Corrections 2 Flashcards
Lesion to which cranial nerve can cause diplopia when looking laterally?
CN VI (abducens)
i.e. defective abudction
Features of a CN IV (trochlear) lesion?
Palsy results in defective downward gaze → vertical diplopia
Which CN is involved in head & shoulder movement?
CN XI (accessory nerve)
Role of CN XII (hypoglossal)?
Tongue movement –> tongue will deviate towards the side of the lesion
Role of CN X (vagus)?
- phonation
- swallowing
- innervates viscera
Features of CN X lesion?
Lesions may result in;
- uvula deviates away from site of lesion
- loss of gag reflex (efferent)
1st line mx of focal seizures?
lamotrigine or levetiracetam
2nd line mx of focal seizures?
Carbamazepine
What should be considered in patients who present with falls soon after a diagnosis of Parkinson’s disease?
Investigate for an alternative diagnosis –> e.g. progressive supranuclear palsy (a parkinson plus syndrome)
What is a fasciculation?
A spontaneous, involuntary muscle contraction and relaxation (i.e. a muscle twitch)
What is the most common presentation of ALS?
Asymmetric limb weakness
What derm feature may be present in tuberous sclerosis?
Depigmented ‘ash leaf’ spots
Features of a lacunar stroke?
presents with 1 of the following:
1) unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2) pure sensory stroke.
3) ataxic hemiparesis
1st line medications for spasticity in MS?
Baclofen & gabapentin
What is the mainstay of mx of cervical myelopathy?
Decompressive surgery –> refer to spinal surgery/neurosurgery!
Where is Wernicke’s area?
Left temporal lobe (superior temporal gyrus)
Is Broca’s area on the L or the R?
L
Mx of MS acute relapse?
High-dose steroids (e.g. oral or IV methylprednisolone) for 5 days
It should be noted that steroids shorten the duration of a relapse and do not alter the degree of recovery (i.e. whether a patient returns to baseline function)
Lesions at which nerve root will cause finger abduction weakness?
T1
What is a PICA lesion also known as?
Lateral medullary syndrome
What is ‘saturday night palsy’?
Occur when there is compression of the radial nerve (typically when an intoxicated person falls asleep with their arm draped over a hard surface like a chair back).
Feautres of springomyelia?
Cape-like loss of pain and temperature sensation
1st line investigation in springomyelia?
MRI spine –> to exclude a tumour or tethered cord
Mx of restless leg syndrome?
Dopamine agonist e.g. ropinirole