GCS and Misc Neurology Flashcards
What are the 3 components of the GCS?
How many points is each one worth?
Eye (4)
Verbal (5)
Motor (6)
Describe how to measure the GCS.
Eye (4): 4 - spontaneous 3 - on verbal command 2 - on pain (supraorbital pressure) 1 - none
Verbal (5): 5 - orientated to time/place/person 4 - confused 3 - inappropriate 2 - incomprehensible sounds 1 - none
Motor (6): 6 - obeys commands 5 - localises to pain (supraorbital pressure) 4 - flexion 3 - abnormal flexion 2 - abnormal extension 1 - none
List 1 instance in which each of the GCS categories (eyes/verbal/motor) cannot be assessed.
How would you note this in the GCS score?
Eyes - when swollen shut; add “C”
Verbal - when intubated; add “T”
Motor - when patient has been given muscle relaxants
What is the definition of a coma, in terms of the GCS?
Inability to obey commands
Inability to speak
Inability to open eyes to pain
Describe the usual classification of TBI according to GCS.
Minor - GCS 14-15
Moderate - GCS 9-13
Severe - GCS <8
List 8 possible causes of Horner’s syndrome.
Congenital Apical lung tumour Brainstem stroke Cluster headache Multiple sclerosis Carotid artery dissection Cervical rib compression Syringomyelia
Which 4 cranial nerves are affected in cavernous sinus lesions?
What other feature would you see?
3, 4, 5, 6
Horner’s syndrome
Which 4 cranial nerves are affected by superior orbital fissure lesions?
3, 4, 5, 6
Which 3 cranial nerves are affected by cerebellopontine angle lesions?
5, 7, 8
Which 3 cranial nerves are affected by jugular foramen lesions?
9, 10, 11
Which 4 cranial nerves are affected by bulbar/pseudobulbar palsy?
9, 10, 11, 12
What are the features of bulbar palsy? (4)
What is this caused by? (4)
FEATURES: Nasal dysarthria Dysphagia (with nasal regurgitation) Tongue atrophy Tongue fasciculations
CAUSED BY: LMN lesion Brainstem stroke Guillain-Barre syndrome Myasthenia gravis
What are the features of pseudobulbar palsy? (3)
What is this caused by? (4)
FEATURES:
Spastic dysarthria
Slow/limited tongue movements
Possible “pseudobulbar” effect
CAUSED BY: UMN lesions Stroke Multiple sclerosis Space occupying lesions
What are the features of internuclear ophthalmoplegia? (2)
What is this caused by? (1)
Which condition is this commonly associated with?
FEATURES:
No adduction of affected eye
Nystagmus (on lateral gaze) of contralateral eye
CAUSED BY:
Medial longitudinal fasciculus lesion (connecting 3rd and 6th nerve nuclei)
ASSOCIATED WITH:
Multiple sclerosis
What causes bitemporal hemianopia?
Lesions in the optic chiasm
