Neuro 2 Flashcards
carpal tunnel syndrome
compression of the median nerve as it travels through the carpal tunnel
carpal tunnel - which fingers are affected
median nerve territory - thumb, index finger, middle finger
carpal tunnel - symptoms are worse at what time of day
worse at night, awakening pt from sleep
what are two signs for carpal tunnel
tinel’s - tap
phalen’s
tinel’s sign
identifies compression of the ulnar nerve - tapping + if pins and needles
Phalen’s sign
full flexion of wrists for 60 seconds, + if numbness or tingling over hand
a systemic inflammatory disorder of the medium and large arteries (vasculitis) of the body
GCA
definitive test for dx GCA
temporal artery biopsy
first line tx for GCA
high dose steroids for several weeks
intense and very brief, sudden, unilateral sharp stabbing pain on face/head
trigeminal neuralgia
HA - severe ice pick piercing HA, pain behind one eye, rhinorrhea
cluster HA
HA - bilateral band-like pain, may last several hours
tension HA
medication overuse HA/rebound HA is defined as
HA occurring 15 or more days per month d/t overuse of acute HA medications for >3 months
rebound HA tx is to
d/c the med immediately or gradually taper the dose and/or reduce frequency
imaging test of choice for MS lesions
MRI of brain and spinal cord
MS - assess CSF for
oligoclonal bands and/or an increased immunoglobulin G index
polymyalgia rheumatica - occurs in what age group
almost always in people 50 or older, peak 70-80 y.o.
polymyalgia rheumatica - s/sx
bilateral joint stiffness and aching lasting 30 mins or longer, commonly in the morning - affects posterior neck, shoulders, upper arms, hips
groin pain
pain at lateral aspects of hips
difficulty putting on clothes, hooking bra, getting out of bed/chair
polymyalgia rheumatica pts are at high risk for
GCA
polymyalgia rheumatica - ESR and CRP
ESR - mild to severely elevated
CRP - elevated
sz - abrupt lose of consciousness, stiff extremities, may appear cyanotic, jerk and twitch
generalized tonic-clonic sz/grand mal sz
rhythmic jerking muscle contractions usually involving arms, neck, and face
clonic sz
sudden, brief muscle contractions alone or in clusters, arms typically involved
myoclonic sz
sudden muscle stiffening, often w/ impaired consciousness and falling
tonic sz
what is trigeminal neuralgia commonly aggrivated by
chewing
eating cold foods
cold air
first line tx for trigeminal neuralgia
carbamazepine or oxcarbazepine
