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Finals Medicine > Neuro > Flashcards

Neuro Flashcards

1
Q

Brown-Sequard Syndrome - pathophysiology and features

A

Hemi-cord lesion

Features

  • Ipsilateralloss of proprioception and vibration
  • Ipsilateral UMN weakness
  • Contralateral loss of pain
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2
Q

Cerebellar signs

A

DANISH

Dysdiadokokinesia
Ataxia
Nystagmus (horizontal - ipsilateral hemisphere)
Intention tremor
Speech (slurred, staccato, scanning dysarthria- words are broken up into separate syllables)
Hypotonia

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3
Q

Causes of cerebellar syndrome

A

PASTRIES

Paraneoplastic (bronchial Ca)
Alcohol (B12 and thiamine deficiency)
Sclerosis
Tumour
Rare (Friedrich's, Alaxia Telangiectasia)
Iatrogenic (Phenytoin)
Endo (hypothyroidism)
Stroke (vertebrobasilar)
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4
Q

Lateral Medullary syndrome

Alternate name, pathophysiology and features

A

Wallenberg’s syndrome

Patho: Occulusion of one vertebral artery

Features (DANVAH):

  • Dysphagia
  • Ataxia
  • Nystagmus
  • Vertigo
  • Anaesthesia (ipsilateral facial numbness, contralateral pain loss)
  • Horner’s syndrome
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5
Q

Beck’s syndrome

Cause, Pathophys, Features

A

Cause: aortic aneurysm dissection or repair

Pathophys: Infarction of the spinal cord in the distribution of the anterior spinal artery (ventral 2/3rd of the spinal cord)

Features:

  • Para or quadriparesis
  • Loss of pain and temperature
  • Preserved touch and proprioception
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6
Q

Scissoring gait - area affected

A

Bilateral UMN lesion

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7
Q

Differentials of Parkinsonism

A

Parkinson’s disease
Multiple system atrophy
Lewy body dementia
Progressive supranuclear palsy

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8
Q

Vertigo causes

A

IMBALANCE

Infection/injury (labyrinthitis, Ramsay Hunt, trauma to petrous temporal bone)
Meniere's disease
BPPV
Aminoglycosides
Lymph
Arterial (stroke/TIA, migraine)
Nerve (acoustic neuroma/vestibular schwannoma)
Central lesions (demyelination, tumour)
Epilepsy (complex partial)
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9
Q

Commonest cause of unilateral sensorineural hearing loss

A

Acoustic neuroma

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10
Q

5 types of tremor

A

RAPID

Resting (Parkinsonism)
Action/Postural (Absent at rest, worse with outstretched hands or movement)
Intention (Cerebellar)
Dystonic (idiopathic)

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11
Q

Features of temporal arteritis

A

Unilateral temple/scalp pain and tenderness
Sudden blindness
Thickened, pulseless temporal artery

Associated with polymyalgia rheumatica in 50%

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12
Q

Migraine triggers

A 
Chocolate
Cheese
OCP
Caffeine
Alcohol
Anxiety
Travel
Exercise
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13
Q

Migraine treatment

A

Always give an anti-emetic (metoclopramide) as an adjunct

Mild-moderate:
1st - NSAID or aspirin
2nd - paracetamol
3rd - paracetamol+aspirin+caffeine

Severe:
1st - triptan+anti-emetic+NSAID
2nd - Ergot alkaloid (ergotamine)
3rd - corticosteroids

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14
Q

Causes of subarachnoid haemorrhage

A 
Berry aneurysm rupture (80%)
Arteriovenous malformations (15%)
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15
Q

First investigation of SAH

A

CT Head

If CT negative, do an LP >12 hours after start of headache

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16
Q

Drug given with SAH to reduce risk of vasospasm

A

Nimodipine (CCB)

Started on admission to reduce risk of poor outcome and secondary ischaemia

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17
Q

Bamford Classification of Strokes

And criteria for each type

A

TACS - all 3 of:

  • Homonymous hemianopia
  • Unilateral motor/sensory deficit
  • Higher cortical dysfunction (speech/hemispatial neglect)

PACS - 2/3 of:

  • Homonymous hemianopia
  • Unilateral motor/sensory deficit
  • Higher cortical dysfunction (speech/hemispatial neglect)

POCS - one of:

  • homonymous hemianopia with macular sparing)
  • cerebellar syndrome

LACS:

