- relapse= methyprednisolone for 5 days - disease modifying agents (reduce relapses etc)- Alemtuzumab, Natalizumab

neuro-things i forget Flashcards by Nicholas Prescott

how long does a migraine last?

4-72h

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tx of trigeminal neuralgia

carbamazepine

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Sx of temporal arteritis

temporal pulsating headache

scalp tenderness

jaw claudication

amaurosis fugax in one eye

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What blood marker is raised in temporal arteritis

ESR

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management of temporal arteritis

prednisolone

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what presents alongside 50% of cases of GCA?

polymyalgia rheumatica

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treatment following a TIA

300mg aspirin
clopidogrel 75mg
simvastatin

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features of temporal lobe focal epilepsy

deja-vu, auditory hallucinations, funny smells

anxiety

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features of frontal lobe focal epilepsy

motor/ jacksonian march

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features of parietal lobe epilepsy

sensory disturbance

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features of occipital lobe epilepsy

visual phenomena

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treatment of:

generalised seizures
partial seizures

generalised= sodium valporate/ lamotrigine

partial= carbamazepine

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Tx of cataplexy

sodium oxybate

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Tx of shingles

acyclovir

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common complication of shingles and its Tx

post-herpatic neuralgia

carbemazepine

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genetic inheritance of Huntingtons

trinucelotide repeat on CR 4

anticipation

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sx of huntingtons

Chorea (involuntary, abnormal movements)

Eye movement disorders

Speech difficulties (dysarthria)

Swallowing difficulties (dysphagia)

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describe the tremor in parkinsons

asymmetrical

worse at rest

improves w/ movement

no change with alcohol

BENIGN ESSENTIAL TREMOR IS THE OPPOSITE TO ALL THESE

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what is an acoustic neuroma/ vestibular schwannoma?

tumours of the Schwann cells surrounding the auditory nerve

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features of an acoustic neuroma/ vestibular schwannoma

hearing loss

tinnitus

balance problems

facial nerve palsy

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Tx of MS

relapse= methyprednisolone for 5 days

- disease modifying agents (reduce relapses etc)- Alemtuzumab, Natalizumab

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how is a suspected diagnosis of GBS confirmed?

nerve conduction studies

stool sample for campylobacter jejuni

spirometry- monitor FVC for respiratory muscle involvement

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what is Progressive Bulbar Palsy?

UMN AND LMN of CN IX- XII

What criteria is used for the diagnosis of ALS?

El Escorial Criteria

how can MND be differentiated from other pathologies?

ocolomotor muscles spared no sensory symptoms rectal and bladder sphincters spared

UMN signs

``` weakness brisk reflexes hypertonia upgoing planters (positive babinksi) clonus ```

LMN signs

``` weakness absent reflexes decreases tone wasting fasciculations ```

what does a hemiplegic gait indicate

UMN

what does a broad-based/ ataxic gait indicate

cerebellar

what does a high-stepping gait indicate

foot drop LMN

what does a waddling gait indicate

pelvic muscle weakness- myopathy

what does an antalgic gait indicate

localised pain (limp)

presentation of NF1

- 6 + cafe au lait spots - FH - axillary freckles - bowing oflong bones - Lisch Nodules - neurfibroma's - glioma of the optic nerve

what is NF2 associated with?

associated with bilateral acoustic neuromas

CSF findings- bacterial meningitis

polymorphs (neutrophils) raised protein low glucose

CSF findings- TB meningitis

lymphocytes raised protein low/normal glucose

CSF findings- viral meningitis

lymphocytes normal protein and glucose

Tx of meningitis

IV cefotaxime and dexamethasone in community (GP)- Benzylpenicillin

triad in Horners

miosis (pupillary constriction) ptosis (upper eyelid droop) anhydrosis (ipsilateral loss of sweating)

what is bells palsy?

LMN lesion of the facial nerve NO FOREHEAD SPARING

how does Ramsay Hunt syndrome present and what causes it?

herpes zoster virus LMN palsy of the facial nerve + RASH AROUND EAR CANAL

how are bells palsy and ramsay hunt syndrome treated?

prednisolone add aciclovir in ramsay hunt syndrome

features of multi-system atrophy

Parkinsons + autonomic dysfunction (postural hypotension, constipation, sweating and sexual dysfunction) + cerebellar dysfunction (ataxia)

side effects of dopamine therapy in parkinsons

dystonia athetosis chorea

features of bulbar palsy

- tongue fasciculations - dysphagia - loss of gag reflex - dysarthria - dysphonia

Tx of myasthenic crisis

Iv Ig

what is Lamber-eaton myasthenic syndrome associated with

small cell lung cancer

presentation of Lamber-eaton myasthenic syndrome

- slow onset - affects proximal muscles - diplopia, ptosis and dysphagia - also get autonomic dysfunction- blurred vision, impotence etc

what is spinal stenosis

narrowing of part of the spinal canal resulting in compression of the spinal cord and nerve roots

what can cause spinal stenosis

- congenital - degeneration - herniated disc - spinal fractures - tumours

presentation of spinal stenosis

- gradual onset (compared to cauda equina) - intermittent neurogenic claudication- lower back/ buttock/ leg pain and weakness - Sx only occur when stood up and moving - SX IMPROVE ON BENDING FORWARD

management of spinal stenosis

- lifestyle- lose weight, exercise, physio - analgesia - decompression/ laminectomy

nerve roots and causes of sciatica

L4-S3- divides into tibial and common peroneal nerves causes- lumbrosacral nerve root compression due to a herniated disc or spinal stenosis

bilateral sciatica- what is this a red flag for?

cauda equina

what is anterior cord syndrome?

- occurs due to flexion injury, or due to injury to the anterior spinal artery. - Patients have preserved function of their posterior column, and so proprioception and vibration are intact - the anterior portion of their cord is affected- they have bilateral loss of motor function, light touch, pain and temperature below the level of the lesion.