Neurological Flashcards
symptoms of a cerebral hemisphere infarct?
contralateral hemiplegia, then spasticity
contralateral sensory loss
homonymous hemianopia
dysphasia
symptoms of brainstem/posterior circulation infarct
locked in syndrome
quadriplegia
visual disturbances
symptoms of lacunar infarct?
motor, sensory, mixed effects - ataxia
cognition + consciousness intact
in what situations should CT scan be performed as soon as possible
anticoagulated, known bleeding tendency, GCS <13, papilloedema, neck stiffness, severe headache at onset of symptoms
Management of ischaemic stroke
Alteplase thrombolysis
Aspirin, switch to clopidogrel after 2 weeks
management for haemorrhagic stroke
surgical
maintain oxygen and fluids
monitor but don’t treat BP as may impair cerebral perfusion
management of a TIA?
immediate aspirin /clopidogrel
novel anticoagulant - Rivaroxaban
presentation of a subarachnoid haemorrhage
thunderclap headache, worst they’ve ever had
vomiting, collapse, coma
how is subarachnoid haemorrhage investigated
CT head
lumbar puncture - bilirubin in CSF confirms SAH
difference between focal and generalised seizure?
Focal (partial) - limited to one hemisphere
Generalised - +/- convulsions, with bilateral discharges, patient usually loses consciousness and memory of seizure
different types of focal seizures and their symptoms?
Temporal - tastes, smells, Deja vu
Frontal - twitching, feel a wave going through head
Parietal - numbness, abnormal limb sensation
Occipital - visuals
Complex - multi lobe
types of generalised seizure?
Absence Myoclonic - muscle jerk, pt conscious Clonic - convulsive, pt goes stiff Tonic - muscles stiffen Tonic-clonic - body stiff, convulsive Atonic - muscle relax, go floppy
preferred medication for focal and generalised seizures
Focal - carbamazepine, lamotrigine
Generalised - sodium valproate
common viral causes of meningitis?
enteroviruses, HSV, mumps, varicella zoster
Common bacterial causes of meningitis
Neisseria meningitides, strep pneumonia, staph aureus
What are Kernig’s and Brudzinki’s sign?
Kernig’s = pain on passive knee extension with hips fully flexed
Brudzinki’s - hips flex on bending head forward
how is meningitis investigates?
Bloods, blood culture, throat swabs
Lumbar puncture - in early stages may be negative so repeat if symptoms persist
Broad spectrum antibiotic of choice for meningitis until cause can be cultured?
Cefotaxime IV
risk factors for migraine?
CHOCOLATE CH - cheese O - oral contraceptive C - Caffeine Ol - alcohol A - anxiety T -travel E - exercise
what classifies as chronic migraines
Headaches on at least 15 days of the month, with at least 8 days being a migraine
common signs of PD?
resting tremor, rigidity, bradykinesia
pill rolling tremor
slow, shuffling steps, Festinant gait
cog wheel rigidity
how does multiple sclerosis typically progress
relapsing and remitting
what conditions may suggest multiple sclerosis?
Optic neuritis - acute painful loss of vision
transverse myelitis
