neuro Flashcards
(191 cards)
condition associated with bilateral acoustic neuromas
neurofibromatosis type 2 (NF2)
how can you distinguish between a CSF leak and mucus coming from a patient’s nose?
check glucose - CSF has glucose
syringomyelia
fluid-filled cavity develop in central canal of spinal cord
|compresses the spinal cord tracts
which part of the spinal cord is compressed first in syringomyelia?
anterior white commissure
spinothalamic tract decussates here at level of entry
which sensory fibres are carried in the spinothalamic tract?
pain and temperature
which sensory fibres are carried in the dorsal column?
light touch, vibration and proprioception
syringomyelia typical presentation
bilateral loss of pain and temperature at level of syrinx
- burns on fingers
-> ‘cape-like’ sensation loss of arms, shoulders and torso
syringomyelia associated malformation
chiari type 1 malformation
syringomyelia imaging
MRI Full Spine
MRI Brain - check for Chiari malformation
What is tuberous sclerosis
autosomal dominant condition with cutaneous, neurological and other features
cutaneous features of tuberous sclerosis? (4)
‘Ash leaf’ spots under UV light = depigmented patches
Shagreen patches = roughened skin over lumbar spine
Adenoma sebaceum (angiofibromas) - facial, butterfly distribution
Subungual fibromata
(Cafe au lait spots - more often in NF)
neurological features of tuberous sclerosis? (3)
developmental delay
intellectual impairment
infantile spasms/partial seizures
‘other’ features of tuberous sclerosis? (6)
Retinal hamartomas = dense white areas on retina
Rhabdomyomas of heart
Gliomatous changes in brain lesions
Polycystic kidneys
Renal angiomyolipomata
Lymphangioleiomyomatosis -> multiple lung cysts
What is mononeuritis multiplex?
Simultaneous/sequential involvement of individual, non-contiguous nerve trunks
This causes acute/subacute sensory and motor loss in asymmetrical pattern
What are the Motor scores of GCS?
6 = obeys 5 = localises to pain 4 = withdraws from pain 3 = abnormal flexion 2 = extending from pain 1 = none
What are the Verbal scores of GCS?
5 = orientated 4 = confused 3 = words 2 = sounds 1 = none
What are the Eye scores of GCS?
4 = spontaneous 3 = speech 2 = pain 1 = none
What is Subacute Combined Degeneration of Spinal Cord?
Degeneration of dorsal and lateral columns due to vitamin B12 deficiency
Uncommon in UK, very common in the developing world
What type of fibres are carries in the corticospinal tract?
Voluntary motor fibre
Upper limbs are medial, lower limbs are lateral
What are the symptoms of Subacute Combined Degeneration of the Spinal Cord?
Loss of proprioception and vibration (dorsal column)
Then distal parasthesia
UMN signs in legs - brisk knee reflex, absent ankle reflex
cerebral oedema secondary to a brain tumour Mx
Dexamethasone IV
normal pressure hydrocephalus management triad
wet, wobbly, wacky
urinary incontinence
gait ataxia
dementia
normal pressure hydrocephalus management
ventriculoperitoneal shunting
10% risk of complications eg. seizure, infection, haemorrhage
migraine acute management
triptan + paracetamol