neurological

Question 1

Parkinson’s Disease signs and symptoms

Answer 1

rigidity, tremor and bradykinesia
Physical presentation
Tremor
Rigidity
Bradykinesia/ Akinesia
Gait disturbance
Stooped posture
Difficulty initiating the first step
Postural instability

Question 2

Partial seizures signs and symptoms

Answer 2

Varied depending on site of origin
Focal motor/sensory symptoms, language disturbance, olfactory, visual or auditory hallucinations, visceral sensations, fear, panic
Alterations in behavioru, pre-emptive aura, reduction in awareness

Question 3

Generalised seizure signs and symptoms

Answer 3

Widespread tonic contraction, leading to clonic jerking
Postictal confusion for hours after
Tongue/cheek/lip biting
Urinary incontinence
Most have normal neurological exam between seizures (idiopathic form)
Aspiration pneumonitis

Question 4

spastic Cerebral Palsy signs and symptoms

Answer 4

Spastic Cerebral Palsy
Spastic Diplegia / diparesis
mainly leg muscle stiffness, arms less / not affected.
Difficulty walking – legs tend to pull together & inward and cross at the knees – known as scissoring.

Spastic hemiplegia / hemiparesis
affects only one side, & the arm is usually more affected then the leg

Spastic Quadriplegia / Quadriparesis
most severe form of spastic CP – affects all 4 limbs, trunk & face.
Cannot walk
Often have other developmental disabilities.

Question 5

Dyskinetic Cerebral Palsy signa and symptoms

Answer 5

people with dyskinetic CP have issues controlling the movement of their hands, arms, feet & legs
Making it difficult to sit & walk
Movements are uncontrollable
can be slow or rapid and jerky.
Face & tongue can be affected
Muscle tone can change from day to day or even in a single day.

Question 6

Ataxic Cerebral Palsy. signs and symptoms

Answer 6

People with ataxic CP have issues with balance & coordination.
Unsteady when they walk
May have difficulty with quick movements, or movements that require a lot of control e.g. writing, or reaching from an object.

Question 7

Mixed Cerebral Palsy

Answer 7

More than 1 type of CP
Most common mixed is: Spastic – dyskinetic CP

Question 8

Myasthenia Gravis signs and symptoms

Answer 8

Variable weakness, with deterioration during the day
Intermittent diplopia and difficulty chewing and swallowing
Often associated with other autoimmune diseases
ACTH receptor antibodies present in 80-90%
Infants born to affected mothers are increased risk of postural deformities and congenital MG

Question 9

Neurofibromatosis – Type I signs and symptoms

Answer 9

Café au lait spots (>5mm in under 10yr olds, >15mm after), axillary and inguinal freckling, neurofibromas
May have learning difficulties, hyperactivity and seizures
Neurofibromas usually appear later
More prone to tumours of the nervous system and other organs
Genetic screening is available

Question 10

Neurofibromatosis – Type II signs and symptoms

Answer 10

Principle presentation is bilateral acoustic neuromas, and other brain and spinal cord tumours
Acoustic neuroma presents with hearing loss and tinnitus