Neuro Flashcards
Alzheimers on imaging
mesial temporal lobe atrophy
anterior cerebral artery stroke
contralateral hemiparesis & sensory loss
Lower extremeties > upper extrem
Total anterior circulation infarct (TACI)
(middle and anterior cerebral)
1 unilat hempiparesis +/- hemisensory loss of face arms and legs
2 homonopious hemaonpia
3 higher cognative dysfxn ie dysphagia
anterior inferior cerebellar
lateral pontine
sudden onset vertigo & vom
ipsilateral facial paralysis and deafness
aphasia where is brocas and what time
presenation
suppilied by
expressive ie speech made then sent here
inferior frontal gyrus
normal comprehension
speech non fluent
repetition impaired
Superior dividion of MCA
aphasia where is wernickes
suplied by
presentation
speech made here then sent to brocas
superior temporal gyrus
inferior MCA
not normal comprehension
speech no sense, word substitution and nedograms
but fluent
‘word salad’
condustion aphasia where
and presentation
stroke in connection of arcuate fasiculus
speech fluent but poor
pt aware of errors
normal comprehension
global aphasia
where
presentation
large lesion affecting all 3
servere expressive and receptive aphasia
may still be able to communicate with gestures
true seizures may show compared to pseudoseizures
prolactin increase 10-20min after
parksinons path
loss of dopaminergic neruons in substantia nigra = loss of excitatory signal
less dopamine (d2) = less GABA (inhibitory) = increased movement
parkinsons tx
Motor sx impacting QOL = levodopa-carbidopa
Motor sx not yet impacting = Dop agonist ie ropinirole
MAO-B inhib ie selegiline
essential tremor presentation n tx
no tremor at rest
worsens with movement
propanolol
cerebellar lesion tremor
no tremor at rest
worsens w movement gets worse w intention ie closer u get
huntingtons ix
genetic testing - CAG repeats in HTT allele
CT/MRI
atrophy (caudate striatal frontal)
dilated lateral ventricles
huntingtons tx
supportive and sx tx
counselling n support for pt and family
psychiatric - SSRIs, ECT, antipsychotics,CBT
Chorea - benzos
Bradykinesia/rigidity - Dopamine agonists, levodopa
Spinal stenosis presentation
Bilateral
burning, lightening pain of thighs and bum
worse on upright - better when leaning forward or climbing stairs
(proximal pseudoclaudication that is positional!)
[peripheral cause would be distal legs too and not positional)
syringomyelia path and ix, sx and tx
associated with
pockets of CSF cysts in spinal cord
ix - MRI
sx - back pain (neck shoulders arms)
loss of pain and temp which progresses to motor sx ie weakness and wasting esp hands and arms
(bc spinothalamic )
Tx - Surgery
associated w chiari malformation (cerebeller tonsils protrude from foramen magnum
normal pressure hydrocephalus path presenation
ix
tx
normal ICP but hydrocephalus
Wet wobbly weird
(incontinence, ataxia, demetia)
ix
CT - hydrocephalus
LP - no raised ICP but improvement of Sx after
tx surgical shunt
picks disease
FTD dementia
lewy body pathway n presentation
Lewy bodies in substantia nigra
fluctuating changes in cognition - cycles get progressively shorter
w lucid period - can be v distressing for pt bc insight
acute delirium and hallucinations
alzheimers tx
cholinesterase inhib
donezepil n rivastigmine
severe = memantine
CJ disease (mad cow)
prions accumulation
young rapid dementia myoclonus
Reversible causes of dementia
b12 def
hypothyroid
electrolyte abnormality (CKD)
syphilis
Normal pressure hydrocephalus
anaemia
Anterior spinal artery occlusion
bilateral spastic paresis
loss of pain and temp