neuro Flashcards
(126 cards)
which parkinsons medication is most likely to cause inhibition disorders?
ropinirole (dopamine receptor agonist)
what are the features of bells palsy?
acute unilateral idiopathic facial nerve paralysis
- lmn palsy - forehead affected (umn spares forehead)
- post-auricular pain, altered taste, dry eyes, hyperacusis
what is the management of bells palsy?
oral pred
artificial tears, eye taping
?refer to ent, ?plastics if no paralysis improvement
what is degenerative cervical myelopathy?
disc degen, ligament hypertrophy, cord signal change
what are the features of DCM?
neck pain, loss of motor function in upper limb, loss of sensory function, loss of autonomic fn (urinary or faecal incontinence and/or impotence)
hoffman’s sign - flick hand - +ve = fingers twitch
secondary prevention in TIA?
clopidogrel 75mg daily
management TIA?
300mg aspirin acutely
which cranial nerves are affected in vestibular schwannomas? (acoustic neuroma)
cn V, VII and VIII
how does drug induced parkinsonism present?
bilateral sx
remain at presenting level
how does idiopathic parkinsons present?
difficulty with fine movts
inc tone
resting tremor
often asymmetrical sx
if a patient presents to primary care with seizue episodes, what is the management?
refer to neuro - antiepileptics must be started by specialists
what type of visual field defects do parietal lesions cause?
contralateral inferior quadranopia
what type of visual field defects do temporal lobe lesions cause?
contralateral superior quadranopia
what type of visual field defect would a patient with sx of diabetes insipidus have?
craniopharyngioma - lower bitemporal hemianopia
how do you differentiate a focal impaired awareness seizure from an absence seizure?
FIA - ?longer, motor phenomena, automatisms, aura
absence - often child, up to 30s, recollection of event, no automatisms
what are the sx of acoustic neuroma?
vertigo, unilateral sensorineural hearing loss and tinnitus cnviii
absent corneal reflex cnv
facial palsy cnvii
mgt ischaemic stroke for first 14 days?
300mg aspirin OD
after 14d - clopidogrel 75mg long term + statin if cholesterol over 3.5
what is the mgt for myoclonic seizures?
m - sodium valproate
f - levetiracetam
what is the mgt for absence seizures?
ethosuximide
2L m- valproate, f- lamotrigine or levetiracetam
(carbamazepine may exacerbate)
what is the mgt for tonic/atonic seizures?
m - sodium valproate
f - lamotrigine
what is the mgt for focal seizures?
focaL - Lamotrigine/Levetiracetam
1L - lamotrigine or levetiracetam
2L - carbamazepine, oxcarbazepine, zonisamide
what is the mgt for generalized tonic-clonic seizures?
m - SV
f - lamotrigine or levetiracetam
what is the management for peritumoural vasogenic oedema?
IV dexamethasone
how does a lacunar stroke present?
pure motor hemiparesis
pure sensory stroke
sensorimotor stroke
ataxic hemiparesis
dysarthria/clumsy hand syndrome