Neuro Flashcards
Neurofibratosis vs tuberous sclerosis
TS
- epilepsy
- shagreen patches
- ash leaf spots
- sublingual fibromata
- retinal hamartomas
NF
- cafe au lait
- phaechromocytoma
- acoustic neuroma (Type 2)
- Lisch nodules
Complication of intraventricular haemorrhages
Hydroephalus
What medication may be stopped in patients with dementia
TCA
Most common cause of viral meningitis in adults
enteroviruses: coxsackie b
gold standard test for venous sinus thrombosis
MR venogram
motion sickness treatment
hyoscine transdermal patch
cyclizine
promethazine
right cranial nerve 6 palsy
right eye adducted and horizontal diplopia
Most common neurological infection seen with HIV
toxoplasmosis
What is seen on CT head with toxoplasmosis
multiple ring enhancing lesions
ill-defined hypodense areas in the bilateral temporal lobes and inferior frontal lobes with history of HIV
Herpes simplex encephalitis
Painful third nerve palsy
posterior communicating artery aneurysm
3rd nerve palsy vs horners
Ptosis + dilated pupil = third nerve palsy; ptosis + constricted pupil = Horner’s
total anterior infarct.
- unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
- homonymous hemianopia
- higher cognitive dysfunction e.g. dysphasia
Lacunar infarct
- unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
- pure sensory stroke.
- ataxic hemiparesis
Posterior infarct
- cerebellar or brainstem syndromes
- loss of consciousness
- isolated homonymous hemianopia
what will EMG show with lambert eaton
incremental response to repetitive electrical stimulation
what is Waterhouse-Friderichsen syndrome
meningococcal meningitis complication
adrenal insufficiency secondary to adrenal haemorrhage).
bitemporal hemianopia
lesion of optic chiasm
upper quadrant defect > lower quadrant defect = inferior chiasmal compression, commonly a pituitary tumour
lower quadrant defect > upper quadrant defect = superior chiasmal compression, commonly a craniopharyngioma
homonymous hemianopia
incongruous defects: lesion of optic tract
congruous defects: lesion of optic radiation or occipital cortex
macula sparing: lesion of occipital cortex
anterior cerebral artery vs middle cerebal artery stroke
contralateral hemiparesis and sensory loss
ACA: lower > upper
MCA: upper > lower
Posterior cerebral artery stroke
contralateral homonymous hemianopia with macular sparing
visual agnosia
(specsavers POSTS my contacts)
Weber’s syndrome (branches of the posterior cerebral artery that supply the midbrain)
ipsilateral CN III palsy
Contralateral upper and lower weakness
Weber never SAW how his interns were the OPPOSITE of weak
Posterior inferior cerebellar artery (lateral medullary syndrome, Wallenberg syndrome)
Ipsilateral: facial pain and temperature loss
Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus
Anterior inferior cerebellar artery (lateral pontine syndrome)
same as PICA but with facial paralysis and deafness
definition of TIA
a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischaemia, without acute infarction.
headache red flags
- vomiting without other obvious cause
- worsening headache with fever
- headache triggered by cough, valsalva (trying to breathe out with nose and mouth blocked), sneeze or exercise
- recent head trauma
- impaired level of consciousness
- new onset cognitive dysfunction
brain abscess treatment
IV 3rd-generation cephalosporin + metronidazole
post TIA treatment
clopidogrel and statin
migraine triggers
Chocolate
Hangovers
Orgasms
Cheese
Caffeine
The oral contraceptive pill
Lie-ins
Alcohol
Travel
Exercise
DVLA rule following TIA
1 month and not need to inform
ataxia causes (lesions)
Cerebellar hemisphere lesions cause peripheral (‘finger-nose ataxia’)
Cerebellar vermis lesions cause gait ataxia
multisystem atrophy
parkinsonism
autonomic disturbance
erectile dysfunction: often an early feature
postural hypotension
atonic bladder
cerebellar signs
what extra test is done in young people strokes
autoimmune and thrombophillia screening
SAH imaging
ct head WITHOUT contrast
‘empty delta sign’
Sagittal sinus thrombosis
normal pressure hydrocephalus imaging
ventriculomegaly in the absence of, or out of proportion to, sulcal enlargement
what is required when using iv phenytoin?
cardiac monitoring
carotid enderectomy criteria
Carotid endarterectomy is considered in a patient who has had a TIA with carotid artery stenosis exceeding 70% on the side contralateral to the symptoms
ondansetron SE
prolonged QT interval
constipation is common
rectal diazepam dose
kids - 5mg
adults - 10mg
most common cause of brain mets
lung (most common)
breast
bowel
skin (namely melanoma)
kidney
autonomic dysreflexia
FIGHT OR FLIGHT response BELOW lesion (due to initial noxious stimulus), and REST AND DIGEST response ABOVE lesion (as it attempts to counteract sympathetic fight or flight response)
carbamezapine uses
- partial seizures
- trigeminal neuralgia
- bipolar
aphasia causes
dominant hemisphere (left) MCA
miller fisher triad
ophthalmoplegia, areflexia and ataxia
how to know if it will be hyperreflexia vs hypo
hyper -> UMN -> CNS
hypo -> LMN -> peripheral
drugs causing IIH
combined oral contraceptive pill
steroids
tetracyclines
retinoids (isotretinoin, tretinoin) / vitamin A
lithium
vision loss with temporal arteritis
anterior ischemic optic neuropathy - swollen pale disc and blurred margins
which anti-epileptic is most associated with weight gain
sodium valproate
TOS
compression of brachial plexus, subclavian artery or vein
where does ondansetron act
medulla oblongata