  • Pure motor
  • Pure sensory
  • Mixed sensorimotor
  • Dysarthria/clumsy hand
  • Ataxic hemiparesis
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18
Q

Millard-Gubler syndrome

Patho and features

A

Pontine infarct

6th and 7th nerves affected

  • Diplopia
  • LMN facial palsy
  • Loss of corneal reflex
  • Contralateral hemiplegia
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19
Q

Immediate medical management of ischaemic stroke

A
  1. tPA if <4.5 hours before onset of symptoms and no contraindications
  2. Aspirin 300mg PO
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20
Q

Secondary prevention of stroke

A

Aspirin/clopidogrel 300mg for 2 weeks
Then clopidogrel 75mg after

Warfarin instead of asp/clop if cardioembolic stroke or chronic AF

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21
Q

Main cause of TIA

A

Atherothromboembolism from carotids

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22
Q

Secondary prevention of TIA

A

Same as for stroke

Aspirin/clopidogrel 300mg for 2 weeks
Then clopidogrel 75mg after

Warfarin instead of asp/clop if cardioembolic TIA or chronic AF

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23
Q

Indications for carotid endarterectomy following TIA/stroke

A

> 70% unilateral disease

Surgery should be performed within 2 weeks

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24
Q

Stroke risk calculation following TIA

A

ABCD2 Score (/7)

Age >60
BP > 140/90
Clinical features
- Unilateral weakness (2 points)
- Speech disturbance
Duration
- >1 hour (2 points)
- 10 mins - 1 hour (1 point)
Diabetes
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25
Q

Subdural haematoma patho and main cause

A

Bleeding from bridging veins between cortex and sinuses

Often due to old injuries, such as deceleration injuries

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26
Q

Subdural haematoma on MRI head

A

Crescentic haematoma over one hemisphere

Possible midline shift

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27
Q

Indications and type of surgery for subdural haematoma

A

Indications for surgery:

  • Bleed >10mm size
  • Midline shift >5mm
  • Expanding bleed
  • Neurological symptoms/signs

Surgery - 2 burr hole craniostomy to remove clot and irrigate

Hemicraniectomy if swelling

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28
Q

Extradural haematoma on MRI head

A

Lemon

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29
Q

Eponymous signs of meningism

A

These signs are more commonly seen in children

Kernig’s sign - With the patient supine and the thigh flexed to a 90° right angle, attempts to straighten or extend the leg are met with resistance

Brudzinski’s sign - Flexion of the neck causes involuntary flexion of knees and hips

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30
Q

Medical management of bacterial meningitis

A

Ceftriaxone 2g BD IV
(+ampicillin 2g BD IV if >50 years)

Dexamethasone IV QDS

Rifampicin prophylaxis for housemates and partners

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31
Q

Contraindications of LP

A 
Thrombocytopenia or coagulopathy
Delaying antibiotics
Raised ICP
Unstable (cardio and respiratory symptoms)
Infection at LP site
Focal neurology symptoms
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32
Q

Encephalitis

Main causes

A

HSV 1 and 2
EBV
CMV

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33
Q

Encephalitis

Investigations

A

CT - bilateral temporal involvement suggests HSV
Bloods - cultures, viral PCR
LP - increased protein, lymphocytes, PCR

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34
Q

Encephalitis

Management

A

Aciclovir 10mg/kg/8h IV infusion 14 days

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35
Q

Causes of seizure

A

2/3 epilepsy is idiopathic

Congenital (NF, Tuberous Sclerosis, TORCH)

Acquired (CVA, SOL)

Other (Withdrawal alcohol/opiates/benzos, metabolic glucose/Na/Ca/urea, infection meningitis, encephalitis)

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36
Q

5 As of complex partial seizures

A

Aura

Autonomic (change in skin colour/temperature)

Awareness lost (blank stare)

Automatisms (lap smacking, fumbling, chewing)

Amnesia

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37
Q 
Petit mal (absence seizure)
Features
A

Abrupt onset and offset
Glazed, blank stare
Lasts <10 seconds
Normal examination

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38
Q

Atonic/akinetic seizure

A

Sudden loss of muscle tone

No LOC

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39
Q

Driving rules after diagnosis of epilepsy

A

Cannot drive for 1 year after seizure

Cannot drive HGV for 10 years

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40
Q

Principles of diagnosing epilepsy

A
  1. Provoked vs unprovoked
  2. Generalised vs focal (MRI and EEG)
  3. Subcategorise (eg absence, myoclonic, tonic clonic)
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41
Q

