Neurological Conditions Flashcards
Who is most typically affected in meningitis?
INFANTS and ADOLESCENTS
What is the cause of meningitis?
It is an inflammation of the meninges as a result of bacterial infection:
- NEISSERIA MENINGITIDIS
- STREPTOCOCCUS PNEUMONIAE
- HAEMOPHILUS INFLUENZAE B
What are the risk factors for meningitis?
NON-MODIFIABLE- young age, winter season
MODIFIABLE- smoking
PMH- splenic dysfunction, splenectomy, immunocompromised, basal skull fractures, otitis media, sinusitis, sickle cell disease, organ dysfunction
What are the symptoms in meningitis?
Infective symptoms- fever, vomiting, nausea, lethargy, irritability, anorexia, headache, muscle ache, chills, shivering, diarrhoea, abdo pain) NON-BLANCHING RASH STIFF NECK UNUSUAL SKIN COLOUR SHOCK AND HYPOTENSION LEG PAIN BACK RIGIDITY BULGING FONTANELLE PHOTOPHOBIA UNCONSCIOUSNESS PARESIS SEIZURES
What are the clinical signs of meningitis?
Kernig’s signs (unable to fully extend at the knee when the hip is flexed)
Brudzinski’s sign (flexion of hip and knees when neck is flexed)
Prolonged cap refill time
Focal neurologcal deficit
Raised ICP
What are the differentials of meningitis?
Viral meningitis Fungal meningitis Viral encephalitis Brain and neuro malignancy Brain and spinal abscess Parameningeal infection SLE
What investigations should be done in suspected meningitis?
BLOODS: Blood culture
SAMPLING: lumbar puncture
IMAGING: CT
What is the appropriate treatment for meningitis?
Antibiotics
- Benzylpenicillin
- Cefotaxime
- Vancomycin
- Ampicillin
- Chloramphenicol
Who is most typically affected by migraine and tension headaches?
More prevalent in WOMEN
What is the cause of migraines and tension headaches?
There are genetic causes and neuroanatomical causes
What are the risk factors associated with tension headaches and migraines?
NON-MODIFIABLE- family history, gender- female
MODIFIABLE- stress, certain foods (cheese, salty, processed food), excess heat and dehydration
What are they key symptoms in migraines and tension headaches?
Severe paroxysmal headaches that are UNILATERAL
Aura
Nausea
Pain that radiates to the back/occiput of the neck
Dull onset/throbbing
Worse on movement
Seizures
What differentials are associated with migraines and tension headaches?
Headaches with TIA, stroke, intracerebral haemorrhage
Temporal arteritis
Dissection of the carotid and verterbral arteries
Meningoecephalitis
What treatment is appropriate for migraines and tension headaches?
Analgesics
Rest and symptomatic relief
Triptans (sumatriptan, zolmitriptan, naratriptan)
Who is more likely to be affected by Parkinson’s
It is 1.5 times more prevalent in MEN, aged 55-65 years old.
What are the main causes of Parkinson’s
IDIOPATHIC
SECONDARY due to vascular reasons, drug induced, post-encephalitic, hydrocephalus
DEGENERATIVE- Alzheimer’s, Parkinson-dementia-MND complex
GENETIC- Wilton’s disease, Huntington’s disease, Dopa-responsive dystonia.
What are the risk factors for Parkinson’s?
NON-MODIFIABLE- Increasing age, gender- male
MODIFIABLE- pesticide exposure
What are the symptoms of Parkinson’s?
Impairment of dexterity Fixed facial expression Resting tremor Rigidity- increased tone Bradykinesia
What are the clinical signs associated with Parkinson’s
Gait disturbance
4-6Hz resting tremor
What are the differential diagnoses of Parkinson’s?
Benign essential tremor Drug-induced tremor Huntington's Wilson's disease Creutzfeldt-Jakob disease Lewy-body dementia Pick's disease Cerebellar tremor Psychogenic tremor
What investigations should be carried out in suspected Parkinson’s?
IMAGING: CT, MRI, PET SCAN, transcranial sonography
What is the management for Parkinson’s?
Monoamine-oxidase-B (MAO-BIs), selegine, rasagiline
Levodopa
Dopamine agonists
Apomorphine
What is the cause of peripheral neuropathy?
CONGENITAL
PMH- diabetes, malignancy, chronic vascular disease, metabolic problems, chronic inflammatory demyelinative, infection
Drugs
OTHER- heavy metal poisoning
What are the risk factors associated with peripheral neuropathy?
Diabetes
Alcohol abuse
Family history
Repetitive motion
