Neuro Flashcards
venous sinus thrombosis gold standard test?
MRI venogram
status epilepticus
in prehospital
PR diazepam
BUCCAL midazolam
how should demyelinating lesions be seen?
MRI with contrast
optic neuritis?
inflammation of optic nerve
colour blind (red)
sudden vision loss
what does damage to the medial longitudinal fasciculus present with?
internuclear opthalmoplegia
impaired lateral gaze
bacterial meningitis presents with?
high WCC
high protein
LOW glucose
normal pressure hydrocephalus
presenstw ith
urinary incontinence, ataxic gait, cognitive impairment
Normal pressure hydrocephalus neuroimaging findings:
ventriculomegaly in the absence of, or out of proportion to, sulcal enlargement
Amaurosis fugax is a form of stroke affecting the _____ artery?
retinal / opthalmic artery
imaging in suspected TIA?
MRI brain with diffusion weighted imaging
bulbar onset amyotrophic lateral sclerosis
features
diff swallowing liquids
facial weakness
reduced jaw jerk reflex
Steppage gait
occurs in sensory neuropathy
foot drop / loss of ability to dorsiflex
autonomic dysreflexia
causes?
unbalanced sympathetic reflex
= HTN
sweaty
agitated
can be caused by a stimulus below the spinal cord injury level
Mx of autonomic dysreflexia?
removal / control of the stimulus
treatment of any life threatening HTN / bradycardia
Broca area is where?
inferior frontal gyrus
speech production
expressive aphaisa
Wernickes is found?
superior temporal gyrus
>language comprehension
receptive aphasia
arcuate fasiculus
conduction aphasia
tonic seizures mx?>
women 26
lamotrigine first line
rare but recognised S/E of lamotrigine?
stevens johnson syndrome
acute ischaemic stroke mx
when do you control bp before thrombolysis?
> 185/110
labetalol IV bolus
NICE guidelines bells palsy
no improvement follwoing 3 weeks
refer urgent to ENT
neuroimaging indicated
mid shaft humeral fractures are associated with?
radial nerve injury
Radial nerve
wrist extension
‘wrist drop’ =palsy
antiepileptic associated with weight gain?
sodium valproate
NMS management?
dopamine agonist
bromocriptine
postural hypotension
2 types?
compensatory tachycardia
autonomic dysfunction
4Ds of postural hypotension
deconditioning
dysfunctional heart
dehydration
drugs
>tamsulosin, antidepressants, anti angina
uvula deviation
vagus nerve
Trochlear nerve clinical
eyemovement
> vertical diplopia
defective downwaed gaze
horizontal diplopia
abducens
vagus nerve
phonation
swallowing
uvula
gag efferent
Acoustic neuromas are?
schwann cell tumours of cochlear nerve
status epilepticus management
ABC
check blood glucose
1st line drugs
benzodiazepine
PR diazepam
buccal midazolam
IV lorazepam
5-10 minutes
x2
ongoing / established status epilepticus?
2nd line agent
levetiracetam
phenytoin
sodium valproate
CT head showing temporal lobe changes
with meningism?
herpes simplex encephalitis
DVLA and epilepsy confirmed
12 month seizure free
5 years no seizures
stroke /TIA
1 month off driving
raised ICP can cause what eye defect?
eye deviation
down and out
hypopigmented macule
tuberous sclerosis
ash leaf spot
what is tuberous sclerosis?
growth of benign tumours in different parts of the body including
brain
kidney
heart
cafe au lait spots
HYPERpigmented
tunnel vision
macula spared
absence seizures first line antiepileptic
ethosuximide
otosclerosis causes?
conductive hearing loss
which scale is effective in differentiating acute stroke from stroke mimics?
ROSIER scale
> recognition of stroke in the emergency room
what is friedrich ataxia?
hereditary
deteriorates
spastic paraparesis
impaired vibration sense
proprioception
syringomyelia
compression of spinal cord
‘SYRINX’
upper limb affected more
left 6th nerve palsy affects?
inability to abduct eye
abducens nerve innervates the lateral rectus muscle
baclofen is a?
GABA-B receptor agonist
muscle relaxant
what is degenerative cervical myelopathy?
gold standard test?
high axial loading can cause disc degeneration and ligament hypertrophy
MRI of cervical spine
Hoffman’s sign
cervical meylopathy
gently flick one finger on a patients hand
reflex twitch of other fingers
most effective treatment of cervical myelopathy?
decompressive surgery
Acute angle closure glaucoma
sudden blockage of aqueous drainage from the eye
= rapid intraocular pressure increase
sudden visual loss
DM
PAINFUL
Acute open-angle glaucoma
cornea may be bulging
dilated pupil
/ unresponsive to light
Vitreous haemorrhage
painless blur / haziness of vision
floaters
‘cobwebs’
transient
bleeding into vitreous humour
mx of acute relapse in MS?
methylprednisolone
syringomyelia has a ___ sensory loss
spinothalamic
spinothalamic is affecting?
pain and temperature
dorsal column?
proprioception
vibration
root which supplies loss of sensation of medial epicondyle and intrinsic hand muscle weakness?
T1
via ulnar ner
klumpke paralysis
Erb-Duchenne paralysis
c5/c6
winged scapula
breech presentation
what is the role of controlled hyperventilation in patients with raised ICP?
hyperventilation = reduce CO2
vasoconstriction occurs
= recude ICP
what is cushing triad in HTN?
widening pulse pressure
bradycardia
irregular breathing
