Neuro Flashcards
Headache
Primary - Migraine, tension, cluster, medication overuse
Secondary - Increased ICP, haemorrhage, GCA
S O - immediate/gradual C - thunderclap/tight band/sharp stabbing R - neck A - vision/n or v/fits/meningism/shoulder pain/sensory/auras T - duration/pattern/change E - positional/time of day/light/sound S
Vertigo/Dizziness
Infectious - Vestibular neuritis, BPPV
Inflammatory - meniere’s
Malignancy - vestibular schwannoma
Psuedo vertigo - cardiogenic, metabolic, haematological
?true vertigo ?Movement worsening Onset, Pattern, Quality, Severity, Timing ?LOC ?Change in hearing - loss and tinitus
Headache
N/V
SOB
Vision Changes
CN palsy - CN2, CN3/4/6, INO, NMO
Refractory error - long/short sighted
Trauma - orbital fracture
Demyelination - MS, GBS
Vascular - stroke, GCA, PCA aneurysm, central retinal A/V occlusion
Eye - Glaucoma, cataracts, retinal detachment
Visual tract - pituitary adenoma, SOL, craniopharyngioma, cavernous sinus thrombosis, bulbar palsy
Onset, Pattern, Quality
Associated Sx - headache, pain, change in appearance, other neurological deficits, trauma
Syncope
Neuro - seizure, intracranial bleed
Cardio - arrhythmia, vasovagl, critical outflow obstruction, ?hypovolaemia, ?postural hypotension
Metabolic - hyopoglycaemia, adrenal insufficiency
Haematological - critical anaemia
Misc - anxiety/panic attack
Pre - associated with movement/exercise, pre-warning, dizziness, chest pain or palpitations, trauma
During - how long, witness account, incontinence, tongue biting, fitting movements
After - post-ictal, confusion/awareness
Extra - MH, systemic illness signs (SOB, chest pain, weight change, pigmentation), FHx of sudden cardiac death
Hearing changes
prebcy… old otosclerosis Meniere’s disease Ramsey hunt syndrome otitis media, choleasteatome foreign body tympanic membrane perforation
onset, pattern, quality infection - fever, discharge, pain, post-auricular vertigo rash FHx of hearing loss/impairment history of trauma
Hemiparalysis
Vascular - stroke
Neurological - Spinal cord trauma, hemisection of cord (brown sequard syndrome)
Weakness
Peripheral - cord compression, cord hemisection, cauda equina, MND, radiculopathy
Central - stroke, demyelination (MS), SOL
Metabolic/AI - DM, PMR, Cushing’s, hypothyroidism, polymyositis/dermatomyositis
NMJ - myasthenia gravis, Lamber-eaton, myotonic dystrophy
Specific to upper limb/face - Horners, brachial plexus palsy
Altered sensation
peripheral - DM, B12/folate (pernicious anaemia, ETOH)
central - MS, stroke, spinal cord compression/hemisection/transection
focal - trauma/iatrogenic post-op, carpal tunnel syndrome, cubital tunnel syndrome
Bowel/bladder issues
cauda equine
spinal cord trauma/compression/transection
neuropathic bladder e.g. UMN disease
medication - e.g. anticholinesterase inhibitors
Confusion
Vascular - intracranial bleeds, stroke
Dementia
Delirium
Wernicke’s encephalopathy/Korsakoff syndrome
Metabolic - hypoglycaemia, sepsis, hyponatraemia
Memory impairment/change in behaviour
Dementia - LBD, frontotemporal
Hypoglycaemia
Trauma
Recreational drugs
Headache - unilateral
Cluster headache
Migraine (typical)
Trigeminal neuralgia
Temporal arteritis/GCA
Headache bilateral
Tension headache
SAH (posterior)
Meningitis
Raised ICP - SOL, hydrocephalus
Headache sudden onset
Subarachnoid haemorrhage
Meningitis
Cerebrovascular accident
Glaucoma
