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MS3 > Neuro 5 > Flashcards

Neuro 5 Flashcards

1
Q

What is Todd paralysis

A

o Self-limited, focal weakness that occurs after a focal or generalized seizure
o Presents in the postictal period with a partial or complete hemiplegia involving ipsilateral upper and lower extremity
o Paralysis usually resolves within 36 hours

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2
Q

What is pseudotumor cerebri and potential causes

A 
♣	Aka idiopathic intracranial HTN
♣	Increased intracranial pressure without hydrocephalus
♣	Risk factors:
•	Woman of childbearing age 
•	Vitamin A excess
•	Tetracyclines
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3
Q

Presentation of pseudotumor cerebri

A

♣ Presentation:
• Headache, diplopia, papilledema
• Lumbar puncture shows increased opening pressure with headache relief

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4
Q

Major side effects of valproic acid

A

NTD, hepatotoxicity, pancreatitis

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5
Q

Major side effects of Lamotrigine

A

Non-serious skin rash or Stevens Johnson syndrome

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6
Q

Major side effects of Levetiracetam

A

Agitation/Mood swings, fatigue

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7
Q

Major side effects of Topiramate

A

Weight loss, kidney stones, glaucoma

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8
Q

Major side effect of phenytoin

A

Osteoporosis, cleft palate, gingival hyperplasia, hirsutsm, SJS, ataxia, diplopia , drug-induced lupus

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9
Q

What drug is Dilantin

A

Phenytoin

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10
Q

What is apraxia

A

Apraxia is a motor disorder caused by damage to the brain (specifically the posterior parietal cortex), in which the individual has difficulty with the motor planning to perform tasks or movements when asked, provided that the request or command is understood and he/she is willing to perform the task

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11
Q

Definition and presentation of pseudotumor cerebri

A

♣ Aka idiopathic intracranial HTN
♣ Increased intracranial pressure without hydrocephalus
♣ Presentation:
• Headache, vision loss, diplopia, papilledema
• Lumbar puncture shows increased opening pressure with headache relief

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12
Q

Describe parts of the CNS involved in volitional bladder control

A

o Dorsomedial frontal lobe connects to the medial region of the pontine micrurition center (PMC), providing volitional control of micturition through a decrease in urethral pressure followed by increased contraction of the destrusor muscle (causing voiding)
o The lateral region of the PMC produces powerful contraction of the urethral sphincter (promoting storage)

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13
Q

Damage to what levels will cause spastic bladder

A

Spastic bladder implies UMN problem

Lesion involving frontal love, pons, or suprasacral spinal cord

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14
Q

Damage to what levels will cause atonic bladder

A

Atonic = LMN problem

Lesion at level of conus medullaris, cauda equina, or sacral plexus

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15
Q

Describe which nerves are involved in:

  • sensory innervation of penis
  • erection
  • ejaculation
A

Pudendal nerve = sensory innervation

Parasympathetic (S2-S4) = erection

Sympathetic (T11-T12) = ejaculation

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16
Q

What physical exam findings indicate a dangerous cause to a HA

A

Papilledema = ICP
Neck stiffness = meningitis
Temporal artery tenderness = giant cell arteritis

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17
Q

Abortive tx of migraine HA

A

Triptans

18
Q

Prophylactic tx of migraine HA

A
  • Beta blockers
  • TCAs (amitriptyline)
  • Anti-epileptics (Valproic acid, Topiramate)
  • Calcium channel blockers
19
Q

How long do migraines typically last

A

4-72 hours

20
Q

How long do tension HAs typically last

A

4-6 hours

21
Q

How long do cluster HAs usually last

A

15 min - 3 hours

22
Q

Describe presentation of tension HA

A

♣ Bilateral headache with constant, steady pain (non-throbbing)
♣ Usually in frontal or occipital lobe (band-like)
♣ No throbbing, no photophobia, no phonophobia, no aura

23
Q

Tx of tension HA

A

♣ Treatment: NSAIDs, Acetaminophen

• Avoid overuse of caffeine, NSAIDs, and barbiturate-containing compounds

24
Q

Describe long-term timing of cluster HA

A

♣ Repetitive (often occur daily at the same time)

♣ May experience periods of high frequency Has followed by month-year HA-free periodss

25
Q

Associated sx of cluster HA

A

♣ Associated with lacrimation, rhinorrhea, and Horner syndrome (ptosis and miosis, not anhidrosis)
♣ Individuals are restless and feel the need to get up and move
• Vs. migraines where patients want rest and quiet

26
Q

Tx of cluster HA

A

♣ More common in young men and smokers

♣ Treatment: 100% O2, sumatriptan

27
Q

Important complication of idiopathic intracranial HTN

A

• Most important complication – visual loss due to compressive optic neuropathy

28
Q

Tx of pseudotumor cerebri

A

AKA idiopathic intracranial HTN

• Treatment = repeated LP, diuretics, lumboperitoneal shunting

29
Q

Tx of giant cell arteritis

A

High dose steroids

30
Q

Tx of trigeminal neuralgia

A

Carbamazepine

31
Q

Diagnose based on pain:

  • “Electric” face pain
  • “Burning/itching” face pain
A 
Electric = trigeminal 
Itch/burn = postherpetic neuralgia
32
Q

Tx of postherpetic neuralgia

A

Gabapentin or TCA

33
Q

Describe presentation of HA associated with idiopathic intracranial HTN

A

o Worse in the morning
o Worse when sitting up or with increase pressure (e.g. Valsalva)
o May be accompanied by pulsatile tinnitus and ransient visual obscurations

34
Q

Describe the ice pack test and what it tests for

A

Test for myasthenia gravis
♣ Ice pack placed over the eyelids leads to improvement in ptosis
♣ Cold temp inproves muscle strength by inhibiting the breakdown of Acetylcholine at the NMJ

35
Q

Stroke of what artery / part of the brain causes Broca’s aphasia

A

Stroke of superior division of middle cerebral artery - lesion to posterior inferior frontal lobe (posterior part of inferior frontal gyrus)

36
Q

Components of language exam

A

Fluency, repitition, naming, comprehension, reading writing

37
Q

Stroke of what artery / part of the brain causes Werknicke’s aphasia

A

Inferior division of MCA - posterior part of the superior temporal gyrus

38
Q

Describe transcortical motor aphasia

A

♣ Lesion to frontal lobe slightly superior to Broca’s area

♣ Nonfluent aphasia similar to Broca’s but with preserved repitiion

39
Q

Describe transcortical motor aphasia

A

♣ Lesion to frontal lobe slightly superior to Broca’s area

♣ Nonfluent aphasia similar to Broca’s but with preserved repitiion

40
Q

Describe transcortical sensory aphasia

A

♣ Lesion in inferior portion of L temporal lobe

♣ Fluent speech with impaired comprehension similar to Wernicke’s but preserved repetition

41
Q

Damage to what part of the brain causes alexia without agraphia

A

Inability to read with a preserved ability to write

Due to lesion involving the splenium of the corpus callosum

42
Q

What symptoms is almost invariably a manifestation of all aphasias

A

Anomia

MS3 (88 decks)

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