Approach to Neuro Cases

Question 1

what are the three types of headaches?

Answer 1

tension, migraine, cluster

Question 2

what is the duration of a tension ha?

Answer 2

minutes-days

Question 3

what is the duration of a migraine ha?

Answer 3

4-72 hrs

Question 4

what is the duration of a cluster ha?

Answer 4

15 minutes-3 hrs

Question 5

what is the characteristic of a cluster ha?

Answer 5

quick onset “ice pick headache”

Question 6

where is the location of a tension headache?

Answer 6

bilateral starts posteriorly and radiates anteriorly

Question 7

where is the location of a migraine headache?

Answer 7

unilaterally- temporal/ frontal region

Question 8

where is the location of a cluster headache?

Answer 8

unilateral- eye/temple region

Question 9

what do the SNOOP signs possibly represent?

Answer 9

a space-occupying mass, vascular lesion, infection (red flags)

Question 10

what does the s in snoop stand for?

Answer 10

systemic symptoms (fever weight loss)

Question 11

what does the n in snoop stand for?

Answer 11

neuro symptoms

Question 12

what does the first o in snoop stand for?

Answer 12

older onset (over the age of 50)

Question 13

what does the second o stand for?

Answer 13

onset sudden-thunderclap headache

Question 14

what does the P in snoop stand for?

Answer 14

papilledema or progression or change in HA history

Question 15

if a patient has episodic dizziness/vertigo that is triggered what might they have if the dix-hallpike maneuver is positive?

Answer 15

BPPV

Question 16

what is spontaneous vertigo that is associated with hearing loss?

Answer 16

meniere disease

Question 17

what is meniere’s disease caused by?

Answer 17

increased endolymphatic pressure in the inner ear

Question 18

what three aspects make up “titrate the evaluation of Dizziness”?

Answer 18

timing of the symptom, triggers, targeted examination

Question 19

what are the three clinical scenarios of vertigo?

Answer 19

episodic triggered, spontaneous episodic, continuous

Question 20

how can you diagnose BPPV?

Answer 20

using the dix-hallpike maneuver

Question 21

what is orthostatic hypotension?

Answer 21

positional changes that result in acute drop in blood pressure

Question 22

what medication can exacerbate orthostatic hypotension?

Answer 22

beta-blockers

Question 23

what are two examples of neuro mediated (reflex) syncope?

Answer 23

carotid sinus syndrome and vasovagal

Question 24

what is carotid sinus syndrome?

Answer 24

head rotation along with pressure applied to the carotid artery resulting in stimulation of carotid sinus –> possible syncope

Question 25

what is vasovagal?

Answer 25

it occurs as an over correction to stimulus of sympathetic nervous system (panic, pain, sight of blood), resulting in rebound over stimulation of PNS resulting in bradycardia and vasodilation