General Neuro Cases and Revision Flashcards
Describe reflexes in an upper motor neuron problem.
Brisk/exaggerated reflex
Describe reflexes in an lower motor neuron problem.
Reduced or absent
What else would be seen in someone with a LMN lesion?
Muscle atrophy
Decreased tone
How many cranial nerves arise from the brainstem?
10
How many cranial nerves arise from the midbrain? Which ones?
2
Oculomotor and trochlear
How many cranial nerves arise from the pons? Which ones?
4
Trigeminal, abducens, facial, vestibulocochlear
How many cranial nerves arise from the medulla? Which ones?
4
Glossopharyngeal, vagus, accessory, hypoglossal
Which type of imaging tells us exactly in the brain/spinal cord a lesion is?
MRI
What is a typical onset of radial nerve pasly?
Someone who has fell asleep drunk with their arm over the back of a chair or something.
This puts pressure on the radial nerve causing the palsy
->reason being drunk or not fully conscious is relevant as would not feel pins and needles
Where would the lesion be in a sixth nerve pasly?
Pons
-> abducent nerve arises from pons
Where would the lesion be if a patient only has left face, arm and leg weakness?
Right internal capsule
Where would the lesion be if the patient has bilateral hand weakness, spastic gait, bladder dysfunction and UMN signs?
Cervical cord
If the damage is in the spinal cord, will there be UMN signs or LMN signs?
LMN signs
If the damage is in the brain, will there be UMN signs or LMN signs?
UMN signs
Where would the lesion in fatigable, bilateral, UL weakness with ptosis and diplopia?
NMJ
->would be myasthenia gravis, fatigable key part of history
In which type of condition may there be a distracted tremor?
Functional neurological disorder
What is meant by a distracted tremor?
A tremor which increases with attention and decreases or disappears when distracted
Which sign is indicative of functional neurological problems?
Hoover’s Sign
Stiffness usually suggests spasticity. Is spasticity an UMN or LMN sign?
UMN
If the bladder is impacted, it it more likely to be an UMN issue or LMN issue?
UMN
If there is a positive Babinski sign (big toe bends up rather than down when lightly running blunt end of neurotip from heel upwards), is this suggestive of an UMN or LMN isuue?
UMN
Are peripheral nerve problems due to UMN or LMN?
LMN
Polyneuropathy?
General degeneration of peripheral nerves
What usually causes cauda equina syndrome?
Herniated disc in lumbar spine
If there are UMN signs in all four limbs, what is probably affected?
Spinal cord
What can cause polyneuropathy?
Alcohol
Diabetes
If there was a tumour of the spinal cord, more specifically the cauda equina, which type of symptoms would you expect to see?
Bladder or bowel symptoms
What is seen in muscle in those with motor neurone disease?
Muscle wasting/atrophy
Motor neurone disease is a progressive disease which causes what?
Progressive weakness
Which nerves are affected first in polyneupathy?
Longest nerves so nerves to the feet
What is the maximum score on GCS?
15
What is the minimum score on GCS and what does it suggest?
3- they are in complete coma
