Neuro cases 1

Question 1

What are the 3 most common types of headaches? What are basic characteristics of each?

Answer 1

1. Migraine: unilateral; patient prefers a dark room, can have n/v associated, photophobia, etc
2. Tension type headache: bilateral; waxes and wanes
3. Cluster: unilateral beginning at one temple

Question 2

The ________ criteria could represent a space occupying mass, vascular lesion, infection, metabolic disturbance, or systemic problem

Answer 2

SNOOP

Question 3

What does SNOOP stand for? 
s
n
o
o
p

Answer 3

Systemic- (illnesses or fevers)
Neuro- (confusion, papilledema)
Onset-(she’s NEW)
Other associated conditions-(head trauma, illicit drug use, worse with Valsalva
P-Previous HA with HA progression or change

Question 4

What are reasons that an emergency evaluation may be needed for a headache?

Answer 4

• Thunderclap headache
• Acute neck pain or associated -Horner syndrome
• meningitis or encephalitis suspicion
• orbital or preorbital sx
• possible CO exposure

Question 5

List the things that the dizziness specific history should include

Answer 5

History of trauma 
Frequency 
Severity 
Associated symptoms (blurry sx, syncope, N/V, hearing loss) 
personal and family hx of similar sx 
review of meds

Question 6

Define vertigo

Answer 6

a sensation of self motion when no movement is occurring or a self distorted movement with head turning

Question 7

What are some possible causes of vertigo?

Answer 7

Asymmetry in the vestibular system

disorder in the peripheral labyrinth

Question 8

What does TiTrATE stand for in the evaluation of dizziness

Answer 8

Ti-Timing of the symptom
Tr-Triggers that provoke the symptom
Ate-And a Targeted Examination

Question 9

What are the three clinical scenarios that dizziness can fall under?

Answer 9

Episodic triggered sx
Spontaneous episodic sx
Continuous vestibular sx

Question 10

Describe the Dix Hallpike Maneuver

Answer 10

This test consists of a series of two maneuvers:(A)With the patient sitting on the examination table, facing forward, eyes open, the physician turns the patient’s head 45 degrees to the right.(B)The physician supports the patient’s head as the patient lies back quickly from a sitting to supine position, ending with the head hanging 20 degrees off the end of the examination table. The patient remains in this position for 30 seconds. Then the patient returns to the upright position and is observed for 30 seconds. Next, the maneuver is repeated with the patient’s head turned to the left. A positive test is indicated if any of these maneuvers trigger vertigo with or without nystagmus

Question 11

_____ occurs with the loose canaliths “get stuck” in the semicircular canals

Answer 11

BPPV

Benign Paroxysmal Positional Vertigo

Question 12

What are the treatments that are used for BPPV?

Answer 12

Epley maneuvers in the office or Brandt Daroff exercises at home

Question 13

Describe Meniere’s disease

Answer 13

vertigo with hearing loss with or without tinnitus

vertigo that requires bed rest

Question 14

What are the classifications of syncope?

Answer 14

Cardiac
Neurally mediated
Orthostatic hypotension

Question 15

What are the THREE Things that the history portion of a syncope reaction should focus on?

Answer 15

1. Is there LOC?
2. hx of CVD?
3. clinical features that would signify why there was syncope?

Question 16

Review these cases for a bit to get more info on the plans and stuff to get a feel for what she wants, just in case. I thought it would be a lot to do flashies on them

Answer 16

K thanks bye