Neuro Flashcards
Wernicke’s area location and responsibility?
Broca’s?
Wernicke’s - receptive temporal lobe
Brocas - expressive frontal lobe
Deficits in oculomotor nerve?
Eye deviation, pupil dilated
CN VII innervates?
muscles of facial expression, taste
CN VII deficits?
facial paralysis
loss of taste
hyperacusis (sensitivity to certain freq)
Receptive aphagia vs expressive aphagia?
Receptive - deficit in Wernicke’s area, can’t understand but can speak fluently
Expressive - deficit in Broca’s, can understand but can’t speak.
Lower motor neuron vs upper motor neuron deficit?
LMN: hypotonia, fasciculations (spontaneous flicker of movment), atrophy
UMN: spasticity (tightness), lack of atrophy
Babinsky reflex in adults vs children?
Adult: Normal response to sole of foot is downward flexion. Babinski sign = upward
Children: normal is upwards
Babinski sign means?
CNS deficit/UMN
Hoffman’s sign apperance?
Flex of last phalange upon flicking
Hoffman’s sign tests what?
Unilateral positive means corticospinal tract has probelm.
Dorsal column pathways crosses where?
Responsible for what?
Crosses at medulla
Responsible for Light touch, Proprioception
Spinothalamic pathways crosses where?
Responsible for what?
Spinal cord
Pain/Temp
“Thunderclap” headache red flag for?
ruptured aneurysm
positional component headache red flag for?
intracranial pressure
headache on awakening red flag for?
mass lesion
focal neurological signs red flag for?
mass lesion, dissection
Neck rigidity red flag for?
meningitis
Older than 50 years with headaches red flag for?
temporal arteritis
Most common headache type?
tension headache
tension headache more common in men/women?
women 88%
Classic/Common/Complicated migraine?
Classic - with aura (strange light/smell/etc)
Common - without aura
Complicated - hemiplegic (half body paralyzed)
Status migrainosis is what?
migraine without aura lasting >72h
Migraine vs Tension headache?
Migraine is unilateral, pulsating, severe pain while tension is usually bilateral, nonpulsatile, vague pain
Migraine aura at leat one…
Reversible visual,sensory, speech disturbance symptoms
Vertigo
Lasts for 5-60m
Hemiplegic aura also has what?
motor weakness, otherwise the same
Treatment for headaches
muscle relaxants (tension) anti-emetics (migraine) Triptans (avoid in hemiplegic migraine) NSAIDS Corticosteroids
Careful of what when treating migraines?
analgesic rebound
Consider prophylactic treatment of headache if what?
> 2days/month
Prophylactic headache treatments?
tricyclic antidepressants beta-blockers Ca-channel blockers Antiepileptics Botulin toxin
Cluster headache distinguishing features?
pounding pain in more anterior locations (orbit, temporal, maxilla) with ptosis and lacrimation
Tardive dyskinesia due to?
chonric dopamine antagonist use (antipsychotics and anti-emetics)
Tardive presentation?
choreic movements in face
dystonia and tics
Treatment of tardives
stop offending meds
benzodiazepines
dopamine depleting agents
botulin toxin if dystonic
Tourette’s syndrome onset, symptoms?
childhood motor/vocal tics ADD OCD learning disabilities
Treatment for tourettes?
dopamine blockers for tics
clonidine, methylphenidate, SSRIs for behavioral
Hemifacial spasm due to?
lesion of facial nerve
Palatal myoclonus due to lesion where?
brainstem involving triangle of guillain-Mollaret
