Neuro Flashcards
unilateral facial weakness/drop, forehead not spared,
Bells palsy
recurrent severe headaches, unilat, esp around eyes, long pain free periods between sets
cluster headache
insidious amnesia, language impairment, poor day to day memory,
Alzheimers
Sudden onset dementia with stepwise derivation
vascular dementia
personality change, disinhibition, well preserved memory
temporal dementia
visual hallucinations, fluctuating cognition, asso with Parkinson’s
levy body dementia
seizure - motor convulsions, jacksonian march, todds paralysis
frontal lobe focal motor siezure
seizure with aura and halluciantions
temporal lobe focal
irritability then generalised muscle spasm then repetitive synchronous jerks, tongue biting
tonic clonic siezure
loss of consciousness with maintained posture
absence siezure
head trauma, lucid interval then increasingly severe headache and dec GCS
extradural haemorrhage
progressive, ascending symmetrical limb weakness and paraesthesia following recent inf
guillan barre syndrome
ptosis, meiosis, anhydrosis
horners
progressive chorea and dementia
clumsiness, involves movements, anxiety, strong FHx,
Huntingtons
severe headache, photophobia, neck + backache, kernigs sign
meningitis
severe episodic pulsatile headache that is associated with systemic disturbance and disrupts normal activities
migraine
weakness in skeletal muscles that worsens with repetitive use, facial weakness
myasthenia gravis
multiple cafe-au lait spots, learning difficulties, headaches, precious puberty
T1 neurofibromatosis
bradykinsia, rigidity, resting asymmetrical pill rolling tremor, postural instability, stooped gait, shuffling, depression and dementia
parkinsons
back pain, hyporeflexia, disturbance of bowel/bladder function, low BP, sensory loss
spinal cord compression
facial droop, arm weakness, speech difficulty, sudden onset
stroke
behavioural changes and centralat hemiparesis (leg>arm)
ACA stroke
contralat hemiparesis (arm/face> leg) hemisensory loss, aphasia
MCA stroke
contralat homonous hemianopia, visual agnosia, slurred speech,
PCA stroke
sudden onset worst headache ever
subarachnoid haemorrhage
trauma, ipsilat fixed, dilated puil, dec GCS, worsening headache
subdural haemorrhage
new onset unilateral headache in pt >50, jaw claudation, scalp tenderness, shoulder pain
temporal arteritis
unilateral stabbing/shooting facial pain lasting for a few seconds
Trigeminal neuralgia
ataxia, confusion, ophlamoplegia, diplopia
wernickes encephalopathy
ataxia, confubulation, amnesia, alert
korsakoff’s psychosis
brisk reflexes, babinski sign, fasciculations, tongue wasting, stiffness and weakness
Motor neurone disease
what’s the most important risk factor for stroke
HTN
what often precedes bells palsy
upper RT inf
management of bells palsy
protection of cornea (glasses/patch)
high dose corticosteroid if acute
what is the aetiology of alzheimers
normal - a and y secretase -> normal degradation product
alz - y and b secretase -> amyloid B (resistant to deg) - accumulator and forms amyloid plaques -> interfere with com -> dementia
hypoerphosphorylated tau -> neurofibrillary tangles -> neuronal and synaptic loss
Inv for alzheimers
CSF - inc tau and B amyloid
focal epilepsy management
lamotrigine/carbamazepine
generalised epilepsy management
sodium valproate
treatment for status elipticus
1 - ABCDE and check glucose (correct if low)
2 - IV lorazepam/IV diazepam - repeat in 10 mins if doesn’t stop
3- if 2 doses don’t stop seizure - IV phenytoin
common cause of status elitpicus
non compliance with anti-epileptic meds
CT of extradural haemorrhage
lemon shape
neonates - inc head circumference and downward facing eyes
obstructive hydrocephalus
when would a lumbar puncture be contraindicated
inc ICP
Dementia, gait disturbance, urinary incontinence
communicating hydrocephalus
cause of huntingtons
CAG repeats
huntingtons CT/MRI
symmetrical atrophy of striatum in brain
where does meningitis cause inflam
pia + arachnoid mater
management of meningitis
cephelosporin
IV dexamethasone
inform public health
UMN signs
hyperreflexi, spastic weakness, extensor palmar response
LMN signs
muscle wasting, hyporeflexia, flaccid weakness, fasciculations
optic symptom of MS
optic neuritis - unilateral deterioration of visual acuity and colour perception, pain on eye movement
Uhthoffs sign
MS - worsening of symptoms as body heats up
Inv for myasthenia gravis
tension test - give short acting anti cholinesterase - rapid and transit improvement
ice pack on eye for 2 mins -> dec ptosis
nerve conduction study
what cells does Parkinson’s affect
dopaminergic neurones of substantiated nigra
pt only symptomatic after 70% loss
Inv for parkinsons
levodopa trial - timed walking and then again after administration of levodopa
bloods - serum caeruloplasmin to rule out wilsons
Brain CT and MRI
management of parkinsons
levodopa
LMN symptoms in single/few muscles and pain in dermatomal pattern
radiculopathy
management for ischaemic stroke
if <3hrs since onset - IV alteplase then aspirin
if >3 - 300mg aspirin
stroke unit follow up
secondary prevention of stroke
AF + - warfarin prophylaxis
AF- - aspirin for 2 weeks then lifelong clopidogrel
treatment for temporal arterisis
high dose oral prednisolone
triggers for trigeminal neuralgia
vibration, brushing teeth, skin contact, wind
