Extra 1 Flashcards
cluster vs paroxysmal hemicrania vs hemicrania continua vs SUNCT
cluster less frequent but longer (1-8 x per day, 15-180 mins each)
PH more frequent- more than 8 x per day, shorter - 15 mins)
PH responds to INDOMETHACIN very very well
Cluster- high flow oxygen and tryptan then prevent with verapamil
unilateral daily headache or continuous headaches with piercing brief headaches on top with redness or congestion or ptosis- responds to INDOMETHACIN
SUNCT is mini clusters lasting 60 seconds but 1-30 x per hour. No good tx.
Brain imaging in trigeminal neuralgia
MRI
can be MS in a young person
When not to give tryptans
hemiplegic migraine, severe CVD, bad hypertension
treat transverse myelitis
IVMP
PLEX if fail
Demyelinating neuropathies
CIDP/GBS Charcot marie tooth 1 Anti MAG PN MMN POEMS paraneoplastic Amiodarone, chloroquine, TNF alpha blockers, tacrolimus, perhexilline
Classic presentations of
acute axonal
chronic axonal
acute demyelinating
chronic demyelinating
AA- pain predom
CA- sensory before motor, longer first
AD- motor first then dysthesias
CD- weak and sensory together
Anti GM1 ab
MMN
Anti MAG Ab
MAG periph neuropathy
ab attack myalin assoc GP
use ritux
Mostly MOTOR
IgM so no PLEX
CSF in neurosyphilis
SERUM treponemal tests remain reactive for life, regardless of if treated
CSF VDRL confirms diagnosis but not sensitive
CSF FTA-ABS sensitive but not specific
order of loss of modalities with carpal tunnel
sensory latences then motor then axonal loss
pronator teres vs CT syndrome
a patient with true carpal tunnel syndrome (entrapment of the median nerve within the carpal tunnel) will not have any sensory loss over the thenar eminence (bulge of muscles in the palm of hand and at the base of the thumb). This is because the palmar branch of the median nerve, which innervates that area of the palm, branches off of the median nerve and passes over the carpal tunnel. This feature of the median nerve can help separate carpal tunnel syndrome from thoracic outlet syndrome, or pronator teres syndrome.
radial nerve gets compressed in the
axilla
ulnar nerve gets compressed at the
elbow or palm with bicycle tools
ramsay hunt- where is reactivation
geniculate ganglion
decrease recovery compared with bells but still 84% recover with slight defect
most common cause of death in friederichs ataxia
HOCM
Fragile X premutation
tremor ataxia syndrome later in life with neurocog deficit
Reflexes in Friederichs vs SCA type 1
Spinocerebellar are hyper reflexic- AD
Friederichs are hyporeflexic and have loss vibration and proprioception- AR
Hemiballismus
Chorea
subthal nuc
caudate (esp HIV), putamen, thal, subthal
How to tell horners pre-ciliary from post ciliary
pre ciliary with phenylephrine both pupils dilate equally
post ciliary the horners dilates MORE
pre ciliary either brainstem symptoms or lung symptoms
post ciliary history of carotid disease or migraine
Argyll robertson vs Adies pupils
AR pupils
- syphilis
- bilat small
- accom not react
- pre tectal nucleus
Adie Holmes -unilateral tonically dilated -reacts slowly to light but does accomodate -loss DEEP TENDON REFLEXES infection of ciliary ganglion
What does ulnar nerve do in thumb
adductor policis
