Neuro Flashcards
findings in CSF of HSV encephalitis?
- lymphocytic pleocytosis (abnormally increased lymphocytes)
- increased RBCs
- elevated protein count
- normal glucose
describe a focal seizure with impaired awareness
episodes of unresponsiveness with repetitive actions and postictal state.
Occur in a single hemisphere
most common intracranial tumor in adults?
brain metastasis
most common cancers that metastasize to brain?
lung, breast, melanoma, renal cell
how do brain metastases show up on MRI?
peripheral, circumscribed, enhancing lesions with vasogenic edema
which area of the brain is affected in HSV encephalitis?
frontotemporal
name a common manifestation of temporal lobe epilepsy?
focal seizures
what is the treatment for Dementia with Lewy Bodies?
- carbidopa-levodopa; parkinsonism
- cholinesterase inhibitors (rivastigmine); cognitive impairment
- melatonin; REM sleep
which drug class are Dementia with Lewy Body patients extrememly sensitive to?
- antipsychotics (esp first generation, risperidone, haloperidol)
- causes worsening confusion, parkinsonism, and autonomic dysfunction
old man acting out dreams is at risk for developing _______
Parkinson’s diesease (alpha synuclein degeneration);
He has REM Sleep Behavior Disorder (RSBD)
what is the most common cause of spontaneous lobar hemorrhage in elderly people with Alzheimer dz?
cerebral amyloid angiopathy
bilateral trigeminal neuralgia is a common sign of ?
multiple sclerosis
CSF findings in Guillain-Barre’ syndrome?
- elevatex protein count
- normal WBC count
- normal glucose
treatment of guillain-barre’?
IV Ig or plasmapheresis
where is the stroke?
- contralateral motor and/or sensory deficits, more pronounced in the lower limb
- may have urinary incontinence
anterior cerebral artery
where is the stroke?
- well-recognized syndromes: pure motor hemiparesis, pure sensory stroke sensorimotor, dysarthria-clumsy hand, and ataxic hemiparesis
- face, arm, and leg all affected with sensorymotor stroke
- no urinary incontinence
lacunar infarct
where is the stroke?
- contralateral motor and/or somatosensory deficits more pronounced in face an upper limb
- homonymous hemianopia or quadrantopia
Middle cerebral artery stroke
where would a stroke causing sudden onset aphasia be?
left lobe (dominant hemisphere); left middle cerebral artery
where would a stroke causing sudden onsetheminaglect or ansognosia be located?
right hemisphere (nondominant hemisphere), middle cerebral artery
pt with brain injury has random episodes fo htn, tachycardia, tachypnea, fever, diaphresis. what is this?
paroxysmal sympathetic hyperactivity; don’t let morphine trip you up
how does “central vertigo” present?
- non-fatigueable nystagmus, which cannot be suppressed by visual fixation
- headache
- difficulty walking
what are some causes of central nystagmus?
cerebellar stroke, MS
diagnose with non-contrast CT
how do you treat idiopathic intracranial hypertension/pseudotumor cerebri?
first line= acetazolamide +/- furosemide
then surgery/shunt
pt has loos of feeling and motor function in legs and cannot urinate. what test do you get?
cauda equina syndrome; get MRI of lumbosacral spine
management of organophosphate (acetylcholinesterase inhibitor) toxicity?
- remove clothes and irrigate eyes and skin
- give atropine (acetylcholine antagonist)
- then give pralidoxime (cholinesterase reactivating agent) after atropine
what is the difference between heat exhaustion and heat stroke?
- heat exhaustion=
- hyperthermia (>104F), weakness, dizziness, profuse sweating, headache, nausea
- heat stroke=
- all of the above, but there is CNS dysfunction and mentation is abnormal
treatment=cooling and oral hydration with salt containing fluids
PT WITH SUPRATHERAPEUTIC INR (OVER 3) PRESENTS WITH SERIOUS BLEEDING (INTRACEREBRAL HEMORRHAGE) WHAT SHOULD YOU DO?
vitamin K + prothrombin complex
pt with MS has sudden onset neurologic sx. how can you differentiate and MS flare from a TIA?
Sx of MS flares last for days to weeks.
Sx of TIAs last less than 24 hours.
Treat assumed TIA with aspirin and statin.
werinicke aphasia (cannot comprend language) affects which part of the brain?
posterior superior temopral lobe of the dominant hemisphere, left in right handed people
common finding with Brocas aphasia?
bilateral 6-10 Hz tremor that gets better with alcohol
esstential tremor; often genetic and treated with beta blockers
Myasthenia gravis pathophysiology involves an autoantibody against what?
nicotinic post-synaptic acetyulcholine receptors
Botulism pathophysiology involves autoantibodies against what?
pre-synaptic nicotinic acetylcholine receptors; botulinum toxin produces an irriversible blockade of the release of acetylcholine
Lambert-eaton myasthenic syndrome pathophysiology involves autoantibodies against what?
against pre-synaptic calcium channels at the motor endplate; paraneoplastic syndrome of small cell carcinoma of the lungs
treatment for postherpetic neuralgia?
focused on pain control;
tricyclic antidepressant (amitriptyline), topical analgesic, gbapentin/pregabablin
first line treatment for resless leg syndrome?
dopamine agonists (pramipexole, ropinirole, levodopa/carbidopa, and bromocriptine)
