Module 2 Neurology Notes Flashcards
What causes drug induced parkinsonism
D2 - antagonists - like haloperidol
What can help drug induced parkinsonism
Anticholinergics - like Benzatropine
Acute consequence of D2 antagonists
Acute dystonia/dyskinesia
Consequence of long term anti-psychotic drugs
Tardive dyskinesia
Differences between NMS and malignant hyperthermia
NMS presents over 1-3 days
MH presents over mins-hours
NMS occurs with neuroleptic anti-psychotics such as haloperidol
MH is caused by inhaled anaesthetics or neuromuscular blocking agents
Tell tale signs of cardiac flow obstruction induced seizure
positionally or exceptionally induced
Tell tale sign of contralateral frontoparietal cortex
Focal motor/sensory symptoms
Affective/ cognitive symptoms
Tell tale sign of temporal lobe seizure
Sensation of fear
de ja vu
gustatory/olfactory hallucinations
Diffuse CBS disfunction is indicative of
Presyncope
Brief post-ictal confusion is indicative of…
Generalised seizure
Is urinary incontinence specific to seizure type?
No, syncope or seizure
What does lateral tongue biting indicate?
Highly specific to generalized tonic clonic seizure
Aspects of Benign febrile convulsions
2-5% of children aged 0.5-5 yeas
During first day of febrile illness
Last less than 10-15 mins
Lacks focal features - 2/3 have 1, 1/10 have 3+
Systemic causes of seizures
Hypoglycaemia Hyponatraemia Hypocalcaemia Uraemia Hepato-encephalopathy Drug overdose Hyperthermia Global cerebral ischaemia Hyperthermia Eclampsia Hypertensive encephalopathy
Treatment of eclamptic seizures
Magnesium Sulfate - not phenytoin
Focal seizures managament
Carbamazepine of Lamotrigine
Not tolerated? Levetiracetam
oxcarbazepine
GTC seizures treatment
Sodium valproate in boys/men
Lamotrigine - although not in Juvenile myoclonic epilepsy
Clobazam in girls as an adjuvant
Absence seizures treatment
Ethosuximide to women/girls
Ethosuximide or Sodium Valproate to men/boys
Myoclonic seizures treatment
Sodium Valproate
Levetiracetam or topiramate in girls/ women
Infantile spasms treatment
Steroid
Vigabatrin
Trigeminal neuralgia
Carbamazepine
Initial management of acutely rising ICP
100 ml 10% mannitol
Management of seizure over 10 mins
IV benzo - midazolam because short acting
Chronic refractive head pain
Topirimate
Intubation BCS score
8 or best motor response is flexing
Dorsum of foot and dorsiflexion impacted
L5
Ankle, lateral aspect of foot and plantar flexion affected
S1
Thumb, bicep and bicep jerk affected
C6
Middle finger, tricep and tricep jerk affected
C7
most common myelopathy
disc-osteophyte cord compression
