Clinical Neurology Flashcards
what is neurology?
dealing with diseases of CNS, PNS and Muscles
incidence of neurological conditions
in GP, high eg migraine
Prevalence is high!
approach to diagnosing neurological conditions
using presenting signs and symptoms to identify anatomy and characterise the syndrome
using mode of onset to determine most likely aetiology
take history, family and social
tests
speed of onset of neurological conditions is down to types of aetiology, what types?
trauma, vascular, toxic/metabolic, infection, inflammatory/autoimmune, congenital, neoplastic, degenerative.
the speed of onset decreases as you go down the list.
common causes of neurological problems
Stroke, contralateral to site of brain lesion
infarct of:
- middle cerebral artery, loss of sensation
- posterior cerebral artery, vision loss
- anterior cerebral artery, leg weakness
- brain stem, loss of balance
recovery varies, up to 2 years
antithrombotics and surgery and preventative measures as treatment.
cognitive examination
mini mental state examination, testing calculation, language, recall, orientation, registration,
PNS exam
test senses
Parkinsons is due to
degenerative disease affecting basal ganglia STN, patients treated with levodopa which can cross the BBB (dopamine) or DBS.
spastic paraparesis is a problem with the
spinal cord, normal lower motor neurone hence fast reflexes but damaged upper motor neurone which is in spinal cord hence stiffness and weakness in leg. can be caused by a lot of things aforementioned
acute polyneuropathy is due to
damage to PNS usually down to loss of sensation and no reflexes and weak muscles. this is due to many things. eg Guillaine barre syndrome (demyelinating disorders).
diagnostic methods for neurology
CT scan
MRI scan
Lumbar puncture testing CSF (L3/L4/5 in adults)
Nerve conduction studies and electromyography (EMG)
Electroecephalogram (EEG)
Evoked potentials
Pathology