Neuro Flashcards
What are typical features of a Bell’s Palsy of viral aetiology?
Preceding ear pain, rapid onset, herpes simplex implicated
What is Ramsay-Hunt caused by and how does it present?
Caused by Herpes Zoster virus and usually presents with a vesicular rash in/around the ear.
What can a facial nerve palsy cause?
Paralysis of the stapedius muscle and hyperacusis, taste impairment in the anterior part of the tongue, speech impairment, unilateral loss of tone and movement
What initial investigations should be carried out for Bell’s Palsy?
Is a clinical diagnosis of exclusion so initially nothing required. However, if palsy persists, nerve conduction studies can be performed if there is no recovery after a few weeks to assess for the presence of axonal degeneration.
What initial treatments given for Bell’s Palsy?
Short course oral prednisolone, Antiviral agents and Eyelid closure (Partial lidsuturing can be used in cases with severe associated ectropion).
Who is there an increased incidence of Bell’s in and till when should surgery not be considered?
Increased incidence in pregnant/diabetic people. Surgery not considered until full 3 months first allowed for recovery.
What is an essential tremor characterised by?
Essential tremor is characterised by a progressive tremor of the upper extremities, present in posture and action, without other neurological signs or symptoms.
What are typical symptoms/history for essential tremor?
Gradual onset, usually have a family history, symmetrical, worse on intentional movement, no other symptoms.
How does Parkinson’s differ from an essential tremor?
The tremor of Parkinson’s disease is normally asymmetrical and worse at rest, not when performing tasks. Even at presentation, one would expect other symptoms of PD (loss of dexterity, problems with walking and balance, sleep disorder, anosmia, constipation, etc.)
What are first-line treatments for an essential tremor?
Reducing caffeine. Primidone (oral 50mg OD) and propanolol - however, asthma contraindicates beta blockers.
