NEURO 6 Flashcards
resting tremor causes
PD, psychogenic, drug induced PD
postural tremor causes
drug induced, ET, psychological, trauma, neuropathy
kinetic
cerebellar, wilsons
head
ET
joint
dystonia, PD
what ix should be done in tremor and in who
TFTs in <45s
dystonic tremor produced how
treatment
dystonic muscle contraction
propanolol, promidone, atenolol, stool, gabapentin
myoclonus with encephalopathy
liver disease, renal failure, alcohol, lithium
myoclonus with dementia
alzheimers, LBD
myoclonus with parkinsonism
multisystem
myoclonus - focal /segmental
injury
juvenile myoclonus epilepsy in who
female teenager who drinks and doesn’t sleep and has gen seizures as well and is worse in the mornings
EEG of JME
3-5Hz wave pattern
treatment of JME
valproate
levetiracetam
TICS causes
tourrets -primary
hunt, wilsons, retts, fragil X, docs, autism, BG lesions, post encephalitis, infections, drugs, poisoning, cocaine, amphetamines
turrets syndrome genetics
ADom M>5
mostly in under 18s
diagnosis of tourreettss
multiple motors tics and 1 or more vocal
occur lots during the day or intermittently over a year with no longer than 3 months tics free
onset <18
exclusion of obvious secondary causes
treatment of tics
clonidine, tetrabenazine
CBT
chorea causes
huntingtons, wilsons, benign hereditary
SLE, anti phosph, coeliac, hashimotos, HIV, levodopa, OCP, anticonvulsants, PD, glucose, thyroid, Na, Mg
treatment of chorea
underlying
terbazine or DA - reserpine
torsion dystonia genetics
where does it start and progresses how
treatment
DYT1. childhood. FH
limbs usually legs and majority progress over 5-10y to become gen/multifoca
cervical - botox
FIRST LINE DEEP BRIAN STIMULATION
TACI where and criteria
middle and cerebral arteries
unilateral hemiparesis +/or hemisensory loss of face, arm and leg
HH
high cogn dysf
PACI
small arteries of anterior circulation
2 of TACI OR isolated cogn dysf OR pure motor/sensory symptoms
posterior circulation infarct
vertibrobascilar arteries
1 of: cerebellar/brainstem syndrome, LOC, isolated HH
lacunar infarcts
perforating arteries around internal capsule, thalamus, BG
1 of:
unilateral sensory (and/or sensory deficit) of face and arm, arm and leg or all 3
pure sensory stroke
ataxic hemiparesis
lateral medullary syndrome (wellenbergs)
post inf cerebellar artery
ipsilateral: ataxia, nystagmus, dysphagia, facial numbness, CN palsy
contrlateral: sensory limb
webers syndrome
brainstem
ipsilateral CN3 palsy and contralateral weakness
cereberal perfusion pressure is
aim in head injury should be
MAP + ICP
>60 (MAP 80 and ICP 20)
normal ICP
9-11
skull vault fracture
linear, depressed, compound
ant cranial fossa
raccoon eyes
middle cranial fosssa
battle sign over mastoid
when should CT be done immediately
GCS <13 initially <15 at 2h post injury suspected open/depressed skull fracture basal fracture signs post trauma seizure focal near signs >1 ep of vom
CT within 8h if amnesia/LOC and:
65 or over, history of bleeding/clotting disorders, dangerous mechanism of injury, >30min of retrograde amnesia, on warfarin
complications
epilepsy
CSF leak
cognitive
early 2w
into nose/middle ear
post concussion synd in 30% of px