Anti-epileptics

A 
Sodium valproate (avoid in pregnancy, also enzyme inhibitor)
Lamotrigine
Carbamazepine (enzyme inducer)
Levetiracetam
Phenytoin (enzyme inducer)
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42
Q

GCS

A 
Eyes (/4):
4 spontaneously open
3 open to voice
2 open to pain
1 nothing
Speech (/5):
5 spontaneous
4 confused
3 inappropriate speech
2 vocalisations
1 nothing
Motor (/6):
6 obeys commands
5 localises to pain
4 withdraws from pain
3 flexes to pain
2 extends to pain
1 nothing
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43
Q

Indications for CT head in trauma

NICE ‘Head injury’ guideline 2014

A

CT head within 1 hour:

  • GCS <13 on initial assessment
  • GCS <15 at 2 hours after injury
  • Suspected open or depressed skull fracture
  • Signs of basal skull fracture
  • Post-traumatic seizure
  • Focal neurological deficit
  • More than one episode of vomiting since head injury
CT head within 8 hours:
- Warfarin
- LOC or amnesia + 1 of the following:
       - Age >65
       - Coagulopathy
       - Dangerous mechanism 
         of injury
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44
Q

Causes of SOL

A

Vascular

  • aneurysm
  • AVM
  • chronic subdura haematoma

Infective

  • TB
  • Cerebral abscess
  • Cyst

Neoplasm

  • Primary
  • Metastasis

Granuloma

  • TB
  • Sarcoid
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45
Q

Idiopathic intracranial hypertension

Features and management

A

Features (similar to SOL)

  • Papilloedema
  • Headache
  • 6th nerve palsy
  • Visual disturbance

Management

  • Weight loss
  • Acetazolamide to decrease ICP
  • Furosemide
  • Lumbar-peritoneal shunt is persistent/worsening symptoms despite medical management
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46
Q

Cushing’s reflex - features

A

Hypertension
Bradycardia
Irregular breathing

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47
Q

Tonsillar herniation

Cause
Pathophysiology
Features

A

Cause: SOL/increased pressure in posterior fossa

Pathophysiology: Herniation of cerebellar tonsils through foramen magnum

Features:

  • 6th nerve palsy
  • Upgoing plantars
  • Irregular breathing and apnoea
48
Q

Transtentorial/Uncal herniation

Cause
Features

A

Cause: Lateral supratentorial mass compressing the temporal lobe

Features:

  • 3rd nerve palsy (mydriasis and down&out)
  • Contralateral hemiparesis (compression of ipsilateral corticospinal tract)
49
Q

Parkinson’s-plus syndromes

Additional features

A
  1. Multiple system atrophy
    - Autonomic (postural HoTN, bladder dysfunction)
    - Cerebellar and pyramidal signs
    - Rigidity > tremor
  2. Progressive supranuclear palsy
    - Postural instability (falls)
    - Gaze palsies
  3. Corticobasilar degeneration
    - Aphasia, dysarthria, apraxia
    - Alien limb phenomenon
  4. Lewy Body Dementia
    - Fluctuating cognition
    - Visual hallucinations
50
Q

Parkinsonism features

A

TRAPPS PD

Tremor (4-7Hz)
Rigidity
Akinesia
Postural instability
Postural hypotension and other autonomic dysfunction
Sleep disorders (insomnia and frequent waking)

Psychosis (visual hallucinations)
Depression/dementia

51
Q

Autonomic dysfunction in Parkinson’s

A 
Postural hypotension
Constipation
Urinary symptoms (urgency, frequency, nocturia, incontinence)
Hypersalivation - dribbling
Hyperhidrosis
Erectile dysfunction
52
Q

Diagnosis of Parkinson’s

A

Diagnosis is clinical

Investigations are not needed for diagnosis
- Can be used in <40s to exclude Wilson’s disease

53
Q

Dopamine agonists used in Parkinson’s

2 examples

A

Ropinirole

Pramipexole

54
Q

MOA-B inhibitors used in Parkinson’s

2 examples

A

Rasagiline

Selegiline

55
Q

MS

Pathophysiology

A

CD4-mediated destruction of oligodendrocytes, leading to demyelination and neuronal death

56
Q

Lhermitte’s sign in MS

A

Neck flexion produces electric shock-like sensation in the trunk and limbs

57
Q

Optic neuritis

Symptoms and signs on fundoscopy

A

Symptoms:

