Neuro Flashcards
Give different types of gait
Ataxic (broad-base and unsteady)
Parkinsonism (small, shuffling steps with stooped posture and reduced arm swing)
High-stepping (due to foot drop)
Waddling (due to proximal LL weakness)
Hemiparetic
Heel-to-toe gait (?weakness, impaired proprioception or cerebellar disorder)
Heel walking (dorsiflexion power problem)
Describe the babinski sign
It is an abnormal plantar reflex (S1) where running a blunt object along the lateral edge of the sole of the foot to medial side of the toes causes extension of the big toe
Give the MRC grading of power
5 = full power against resistance 4 = power against gravity but with less resistance 3 = power against gravity but not resistance 2 = no power with gravity but can move 1 = muscle flickering 0 = no evidence of contraction
Whats the difference between spasticity and rigidity?
Spasticity is velocity dependent - the faster you do it the worse it is ‘spastic catch’
Rigidity is ‘velocity independant’ - it feels the same regardless of how fast you move the limb
what tuning fork should you used for vibration sensation?
128Hz
What are the 5 things that you test for for the optic nerve?
Visual acuity Pupillary reflexes Visual fields Inattention Accommodation
What are the different causes of peripheral neuropathy?
V - vasculitis I - syphilis Toxins - alcohol, lead A M - B12/folate deficiency, uraemia I - GBS, CIPD N
What are the causes of mainly sensory neruopathies?
DM
B12
Alcohol
Mercury
What does myotonia mean?
Inability to relax voluntary muscle after vigorous effort
Where does the MND pathology occur anatomically?
The anterior horn cells of the motor pathways
A patient presents with ataxia, speech impairment, nystagmus and reduced tone on examination.
You suspect cerebella syndrome - what are on your list of differentials?
MS Stroke Tumour - acoustic neuroma/meningioma Drugs - phenytoin Alcohol Paraneoplastic Hypothyroidism
