neuro

Question 1

Which nerve is most susceptible to damage from a fracture of the shaft of the humerus

Answer 1

radial nerve

Question 2

Give 4 features of a common peroneal nerve lesion

Answer 2

• foot drop
• weakness of foot dorsiflexion and eversion
• weakness of extensor hallucis longus
• sensory loss over the dorsum of the foot and the lower lateral part of the leg
• wasting of the anterior tibial and peroneal muscles

Question 3

Differences between a benign essential tremor and Parkinson’s tremor

Answer 3

• Essential tremor worsens when holding arms outstretched
• Essential tremor worsens with activities such as writing whereas Parkinson’s tremor improves with purposeful actions
• Essential tremor is often symmetrical where PD is often asymmetrical
• Essential tremors has autosomal dominant trait where PD has no genetic trait
• Essential tremor is higher frequency than PD
• Essential tremor improves with alcohol whereas PD tremor has no change

Question 4

side effects of levodopa

Answer 4

• dry mouth
• dyskinesia
• dystonia
• postural hypotension
• psychosis

Question 5

Examples of dopamine agonists

Answer 5

Bromocriptine, Cabergoline, Pramipexole,
Ropinirole

Question 6

Examples of MAO inhibitors

Answer 6

Rasagiline or Selegiline

Question 7

Define a seizure

Answer 7

transient episodes of abnormal electrical activity in the brain

Question 8

general advice to offer patients with epilepsy

Answer 8

• Take caution with swimming/ heights
• To shower rather than have a bath
• Record any further episodes
• If a seizure lasts more than 5 minutes, or 2 minutes with LOC, call 999

Question 9

What follow up needs to be arranged after a child has their first epileptic seizure

Answer 9

urgent referral to paediatric neurologist

Question 10

first line treatment for trigeminal neuralgia

Answer 10

carbamazepine

Question 11

When is acupuncture used in the management of migraines

Answer 11

as prophylaxis if both propranolol or topiramate are ineffective or contraindicated

Question 12

Describe the flow of cerebrospinal fluid through the ventricles

Answer 12

The CSF flows from the two lateral ventricles –> foramina of Monro –> third ventricle –> cerebral
aqueduct –> fourth ventricle –> foramina of Luschka & Magendie –> subarachnoid space.

Question 13

Features of brown-Sequard syndrome

Answer 13

hemisection of the spinal cord:
* Ipsilateral spastic paralysis below the level of the lesion
* Ipsilateral loss of fine touch, proprioception and vibration sense
* Contralateral loss of pain and temperature sensation