  • Pain on eye movement
  • Rapid loss of central vision

Fundoscopy:

  • Reduced acuity
  • Loss of colour vision, red initially
  • White optic disc
  • Central scotoma
58
Q

Best investigation for MS

A

MRI, particularly gadolinium-enhancing

Lesions are typically present in periventricular white matter

59
Q

Diagnosis of MS

A

Clinical diagnosis by demonstration of focal neurological events separated in space and time

Confirmed by MRI and potentially CSF

60
Q

Devic’s syndrome

A

An MS variant distinguished by presence of NMO-IgG antibodies

61
Q

Management of acute attack of MS

A

Methylprednisolone 1g IV OD for 3 days

62
Q

Long-term management of MS

A

Interferon-beta
Glatiramer

Biologics:

  • Alemtuzumab
  • Natalizumab

+Symptomatic treatment

63
Q

Cord compression - features

A

At level of the lesion:

  • Radicular pain in the dermatomal distribution
  • LMN signs

Below of the lesion:
- UMN weakness and sensory loss

Other features:

  • Painless bladder retention (neuropathic bladder)
  • Faecal incontinence
64
Q

Cord compression - causes

A 
Trauma
Infection - abscess, TB
Secondary malignancy - breast, thyroid, bronchial, renal, prostate
Primary cord tumour
Haematoma (warfarin)
65
Q

Cauda equina - features

A 
Saddle anaesthesia
Urinary/faecal incontinence
Back pain
Radicular pain down legs
Bilateral flaccid, arreflexic lower limb weakness
Poor anal tone
66
Q

Hoffmann reflex

A

Flick to the middle finger pulp causes a brief pincer flexion of the thumb and index finger

https://www.youtube.com/watch?v=MUffMh-paJc

67
Q

Investigation of choice for cervical spondylosis

A

Cervical MRI

68
Q

Cervical spondylosis - features

A

Motor and sensory disturbance according to the level of compression

Most commonly C7:

  • Motor weakness of triceps, finger extension
  • Numb middle finger
69
Q

Severe UC flare

according to Truelove and Witts’ severity index

A

Patient has bloody stool or >6 stools per day plus at least one of:

  • Temperature >37.8
  • HR >90 bpm
  • Anaemia (Hb >105)
  • ESR >30
70
Q

Nerve root affected in foot drop

A

L5

Can be differentiated as the cause of foot drop (rather than peroneal nerve palsy) if the patient also has weak foot inversion

71
Q

Nerve foot affected with weak plantarflexion

A

S1

72
Q

Spinal stenosis - clinical features

A

Spinal claudication

  • Aching/heavy buttock and lower limb pain on walking
  • Rapid onset
  • Pain eased by leaning forward
73
Q

Management of cauda equina

A

Emergency decompressive laminectomy within 48 hours of onset of symptoms

74
Q

Most likely cause of Bell’s Palsy

A

HSV-1

75
Q

Bell’s Palsy - clinical features

A
  • Complete unilateral facial weakness within 24-72 hours
  • Hyperacusis (stapedius palsy)
  • Drooling, speech difficulty
76
Q

Bell’s Palsy - diagnosis

A

Clinical diagnosis

77
Q

Bell’s Palsy - treatment

A

Prednisolone

  • Given within 72 hours of symptom onset
  • 60mg PO for 5 days, then tapered
78
Q

Ramsay Hunt syndrome - pathophysiology

A

VZV reactivation in the geniculate ganglion of 7th nerve

79
Q

Ramsay Hunt syndrome - clinical features

A
  • Preceding ear pain
  • Unilateral complete facial weakness
  • Vesicular rash in the ear
  • May also affected CN8 (vertigo, hearing loss, tinnitus)
80
Q

Most common cause of mononeuritis multiplex

A

Diabetes

81
Q

Median nerve neuropathy

Nerve roots
Causes
Motor and sensory features

A

Nerve roots:
- C6-T1

Causes:

  • Carpal tunnel
  • Wrist trauma

Motor:

  • LOAF muscles (flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, lateral two lumbricals)
  • Thenar wasting

Sensory:

  • Numbness of radial 3/5 fingers and palm
  • Aching pain
  • Tinel’s and Phalen’s positive
82
Q

Ulnar nerve neuropathy

Nerve roots
Causes
Motor and sensory features

A

Nerve roots:
- C7-T1

Causes:
- Elbow trauma (supracondylar fracture)

