Neurology Flashcards
how to assess Fluency (language assessment)
Fluency is normal if patient speaks in complete sentences without hesitancy between words.
How to assess Comprehension (language assessment)
Comprehension is normal if patient is able to answer your questions appropriately and follow
exam instructions.
a. “Do what I say: Look to the door and then look to the window.”
b. If not done perfectly, give simpler command: “Show me your thumb.”
How to Assess Repetition (language assessment)
Repetition.
a. “Repeat after me: I went to the store and forgot my wallet.”
How to assess naming (language assessment)
. Naming.
a. Point to objects around room, asking what they are: watch, pen, telephone.
b. If done well, ask more difficult ones: (watch) band, (pen) cap, (telephone) receiver.
How to assess reading (language assessment)
Reading.
a. Have patient read and follow a written command: Close Your Eyes.
How to assess writing
language assessment
Writing.
a. Have patient write a complete sentence of their choosing
CN II
corrected visual acuity 20/20 bilaterally*; visual fields full; optic discs sharp with venous
pulsations present bilaterally.
CN III, IV, VI
pupils 4 mm and reactive to light; extraocular movements intact; no ptosis
CN V
facial sensation equal to pinprick in all 3 divisions bilaterally
CN VII
face symmetric with normal eye closure and smile.
CN VIII
hearing normal to rubbing fingers*.
CN IX X
palate elevates symmetrically; phonation normal.
CN XII
tongue midline with good movements.
Treatment of medication overuse headache
Discontinuation of offending analgesic
bridging agent maybe used if overuse headache is severe
- 1-2 week tapering course of steroids
clinical features of serotonin syndrome
changes in mental status (agitation, delirium, anxiety) autonomic dysregulation (diaphoresis, hypertension, tachycardia, hyperthermia, vomiting, diarrhoea) neuromuscular hyperactivity (myoclonus, hyperreflexia and tremor)
