
differences
Tick paralysis has no sensory sxs
Pt with acute blindness:
what to look for in diagnosis of optic neuritis
afferent pupillary defect–pathognomonic for optic neuritis in pt with acute vision loss
pt with ptosis
-what’s the critical ddx? (4)
horner’s syndrome, CN 3 dysfunction, MG, lambert eaton
acute periodic paralysis, 2/2 hypoK
-what to be cautious about
too much too quickly can kill
do not aggresively relete K. just start 40-80 PO KC
