Neuro Flashcards
Epi of compressive
neuropathies
musical instruments, typing,
repetitive mvts
Epi of peripheral
neuropathies
diabetic pts, HIV,
fluoroquinolone abx
What is classic migraine
HA?
with aura
What is epi of ALS?
M>F 50-70yo
What is epi of Alzheimer’s
disease?
MC >60 y RF: CV, lower ed, sedentary, brain trauma, benzodiazepine use
What is epi of benign
essential tremor?
MC tremor, bimodal 20s and
60s, autosomal dominant
What is epi of Chronic
Inflammatory Demylinating
Polyneuropathy?
M>F
What is epi of cluster HA?
young & middle aged males
What is epi of
Frontotemporal Dementia?
Rare
35-75 y
What is epi of huntingtons?
autosomal dominant with
anticipation, age 30-50y
What is epi of migraine
HA?
MC women, FH
What is epi of MS?
Women 20-40 y
What is epi of myasthenia
gravis?
women 20-40y
What is epi of post herpatic
neuralgia?
advanced age, F>M
What is epi of restless leg
syndrome?
MC elderly, genetic,
secondary to Fe deficiency,
pregnancy and caffeine
What is epi of TG
neuralgia?
middle aged women
What is epi of vascular
dementia?
2nd MC Caused by strokes RF: HTN, hypercholesterolemia, FH CVD, diabetes, smoking, A fib
What is etiology of Guillian
Barre syndrome?
CMV, EBV, HIV, mycoplasma
What is pathophys of ALS?
necrosis of both upper & lower
motor neurons and excess
glutamate in brains
What is pathophys of
Alzheimer’s disease?
APOE4 muttaion
What is pathophys of
bells palsy?
unilat CNVII
What is pathophys of
blow-induced
dementia?
Chronic traumatic encephalopathy
What is pathophys of
cluster headache?
activated by TG pathway
What is pathophys of
Guillian Barre
Syndrome?
Immune mediated demylinating of
peripheral nerves
What is pathophys of
HZV?
VZV deactivated in dermatome
and infects nerve & skin
What is pathophys of
Lacunar infarction?
small vessel infarction
What is pathophys of
MS?
Axon degeneration of white
matter
CNS IgG production & T cell
reaction
What is pathophys of
myasthenia gravis?
Auto Ab against Ach at
neuromuscular
junction→progressive weakness
What is pathophys of
normal pressure
hydrocephalus?
Primary: poorly understood
Secondary: impaired CSF
reabsorption across arachnoid villi
due to inflammation
What is pathophys of
TG neuralgia?
compression of TG nerve
What is the epi of
tension HA?
MC age ~30
What is the etiology of
bacterial meningitis?
group B strep or N. meningitis
What is the etiology of
fungal meningitis?
cryptococcus, histoplasma
blastomyces or coccidioides
What is the etiology of
viral meningitis?
enterovirus
What is the pahtophys
of subarachnoid
hemorrhage?
AVM and bleeding into
subarachnoid space
What is the pathophys
of cerebral infarction?
anterior or posterior cerebral
What is the pathophys
of migraine HA?
vassodilation and TG nerve
innervation
What is the pathophys
of TIA?
emolbus lasting <24 hrs
How do you treat
bacterial
meningitis?
IV Abx ceftriazone and vancomycin
Add ampicillin if >65 yr
How do you treat
benign essential
tremor?
avoid caffeine, provide with weighted
spoons, magnetic buttons
if severe use propanolol BID or
primadone
How do you treat
Cerebral Infarction?
thrombolytics within 3 hrs
How do you treat
CJD?
Fatal in 1 year
How do you treat
cluster HA?
100% O2, anti-migraine meds
Verapmil pphx
NO Beta blockers
How do you treat
fungal meningitis?
V anti-fungals and lifetime pphx
fluconazole (immunosuppressed)
How do you treat
huntingtons
disease?
supportive
How do you treat
migraine
headaches?
triptans or ergoamines and antiemetics
How do you treat
restless leg
syndrome?
dopamine agonists (primipezole or ropinirole) and Fe supplementation
How do you treat
subarachnoid
hemorrhage?
surgical decompression, anti-emetics,
excision and cauterization and HTN
management
How do you treat
tension headaches?
NSAIDs, aspirin, Ace combo with
caffeine
How do you treat
TIA and Lacunar
Infarct?
aspirin, supine position in increase
perfusion and reduce underlying
cause
How do you treat
viral meningitis?
supportive IV fluids, acyclovir if hx of
herpes
reatment for ALS
Riluzole reduces progression for 6 mo
Fatal w/in 3-5 yrs
Can prolong with ventilatory support
Treatment for
compressive
neuropathies
Splints NSAIDs PT Rest/activity modification Surgical decompression
Treatment for HZV
Acyclovir, valtrex, famivir at onset of sx Pain control (opiates, anticonvulsants)
Treatment for peripheral
neuropathies
Anti-convulsants (first line) Anti-depressants Weak opioid agonist Lidocaine patches Exercise, diet and weight loss
Treatment for post-herpatic
neuralgia
Anticonulsants
Antidepressants
Weak opioid agonist,
lidocaine patches or creams
Treatment for TG neuralgia
Anti-convulsants (carbamazepine Gabapentin) Glycerol inj or knife radiosurgery Surgical decompression
What is tc for Guillian Barre
syndrome?
Plasmapheresis IVIG Dec time in ICU but will resolve on its own 60% full recovery in 1 yr
What is treatment for
Chronic Inflammatory
Demylinating
Polyneuropathy?
Prednisone
Plasma exchange or IVIG
Respiratory support
Immunosupressants
What is tx for MS?
Acute exacerbations: IV corticosteroids Relapse/progressive: β- interferon Amantadine for fatigue
What is tx for myasthenia
gravis?
Ach inhibitors: pyridotigmine or neostigmine (GI side effects and muscle twitch) Prednisone-most effective Plasma exchange Immunosupression
What is tx of Alzheimer’s
Disease?
Acetylcholinesterase inhibitors slow disease slightly (mild) Memantine to slow progression slightly (modsevere) Avoid sedatives Highly structured routines, caregiver, memory clinic, avoid changes in environmen
What is tx of Blow-induced
Dementia?
Prevention at young age
What is tx of
Frontotemporal Dementia?
Atypical APS not typical ones
acholinesterase inhibitors
What is tx of Normal Pressure Hydrocephalus?
Ventricular shunt placement (may require revisions overtime)
What is tx of Vascular Dementia?
Actylcholinesterase inhibitors and memantine used despite evidence
Control BP
PT and OT, caregiver edu, minimize change in pts environment
