Facial paralysis Flashcards
What is Ramsay Hunt syndrome?
Facial nerve palsy, vertigo and hearinb loss
How do you treat Ramsay Hunt syndrome?
Aciclovir
How is meningitis treated?
IM benzylpenicillin - only if doesnt delay hospital transfer
What is the gold diagnostic for Subarrachnoid harmorrhage?
Lumbar puncture
CSF
Treatment for acute migraine
Analgesia: Aspirin, ibuprofen or sumatriptan
Naproxen
Tolfenamic acid
Dclofenac potassium
Paracetemol if unable to have others
Antiemetics:
Metaclopramide, prochlorperazine
What does a ruptured berry aneurysm cause?
Sub arrachnoid haemorrhage
How do you treat bells palsy? What is the caveat?
Steroids eg prednisone, have to present in 72 hours of symptom onset, for 10 days
Symptoms of normal pressure hydrocephalus
Wet, wobbly and weird
What is metaclopramide and why is it contraindicated in parkinsons?
Antiemetic, dopamine/5HT3 antagonist, prokinetic
Cardiac effect of ondenestron
Increase QT interval + risk of torsades de pointes
What is ondestron used for?
anti-emetic 5HT3/serotonin antagonist
Treatment for haemorrhagic stroke
Take off anticoagulation
Aggressive BP control - <140 systolic within an hour of admission
What is interferon beta used in?
Relapsing remitting MS when able to walk unaided
How to treat status epilepticus?
4g IV lorezapam
How can isoniazid cause polyneuropathy?
Via B6 deficiency
What symptoms does a corticobulbal tract lesion cause?
Pseudobulbar palsy
Preventative treatment for migraines
Propanolol
MetoprololBisoprolol esp if cardiac indications
Teratogenic:
Topirimate
Sodium valproate - episodic or chronic migraine
How long does Bells palsy take to improve?
3-4 months
Refer if more than 5 months of symptoms
When emergency referral for bells palsy
Worsening of existing neurologic findings, or new neurologic findings.
Features suggestive of an upper motor neurone cause (for example limb paresis, facial paraesthesia, other cranial nerve involvement, postural imbalance).
Features suggestive of cancer (for example, gradual onset of symptoms, persistent facial paralysis for more than 6 months, pain in the distribution of the facial nerve, head or neck lesion suggestive of cancer, history of head and neck cancer, hearing loss on the affected side).
Systemic or severe local infection.
Trauma.
Ramsay hunt vs bells palsy
Ramsay hunt has a rash and is more paingul, caused by herpes zoster virus
What rhythm is a person with a TIA most likely to have?
Atrial fibrillation
When consider blood pressure lowering medication in haemorrhagic stroke
Consider rapid blood pressure lowering for patients who present within 6 hours of symptom onset with a systolic blood pressure between 150 and 220 mmHg and who do not fit any exclusion criteria.
Treatment for Multiple scleroisis relapse
Oral methylprednisolone as early as possible
