Neuro conditions Flashcards
Benign Essential Tremor
- symetrical or asymmetrical? onset?
- worse when?
- improved with?
- Absent in?
- Management
is an autosomal dominant condition which usually affects both upper limbs >>fine tremor affecting all the voluntary muscles.
It is most notable in the HANDS but affects many other areas, for example causing a head tremor, jaw tremor and vocal tremor.
Features
- Fine GRADUAL tremor
- Symmetrical
- NON resting tremor
- Worse when tired, stressed or after caffeine
- Improved by alcohol> da faq?
- Absent during sleep
Managment
- Propranolol (a non-selective beta blocker)
- Primidone (a barbiturate anti-epileptic medication)
Causes of Tremors
Multiple sclerosis
pathophysiology, epidemiology, causes
Chronic cell mediated type four hypersensitivity characterized by demyelination of CNS
cx
- EBV
- low vitamen D
- smoking
- obesity
- genetic HLADR2
epidem
- more common in women
- age 20-40 yrs
- More common in higher latitudes
Multiple sclerosis
pathophys, symtoms and signs
Six MS eponyms
What investigation do u want to carry out and why?
(b4 referring to a neurologist and after)
MS & pregnancy
Managment of MS (3 appraches)
Parkinsons disease
triad, pathophys, presentation, non motor symp, diagnosis, staging
POSTURAL HYPOTENSION
due to failure of the ANS to regulate BP due to an inadequate release of NE, leading to orthostatic hypotension
Parkinsons D.
- Tx and SE,
- what will influence ur drug of choice?
- how is levadopa given?
- parkinsonism DDx
- give 3 abnormal movement assoc withw/ excessive motor activity
- Role of antimuscuranics?
first-line treatment:
- if the motor symptoms are affecting the patient’s quality of life: levodopa
- if the motor symptoms are not affecting the patient’s quality of life: dopamine agonist (non-ergot derived), levodopa or monoamine oxidase B (MAO‑B) inhibitor
help tremor and rigidity NOT BRADYKINESA
if the medication is not taken/absorbed, what risk does that put on the ptx?
Impulse control disorders r more common in which medication?
acute akinesia or neuroleptic malignant syndrome
DOPAMINE AGONIST THERAPY
Name 7 side effects of Levadopa
why is it important NOT to acutely stop levodopa?
- Dyskinesia (involuntary writhing move), ‘on-off’ effect
- Dry mouth
- Drowsiness
AAnorexia
- Palpitation
- Postural hypotension
- Psychosis
Can result in dystonia
Parkinsoniam plus syndromes
Gullian-barre syndrome
Pathophy, 3 common pathogens, presentation, clinical course, Ix(2), mx, prognosis
Motor neuron disease
types
Diagnosis
Conifrmed by EMG >> decreased number of AP
Nerve conduction studies>> NORMAL motor function
Qs to ask in history for MND
MND
symptoms and sign
MND
Mx
No cure
RILUZOLE >> glutamate inhib , slows down progression
- support ptx and their family
- breaking bad knews
- MDT
- palliative shit (ACP)
- BIPAP
Subarachnoid hemmorhage
Symp
rfx
epidem
assoc condition
Ix (3)
mx
complic (4)
Difference in WEAKNESS with myasthena gravis vc Lambert-Eaton myasthenic syndrome
2 main symptoms in LEMS
Myasthenia Gravis
define, ix (2), symp, signs
myasthenia gravis
examination
Myasthenia gravis
treatment
