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Neuro > Neuro Conditions + Treatments > Flashcards

Neuro Conditions + Treatments Flashcards

1
Q

What is the treatment of spinal bifida?

A

Folic acid supplements - mother
Myelomeningocele - primary surgical closure or intra-uterine repair

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2
Q

What is Spina Bifida?

A

Affects tissues overlapping the spinal cord - defective closure of caudal neural tube and non-fusion of vertebral arches

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3
Q

What is hydrocephalus?

A

Accumulation of CSF in ventricles - obstructive or communicating

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4
Q

What is the treatment for hydrocephalus?

A

Communicating - LP, lumbar drain, and external ventricular drain
Obstructive - endoscopic third ventriculostomy and external ventricular drain

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5
Q

What is Parkinson’s disease?

A

Degeneration of DA cells in substantia nigra - stiffness, slow movements, change in posture, and tremor.

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6
Q

What is the treatment of Parkinson’s disease?

A

Levodopa
Carbidopa or Benserazide - AAAD inhibitor
Entacapone or Opicapone - COMT inhibitor
Selegiline, reasagiline - MAOB inhibitor

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7
Q

What is multiple sclerosis?

A

CNS white matter disease - demyelination
Relapsing remitting course and develop progressive disability

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8
Q

What is the treatment of acute relapse in multiple sclerosis?

A

Oral prednisolone, rehabilitation and symptomatic treatment

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9
Q

What is 1st line treatment for multiple sclerosis?

A

Beta interferons and glatiramer acetate by SC or IM injections
Or teriflunomide and dimethyl fumarate by oral

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10
Q

What is myasthenia gravis?

A

Fatigable weakness - NMJ disorder
Gets worse with repetitive movements or at end of day

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11
Q

What is the treatment for myasthenia gravis?

A

Cholinesterase inhibitors - pyridostigmine
Immunoglobulins, steroids, steroid sparing immunosuppression and thymectomy

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12
Q

What is peripheral nerve disease?

A

Involves sensory, motor and autonomic involvement
LMN signs

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13
Q

What is the treatment of peripheral nerve disease?

A

Stop drug, surgery or immunoglobulin

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14
Q

What is motor neuron disease?

A

Amyotrophic lateral sclerosis - anterior horn cells disease
Pure rapidly progressive disease
Usually limb first then bulbar and resp. UMN and LMN signs

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15
Q

What is the treatment for motor neutron disease?

A

Riluzole - glutamate antagonist
Physio, OT, SALT, PEG and non-invasive ventilation

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16
Q

What is myelopathy?

A

Compression of spinal cord - pain, loss of feeling, and loss of bladder control
UMN signs

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17
Q

What is the treatment for myelopathy?

A

PT an corticosteroids
Spinal decompression surgery - ex. laminectomy

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18
Q

What is the treatment for spinal stroke/ infarction?

A

Reduce risk of recurrence - maintain BP, reverse arrhythmia, and aspirin/ clopidogrel
OT and physio.

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19
Q

What is the treatment for B12 deficiency myelopathy/

A

Intramuscular B12 injections

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20
Q

What is functional neurological disorders?

A

Change in function rather than structure - symptoms not explained by neurological disease
Tremor can stop with distraction of movement.

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21
Q

What is the treatment of function neurological disorders?

A

Antidepressants - anxiety and depression
Physical rehab and psychiatry

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22
Q

What is meningitis?

A

Inflammation/ infection of meninges
Classical triad - altered mental state, fever and neck stiffness.

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23
Q

What is the treatment for meningitis?

A

IV ceftriaxone for bacterial
Immunisation - meningococcal, pneumococcal and Hib vaccines

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24
Q

What is encephalitis?

A

Inflammation/ infection of brain substance
Viral has slower onset and more prominent cerebral dysfunction
Progressive headache and fever.

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25
Q

What is the treatment for encephalitis?

A

Viral - acyclovir
Bacterial - targeted antibiotics

26
Q

Describe a brain abscess and empyema

A

Abscess - localised area of pus
Empyema - thin layer of pus between dura and arachnoid membranes
Signs of raised ICP

27
Q

What is the treatment for brain abscess and empyema?

A

Surgical drainage
Penicillin or ceftriaxone
Metronidazole for anaerobes
High dose needed

28
Q

What is Creutzfeldt-Jacob Disease?

A

Transmissible proteinaceous prion
Rapid progression and often death in 6 months
Early abnormal behavioural changes

29
Q

What is the treatment for CJD?

A

Sedatives/ antidepressants and antipsychotics
Benzodiazepines/ antiepileptics

30
Q

What is pyogenic vertebral osteomyelitis and discitis?