Motor:

  • Claw hand
  • Hypothenar wasting
  • Froment’s positive (tests adductor pollicis - patient hold paper between and thumb and index finger, then paper is pulled out by examiner)

Sensory:
- Ulnar 1.5 fingers

83
Q

Radial nerve neuropathy

Nerve roots
Causes
Motor and sensory features

A

Nerve roots:
- C5-T1

Causes:
- Humeral fracture

Motor:

  • Finger/wrist drop
  • If trauma is high up - triceps paralysis

Sensory - Snuff box

84
Q

Sciatic nerve neuropathy
Nerve roots
Causes
Motor and sensory features

A

Nerve roots:
- L4-S3

Causes:
- Pelvic/femoral fracture

Motor:
- Hamstrings and all muscles below the knee

Sensory:
- Below knee laterally and foot

85
Q

Common peroneal
Nerve roots
Causes
Motor and sensory features

A

Nerve roots:
- L4-S1

Causes:
- Fibular head fracture

Motor:

  • Foot drop
  • Weak ankle dorsiflexion and eversion (intact inversion)

Sensory:
- Below knee laterally

86
Q

Tibial nerve neuropathy
Nerve roots
Motor and sensory features

A

Nerve roots:
- L4-S3

Motor:

  • Loss of plantarflexion
  • Foot inversion
  • Toe flexion

Sensory:
- Sole of foot

87
Q

Miller-Fisher syndrome

A

Variant of GBS

Triad of:

  • Ataxia
  • Areflexia
  • Ophthalmoplegia (acute onset of external ophthalmoplegia is a cardinal feature)
88
Q

GBS - management

A

IVIg/Plasma exchange

Support (4As)

  • Airway/ventilation (may need ITU admission if FVC <1.5L)
  • Analgesia
  • Autonomic (inotropes)
  • Antithrombotic (TEDS stockings, LMWH)
89
Q

GBS - clinical features

A

2/3 have preceding URTI or gastroenteritis within 6 weeks before onset of neuro symptoms

Progressive symmetrical muscle weakness (flaccid paralysis)

  • Lower limbs before upper extremities
  • Proximal muscles before distal muscles

Paraesthesia of hands and feet

Areflexia

90
Q

GBS - initial investigations

A

LP

  • Exclude infectious causes
  • CSF protein with normal cell count is the classic finding

Spirometry

  • Performed every 6 hours initially
  • FVC <20mL/kg indicates ITU admission

Neurophysiological evaluation
- Nerve conduction studies

Serology and stool culture
- To try to identify a cause (CMV, EBV, C jejuni)

91
Q

Charcot-Marie-Tooth syndrome

A

Group of inherited motor and sensory neuropathies

Onset in puberty

Motor:

  • High stepping gait
  • Symmetrical muscle atrophy (champagne bottle legs)
  • Pes cavus, toe clawing

Sensory:
- Loss of sensation in stocking distribution

Initial investigation - nerve conduction studies

92
Q

Charcot-Marie-Tooth syndrome

Management

A

Physiotherapy and exercise

Occupational therapy

Bracing/orthopaedic surgery for foot deformities

93
Q

Bulbar Palsy

Cranial nerves affected
Clinical features

A

CN 9-12
Lower motor signs in the tongue, talking and swallowing

Clinical features:

  • Tongue fasciculations, flaccid
  • Quiet/nasal speech
  • Absent jaw jerk reflex and gag reflex
94
Q

Bulbar palsy vs pseudobulbar palsy

A

Bulbar is LMN, pseudobulbar is UMN
Pseudobulbar palsy is more common

Tongue:

  • Bulbar - fasciculations, flaccid
  • Pseudobulbar - spastic, slow movements

Speech:

  • Bulbar - quiet/nasal speech
  • Pseudobulbar - slow speech (hot-potato speech)

Jaw jerk reflex:

  • Bulbar - normal/absent
  • Pseudobulbar - brisk
95
Q

Motor neurone disease - classification

A

ALS

  • Cortex and anterior horn
  • UMN and LMN
  • Asymmetrical limb involvement is the most common presentation

Progressive bulbar palsy

  • CN 9-12
  • LMN

Progressive muscular atrophy
- Anterior horn
- LMN only
Distal to proximal progression

Primary lateral sclerosis

  • Motor cortex
  • Mainly UMN
  • Spastic leg weakness and pseudobulbar palsy
96
Q

