Neuro Flashcards
Ulnar claw
Mild extension at 4th and 5th MCPJ and relative flexion of the fingers
Which muscle differentiates a C8/ T1 lesion from ulnar lesion? Ie not a radiculopathy but an ulnar neuropathy
Abductor policis brevis - median nerve
Hoffmans sign
Hold DIPj and flick the finger
Thumb and index finger flex
Causes of peripheral neuropathy
Metabolic: Diabetes
Hypothyroid
Uraemia
Vitamin B1/ 6/ 12 deficiency
Toxic: chemo, alcohol
Inflammatory: CIDP, sarcoidosis, vasculitis, RA
Paraneoplastic: lung cancer, paraproteinaemia
Predominantly sensory: DM, alcohol, drugs, vit b deficiency
Predominantly motor: GBS and botulism acutely, lead toxicity, porphyria, HSMN ie CMTD
Why do we do nerve conduction studies for peripheral neuropathy?
Determine if it is demyelinating or axonal
Demyelinating = more likely to be inflammatory condition ie CIDP
Why is nerve conduction studies useful in HSMN?
HSMN type 1 is demyelinating
Type 2 is axonal
(HSMN also known as Charcot Marie tooth)
Inheritance of CMTD
Type 1 is autosomal dominant
how to differentiate a posterior stroke from a middle cerebral artery stroke with visual field defects
They both have homonomous hemianopia but a posterior stroke has macular sparing
How to differentiate a middle cerebral stroke from trigeminal neuropathy?
Test sensation on the neck - trigeminal neuropathy will have intact sensation on neck
Corneal reflex will be intact in hemispheric damage
How to differentiate cerebella versus sensory ataxia?
Cerebellar ataxia will have nystagmus and dysarthria
Sensory ataxia will have impaired sensation, particularly proprioception and vibration. They will also have pseudo athetosis in the upper limbs. Removing the visual input exacerbate the ataxia
What causes both central and peripheral sensory ataxia
B12 deficiency
lower motor neuron signs and peri oral fasciculations
Kennedys disease
Bulbar dystrophy
X linked
Very slow to progress
MND drug
Riluzole
Cerebellar ataxia and peripheral neuropathy
Alcohol
RAPD also known as
Marcus Gunn