A

Spinal infection
Mainly lumbar then thoracic and cervical
Axial pain and sign is fever.

31
Q

What is the treatment for pyogenic vertebral osteomyelitis and discitis?

A

Broad spectrum IV antibiotics for 6-8 weeks
Immobilisation if pain and stabilises spine
Then possible surgery

32
Q

What are spinal haematomas?

A

Subdural, subarachnoid, and intramedullary haemorrhage
Intense knife like pain in location
MRI is gold standard

33
Q

What is the treatment of spinal haematoma?

A

Coagulopathy
Emergency surgical decompression - laminectomy

34
Q

What is cauda equina syndrome?

A

Surgical emergency - compressive, ischaemic and/or inflammatory causes.
LMN sings bilaterally, saddle anaesthesia and bladder/bowel involvement

35
Q

What is the treatment of cauda equina syndrome?

A

Surgical decompression - emergency

36
Q

What is the difference between myelopathy and cauda equina syndrome?

A

Myelopathy - UMN and bladder/ bowel involvement
Cauda equina - LMN and bladder/ bowel involvement

37
Q

What is glioblastoma multiforme (GBM)?

A

Type of glioma
Spread through white matter in CSF pathway
Raised ICP, epileptic fits, 3 and 6th palsy, and altered consciousness

38
Q

What is the treatment of GBM?

A

Steroids and anticonvulsants
RT of whole brain or stereotactic
Surgery

39
Q

What is a stroke?

A

Sudden onset of focal or global neurological symptoms - ischaemia or haemorrhage
Symptoms last more than 24hrs

40
Q

What is the treatment of a stroke?

A

Ischaemic - CT scan and tPA/ thromboectomy
Aspirin if after 3 hrs

41
Q

What is the treatment of a tension type headache?

A

Paracetamol and NSAIDs
Tricyclic antidepressants - amitriptyline

42
Q

What is a migraine?

A

Unilateral, aura, photophobia, phonophobia, episodic and is disabling.

43
Q

What is the treatment for migraines?

A

Modifiable lifestyle factors
Aspirin, triptans and NSAIDs
Prophylactic - propranolol, candesartan, antiepileptics, amitriptyline

44
Q

What is trigeminal neuralgia?

A

Primary headache - intense pain along nerve. Brief and severe.
Unilateral - maxillary or mandibular
Triggers

45
Q

What is the treatment of trigeminal neuralgia?

A

Carbamazepine
Surgical - glycerol ganglion injection, stereotactic radiosurgery, and microvascular decompression

46
Q

What is a cluster headache?

A

Trigeminal autonomic cephalalgias - unilateral head pain in mainly V1
Bouts lasting 1-3 months and circadian rhythm

47
Q

What is the abortive treatment for cluster headache?

A

Triptans - sumatriptan
Oxygen 10-15 ltrs

48
Q

What is transitional or preventative treatment for cluster headaches?

A

Oral prednisolone and greater occipital nerve block
Preventative - verapamil and 2nd line is topiramate

49
Q

What is paroxysmal hemicrania?

A

Trigeminal autonomic cephalalgias - 2-40 attacks a day
Absolute response to indomethacin

50
Q

What is SUNCT/SUNA?

A

Short lasting unilateral neuralgiform with or without autonomic symptoms
Stabbing/ pulsating pain, 10-240 secs, had triggers, have 2-300 a day/

51
Q

What is the treatment for SUNCT/SUNA?

A

Lamotrigine, topiramate and oxcarbazepine
Transitional - GON block
Surgical - occipital nerve and deep brain stimulation.

52
Q

What is intracranial hypotension?

A

Can be spontaneous or after LP
Headache worse upright and lessens when lying back as brain sink

53
Q

What is the treatment of intracranial hypotension?

A

Epidural blood patch
Best rest, fluids, analgesia, caffeine

54
Q

What is a subarachnoid haemorrhage?

A

Aneurysmal rupture and bleeding into subarachnoid space
Thunderclap headache - whole head and instantaneous

55
Q

What is the treatment of subarachnoid haemorrhage?

A

Coiling and clipping
Nimodipine for vasospasm

56
Q

What is the treatment of absence seizures?

A

Ethosuximide

57
Q

What is first line for partial and secondary generalised seizures?

A

Lamotrigine, carbamazepine, and levetiracetam

58
Q

What is the treatment for focal seizures?

A

Carbamazepine

59
Q

What is first line for primary generalised seizures?

A

Sodium valproate, lamotrigine, and levetiracetam

60
Q

What is the treatment for status epilepticus?

A

Midazolam and Lorazepam

Neuro (40 decks)

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