Neuro signs Flashcards

1
Q

What are the signs of a cerebellar lesion?

A
DANISH
Dysdiadochokinesia and Dysmetria 
Ataxia
Nystagmus
Intention tremor
Slurred, staccato, scanning speech
Hypotonia
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2
Q

What is lateral medullary syndrome? What are the signs?

A
A syndrome caused by actue ischaemia of the lateral medulla, by occlusion of a vertebral artery -> PICA (posterior inferior cerebellar artery)  
DANVAH
Dysphagia and slurred speech 
Ataxia (ipsi)
Nystagmus (ipsi) and diplopia
Vertigo
Anaesthesia (ipsi face, contra pain)
Horner's syndrome (ipsi)
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3
Q

What is pyramidal weakness?

A

Weakness affecting the extensors > flexors in the upper limbs and flexors > extensors in lower limbs. A key part of the UMN syndrome

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4
Q

What are some signs of UMN lesion?

A

Pyramidal weakness
Spasticity +/- clonus
Brisk reflexes
Upgoing plantars

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5
Q

What are some signs of LMN lesion?

A

Muscle wasting and fasciculation
Flaccid tone
Reduced reflexes
Normal plantars

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6
Q

What is Brown-Sequard syndrome?

A

A syndrome of cord hemisection with these signs below the level of the lesion:

  • Ipsi loss of touch and vibration
  • Ipsi UMN signs
  • Contra loss of pain and temperature
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7
Q

What is Romberg’s test?

A

Test for cause of ataxia. Ask the patient to stand with their feet together and close their eyes.
If off balance with eyes open: cerebellar
If off balance with eyes closed only: Romberg +. Proprioceptive deficit

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8
Q

What is internuclear ophthalmoplegia?

A

Defect of the MLF (medial longitudinal fasciculus) causing ophthalmoplegia

  • Ipsi eye fails to adduct
  • Contra eye has nystagmus on abduction
  • Can converge normally
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9
Q

How do you name a nystagmus?

A

Named by the direction of the fast phase

eg. right-beating has fast phase to the right, slow saccade to the left

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10
Q

What are some causes of ptosis?

A
  • Horner’s syndrome
  • 3rd nerve palsy
  • MG
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11
Q

What is Horner’s syndrome?

A

A syndrome caused by compression of the sympathetic fibres supplying the 3rd nerve

  • > Ptosis
  • > Miosis
  • > Anhydrosis
  • > Enophthalmos
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12
Q

What are the causes of Horner’s syndrome?

A

Several causes which can be classified by location of lesion

1) Central: vascular eg. brainstem stroke (wallenberg syndrome eg. LMS), SOL, demyelination eg. MS
2) Preganglionic: tumours (breast, Pancoast), dissection
3) Postganglionic: tumour, Herpes zoster, dissection

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13
Q

Describe how to assess GCS

A
Eyes 4, Voice 5, Motor 6 
E: 
4) Opens spontaneously
3) Opens to voice
2) Opens to pain
1) No opening 

V:

5) Speaking clearly
4) Confused
3) Words without meaning
2) Noises
1) No vocalisation

M:

6) Obeys commands
5) Localises to pain
4) Withdraws from pain
3) Flexes to pain
2) Extensor response
1) No response

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14
Q

Describe the difference between bulbar signs and pseudobulbar signs

A

Bulbar: LMN lesion

  • Slurred, nasal speech
  • Flaccid, fasciculating tongue
  • Absent gag reflex

Pseudobulbar: UMN lesion

  • Slow deliberate speech,
  • Slow and spastic tongue movement
  • Exaggerated gag and jaw jerk
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