Neurological Disorders Flashcards
4 types of Nervous System
Central Nervous System (CNS)
Peripheral Nervous System (PNS)
Somatic nervous system
Autonomic nervous system
What is Trigeminal Neuralgia
Idiopathic or due to a compression process ( tumours )
or multiple sclerosis (younger patients)
Symptoms of Trigeminal Neuralgia
Unilateral facial pain (mandibular and maxillary
divisions)
Pain is brief
Severe, sharp/stabbing/electric-shock-like
Trigger areas where even gentle stimulation may produce
the pain (washing, shaving, chewing food, cold breeze)
What is Bell’s Palsy-VII C
Acute isolated facial weakness
Caused by a viral infection
What is a stroke
A stroke is a focal neurological deficit,
secondary to a vascular lesion, that lasts
for longer than 24 hours.
What is a stroke caused by?
Infarction
(embolic or thrombotic)
Haemorrhage
What is a TIA
A Mini stroke when
a cerebral artery is temporarily blocked, decreasing blood flow
to the brain.
What is a Intracerebral haemorrhage?
Hypertension, vascular malformations, bleeding disorders, head injury
Headache, hemiparesis, loss of consciousness,
nausea, vomiting, seizures
More than 50% of patients died with in a few days
What is a Subarachnoid haemorrhage?
80% due to “congenital“-berry aneursym
Sudden severe headache, loss of consciousness or epileptic seizure, nausea, vomiting, “reactive hypertension”, papilloedema, plantar responses are
usually extensor
Risk factors of a stroke or TIA?
Hypertension, smoking, diabetes mellitus, obesity,
low physical exercise, cholesterol concentrations.
high salt intake, high fat intake, low
potassium intake, low vitamin intake, excess
alcohol intake.
Increasing age, male gender, afro-Caribbean
descent, positive family history of strok
Management of Stroke or TIA
Diagnosis - all patients with an acute stroke
require urgent admission to hospital
Determination of risk factors for stroke
Supportive care for the majority of acute
patients
Rehabilitation
What is Multiple Sclerosis
Multiple Sclerosis is a chronic inflammatory
autoimmune disorder of the central nervous
system
Clinical Features of MS
Optic nerve damage: optic neuritis-sudden,
reduced vision, usually unilateral
Cervical spinal cord damage:
Sensory deficits:-tingling
Motor deficit: weakness of the legs
Brain stem & Cerebellar damage: ataxia,
dysarthria, diplopia, dsphagia, nystagmus,
vertigo
Other damage: trigeminal neuralgia, neurogenic bladder dysfunction-urgency,
incontinence, frequency
dementia in the later stages
Management of MS
- Acute treatment using steroids
- Symptomatic treatment
- Disease-modifying treatment: immune modulators-
reduction in the frequency and severity of attacks
Progress of the disease vari
What is epilepsy
recurrent paroxysmal
transient disturbance of
brain function due to
disturbance of electrical
activity in the brain,
where the disturbance is
unrelated to infection
or acute cerebral
insult.
Types of seizure patterns
Generalised seizures
Partial seizures
What is Parkinson’s disea
Parkinson’s disease is due
to the degeneration of
dopaminergic neurones in
the basal ganglia.
Parkinson’s symptoms
The main features are: rest tremor, shuffling gait,
expressionless, unblinking eyes).
Other features include, slurred monotonous
speech, small handwriting, increased salivation
and dribbling.
Dementia occurs in 40% of patients with
Parkinson’s disease. A degree of cognitive
impairment is present in up to 70% of patients.
What is a migraine?
Migraine Is the Most
Common Cause of Recurrent
Headache in the Population
How to diagnose a Migraine?
Fully reversible visual symptoms (e.g. Flickering lights, spots or lines; or loss of vision)
Fully reversible sensory symptoms (e.g.
Migraine criteria
At least 5 attacks
fulfilling B-D;
Lasting untreated 4-72
hours;
Two of the following:
unilateral, pulsating,
moderate or severe pain
intensity, worsening
with physical activity;
One of the following:
photophobia or
phonophobia, nausea
and/or vomiting;
Not attributed to another disorder
Aetiology of a migraine
Some studies suggest that the
aura is due to an spreading area of vasoconstriction over the brain There is some evidence that
the headache in migraine is due to subsequent vasodilatation of blood vessels
Neuronal theory:
Neuronal dysfunction could be the cause of the spreading
vasoconstriction
migraine management
General measures
• Identifying and avoiding trigger factors which can reduce
the frequency of migraine attacks by up to 50%.
Examples of possible trigger factors include: extremes of
weather, long distance travel, loud noise or bright lights
missing meals, too much or too little sleep, emotional stress
and anxiety, dietary triggers, if real, become obvious to
patients and are usefully avoided
• Regular sleep and dietary measures: sleep can aid
recovery, keep regular mealtimes
2. Management of an acute attack
First line treatments are simple analgesics such
as aspirin, ibuprofen or paracetamol
Second-line treatments: triptans (5HT1
receptors agonist) are indicated for the
treatment of attacks unresponsive to adequate
doses of analgesics
