Neuro Path (other) Flashcards
Which two headaches are unilateral?
Cluster and Migraine
Duration of cluster headache
15 min- 3 hrs; repetitive, but brief
What kind of headache is characterized by steady pain, no photophobia, phonophobia, or aura?
Tension
Excrutiating periorbital pain with lacrimation and rhinorrhea?
Cluster
Tx for Cluster headache
Acute: Sumatriptan and 100% O2
Prevention: Verapamil
What headache lasts between 4-72 hours?
Migraine
Duration of tension headache?
Constant for an avg of 4-6 hours
Tx for Tension headache
Analgesics, NSAIDs, acetaminophen
Chronic pain: amitriptyline
Characteristics of migraine
1) Pulsating pain
2) Nausea, photophobia, or phonophobia
3) Aura
Vasoactive peptides, __ and ___, are released during a migraine.
Substance P and Calcitonin gene-related peptide (CGRP)
Acute tx of migraines
Dihydroergotamine, NSAIDS, triptans,
ABC TV prophylactic meds for migraines
Amitriptyline
B-blockers
Calcium ch. blockers
Topiramate
Valproate
First-line therapy for trigeminal neuralgia
carbamazepine
Akathisia
restlessness and intense urge to move
with neuroleptic use or Parkinson’s
Dystonia
SUSTAINED, involuntary muscle contractions
ie. Writer’s cramp, blepharospasm (eyelid), torticollis
Non-alcoholic tx for essential tremor
Non-selective b-blockers or primidone (barbituate)
What enzyme metabolizes MPTP into MPP+ leading to dopaminergic neuron damage?
MAO B
inhibit process with selegiline
____ are characteristic of Parkinson disease. They are composed of _____ inclusions.
Lewy bodies; a-synuclein
Trinucleotide repeat on chromosome 4
Huntington Disease:
Caudate loses Ach and GABA (CAG)
What NT is increased in Huntington’s?
Dopamine
NMDA-R binding and glutamate excitotoxicity cause __.
Neuronal death in Huntington’s
___ increases the risk and ____ decreases the risk of sporadic form of Alzheimers.
ApoE4 increases risk
ApoE2 decreases risk
What proteins are associated with the familial form of AD?
APP increase and presenilin 1/2
Senile plaques composed of ____ may cause ___ leading to intracranial hemorrhage in AD.
Beta-amyloid; amyloid angiopathy
Insoluble ___ ____ protein leads to ____, the number of which correlates with the degree of dementia in AD.
hyperphosphorylated tau protein; neurofibrillary tangles
Histological changes in frontotemporal dementia
intracellular inclusions of hyperphosphorylated tau = ROUND Pick bodies OR ubiquitinated TDP-43
If you have parkinsonian features with an unusually early onset of dementia and/or visual hallucinations, you are more likely to have…
Lewy body dementia (haLewycinations)
Look for intracellular Lewy bodies still
Note: this is NOT Parkinson’s
2nd most common cause of dementia in elderly?
Vascular dementia (MRI/CT will show multiple cortical and/or subcortical infarcts)
Startle myoclonus is associated with ___.
Creutzfeldt-Jakob disease
EEG and CSF findings with CJD
Periodic sharp waves on EEG and increased 14-3-3 protein in CSF
What are some risk factors of pseudotumor cerebri?
Vitamin A excess Tetracycline Danazol Female Obesity
Tx for IIH?
Weight loss, Acetazolamide, Topiramate
Lhermitte phenomenon
Neck flexion may cause sensation of electric shock running down spine (in MS)
Tx for MS spasticity
Baclofen = GABA B agonist Tizanide= alpha-2 agonist
Disease modifying therapies for MS
beta-IFN
Glatiramer
Natalizumab
