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Neuroscience > Introduction to neurology > Flashcards

Introduction to neurology Flashcards

1
Q

What is neurology?

A

diseases of brain, spinal cord, peripheral nerves and muscle

use patients’ symptoms, history and examination to help guide diagnosis

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2
Q

What is syndrome?

A

signs and symptoms people present with - CHECK HISTORY

damage to NS causes a collection of symptoms

gives idea of underlying anatomy

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3
Q

Speed/mode of onset indicated?

A

determines most likely underlying aetiology

traumatic –> vascular –> toxin –> infection –> inflammatory autoimmune –> genetic –> neoplasia –> degenerative

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4
Q

What is stroke?

A

clinical syndrome

  • loss of vision
  • paralysis on one side
  • weakness on one side
  • difficulty with speech
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5
Q

What is typically affected with high BP, smoker, cannot move one side of body?

A

brain due to stroke

muscle unlikely to affect one side only

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6
Q

Types of stroke?

A

80% infarct (blocked vessel) due to clot from arteries in neck typically (carotid arteries)
20% haemorrhage (bleeding) due to high BP often

smokers/family history/diabetes/excess alcohol at higher risk

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7
Q

What problems are caused by stroke?

A

can affect any part of brain (also brainstem)

tend to cause problems on other side of lesion (contralateral)

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8
Q

How to assess stroke?

A

MRI - see whether infarct/haemorrhage

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9
Q

Syndrome for middle cerebral artery stroke?

A

most commonly affected

weakness and loss of sensation contralaterally

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10
Q

Syndrome for posterior cerebral artery?

A

in occipital lobe

visual loss contralaterally

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11
Q

Syndrome for anterior cerebral artery?

A

contralateral leg weakness

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12
Q

Syndrome for brainstem?

A

problems with balance, eye movements, speech and swallowing (cranial nerves), breathing

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13
Q

Recovery for brainstem stroke?

A

very variable

up to 2 years

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14
Q

Treatment for stroke?

A

IV thrombolysis dissolve clot, thrombectomy to remove clot

neurosurgery for haemorrhage or dangerously high pressure

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15
Q

Preventative measure for further stroke?

A

thin blood with aspirin

treat diabetes and high cholesterol

treat very narrow carotid arteries

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16
Q

How to diagnose neurological problems?

A

cognitive/thinking abilities using mini mental state examination

cranial nerves (smell, vision, eye movements, facial sensation and movements)

limbs - power, coordination, reflexes and sensation

17
Q

What are the symptoms of parkinson’s?

A

akinetic rigid syndrome - parkinsonism

main features are rigidity (stiffness), tremor (shaking) and bradykinesia

18
Q

What is Parkinson’s disease?

A

slowly progressive degenerative disease of dopamine neurones of substantia nigra of basal nigra (loss of neurones to caudate and putamen - parts of basal ganglia)

19
Q

What drug is used to treat Parkinson’s?

A

levadopa - can cross blood brain barrier

electrodes implanted deep into brain to improve movement

20
Q

Where would be affected with weak and stiff lower limbs (increased tone) and brisk reflexes (upper motor neurone)?

A

Spinal cord
not brain - no cranial nerves affected
no muscle - rest of body working fine

21
Q

What is the cause of stiff legs, over 4 months?

A

spastic paraparesis

trauma
inflammatory/autommune (MS)
degenerative (MND)
Vitamin deficiency (B12)
neoplastic (spinal cord tumour, metastatic)
Infection (viral, syphilis)
vascular (anterior spinal artery thrombosis)

22
Q

Cause of spastic paraperesis?

A

tumour of plasma cells - multiple myeloma

treat with radio/chemotherapy quite quickly

23
Q

Cause of paraesthasiae (ascending pins and needles), 3 days, cannot walk

A

Peripheral nerves - acute polyneuropathy

normal cognition and cranial nerves

24
Q

Causes of acute polyneuropathy?

A

infection (diphtheria)
autoimmune (AIDP, GBS)
drugs (chemo)
exposure to toxins

25
Q

What are GBS/AIDP?

A

common causes of acute neuromuscular weakness
progressive ascending sensorimotor paralysis with areflexia (reach nadir in 4wks, affect 1 or more limbs)

can cause complete paralysis, need ventilation

26
Q

Treatment of GBS/AIDP?

A

Caused by antibodies binding to myelin causing demyelination

plasma exchange to wash out toxic antibody or IV Ig

supportive (ventilation) whilst treated/cardiac monitoring

anticoagulation - minimal movement so prone to clots

27
Q

Methods for diagnosis of neurological problems?

A 
lumbar puncture (CSF) to look for infection, tumour, inflammation, signs of Alzheimers
at L1/2 where no spinal cord

EEG - spikes in epilepsy (spike all at one time)

Nerve conduction studies - check how quickly nerves work, how many axons died

Visual evoked potentials - record speed of signal due to loss of myelin

Histology - stain for amlyoid plaques in Alzheimer’s

Neuroscience (11 decks)

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