ALS - clinical features

A

UMN signs:

  • Weakness
  • Spasticity
  • Hyperreflexia
  • Upgoing plantar

LMN signs:

  • Weakness
  • Atrophy
  • Fasciculations

Never:

  • Sensory
  • Sphincter
  • Eye movement
97
Q

ALS - role of investigations

A

ALS is a clinical diagnosis

Investigations are used to exclude differentials and detect LMN disease in limbs that are clinical unaffected

Exclude differentials

  • Imaging (area of spine with suspected lesions, brain if bulbar signs)
  • Nerve conduction and blood tests if peripheral nerve signs

Asses limb involvement is asymptomatic limbs
- EMG

98
Q

Duchenne muscular dystrophy - inheritance

A

X-linked recessive

30% are spontaneous

99
Q

Becker muscular dystrophy s Duchenne

A

Becker presents later, is less severe and has better prognosis

Both are X-linked recessive

100
Q

Myasthenia gravis - initial investigations

A

Antibodies:

  • Anti-AChR
  • Muscle-specific tyrosine kinase (MuSK) antibodies

Serial FVC and NIF - if suspected MG crisis

EMG

CT chest - performed at diagnosis to detect thymoma (15%) or thymic hyperplasia (75%)

101
Q

Lambert Eaton vs Mysasthenia Gravis

A

Lambert Eaton:

  • Leg weakness before ocular involvement
  • Autonomic dysfunction (dry mouth is most common/metallic taste)
  • Areflexia
102
Q

Neurofibromatosis type 1

Inheritance
Clinical features

A

Von Recklinghausen’s disease

Inheritance: Autosomal dominant

Clinical features:

  • Cafe-au-lait spots
  • Freckling (axillary)
  • Neurofibromas
  • Lisch nodules (small hamartomatous nodules in the iris)
  • Neoplasia (CNS, phaeo, AML)
  • Epilepsy
  • Renal artery stenosis
103
Q

Cafe-au-lait spots

Causes

A

Neurofibromatosis (I and II)
McCune-Albright
Multiple Lentigenes
Urticaria Pigmentosa

104
Q

Neurofibromatosis type 2

Inheritance
Clinical features

A

Inheritance:
- Autosomal dominant (50% de novo)

Clinical features:

  • Bilateral acoustic schwannomas are characteristic (first sensorineural hearing loss, the tinnitus, then vertigo)
  • Cafe-au-lait - typically fewer than in NF1
  • Bilateral cataracts
105
Q

Syringomyelia

Pathophysiology
Clinical features

A

Tubular cavity in the central canal of the cervical cord

Clinical features:

  • Sensory loss (loss of pain/temperature, preserved touch/proprioception/vibration)
  • Hand wasting (claw hand)
  • Absent upper limb reflexes
  • Charcot joints (shoulder, elbow)
106
Q

Friedrich’s ataxia

Clinical features

A

Mitochondrial disease

  • Pes cavus and scoliosis
  • Bilateral cerebellar signs
  • Leg wasting and areflexia
  • Optic atrophy
  • HOCM
  • DM - hyperglycaemia
107
Q

Cluster headache

Principles of management

A

100% oxygen
Subcutaneous triptan

Verapamil is used for prophylaxis

108
Q

Migraine

Principles of management

A

Acute management:
- Triptan + NSAID/paracetamol

Prophylaxis:
- Topiramate or propranolol

109
Q

Epilepsy

Recommended diet

A

Ketogenic diet

110
Q

Venous sinus thrombosis

Gold standard investigation

A

MR Venogram

111
Q

Degenerative cervical myelopathy

Treatment

A

Cervical decompressive surgery

112
Q

Restless leg syndrome

Management

A

Dopamine agonists, eg ropinirole

113
Q

Reflexes and roots

A

Ankle S1-2
Knee L3-4
Biceps C5-6
Triceps C7-8

114
Q

Trigeminal neuralgia

First-line treatment

A

Carbamazepine

115
Q

Cavernous sinus syndrome

Clinical features

A

Clinical features:

  • Signs of pain
  • Ophthalmoplegia
  • Proptosis
  • Trigeminal nerve lesion
  • Horner’s syndrome
116
Q

Subacute combined degeneration of the cord

Clinical features

A

Typically develops over months

  • Ataxic gait (dorsal columns)
  • Mixed UMN and LMN signs (lateral motor tracts and peripheral nerves)

Finals Medicine (2 decks)

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