Neurology Flashcards
What is an epileptic seizure? Is it the same as epilepsy?
a paroxysmal event in which changes of behaviour, sensation or cognitive processes are caused by excessive, hypersynchronous neuronal discharges in the brain
epilepsy is a chronic condition, an epileptic seizure is an acute event, so they are not the same
How are epileptic seizures characterised?
usually 30-120 seconds
‘positive’ ictal symptoms
‘negative’ postictal symptoms
stereotypical seizure type
may occur from sleep
may be associated with other brain dysfunction
What are the phases of a seizure?
beginning (prodrome and aura)
middle (ictal)
end (post-ictal)
What is the likely diagnosis if a patient is having seizures during sleep?
epilepsy- seizures while asleep is common for epileptic patients
What is hemiparesis?
weakness/ inability to move on one side of the body
What is the main triad of meningitis symptoms?
fever
headache
neck stiffness
What is the mortality of bacterial meningitis?
5% with treatment
What is measured in the Glasgow coma scale?
best eye response
best verbal response
best motor response
What are the main organisms responsible for encephalitis?
virus’:
herpes simplex
varicella zoster
What are the types of strokes?
ischaemic- blood vessel in brain is blocked
hemorrhagic- bleeding from a blood vessel within the brain
How do you assess TIA risk?
ABCD^2 assessment
What is IAPT?
improving access to psychological therapies
What are the three cardinal features of Parkinson’s?
bradykinesia/ askinesia:
- problems with buttons, typing on keyboard, etc
- writing smaller
- small steps, dragging one foot
tremor:
- at rest
- may be unilateral
rigidity:
- pain
- problems turning in bed
What is bradykinesia?
slowness of movement
What happens anatomically in Parkinson’s?
loss of dopaminergic neurons in substantia nigra
presence of lewy bodies
What is the most powerful Parkinson’s drug?
L-Dopa
Why aren’t anticholinergics used to treat Parkinson’s?
- we have more powerful medications for Parkinson’s
- they affect cognition and cause confusion
What is the commonest cause of dementia?
alzheimer’s disease
What is the first cognitive marker of Alzheimer’s?
memory impairment
What will vitamin abnormalities on a blood test in a patient with dementia suggest?
that the cause of dementia is reversible
What is the limitations of structural brain scans to diagnose Alzheimers?
atrophy is a late presentation
some people just have small brains
How is dementia managed?
socially active
cognitively active
control vascular risk factors
treat mood and anxiety
drugs:
- acetyl choline esterase inhibitors
- memantine (anti-glutamate)
Do dementia drugs modify disease progression?
not disease modifying, but give a longer period of stability before deterioration
Do dementia drugs modify disease progression?
not disease modifying, but give a longer period of stability before deterioration
What is a ‘spider sign’?
blood in the csf on a CT scan- subarachnoid haemorrhage
What are the signs of a lower motor neurone disorder?
weakness
reduced tone
muscle wasting
fasciculation
absent deep tendon reflex
What are the causes of lower motor neuron injury?
motor neuron: MND, spinal muscular atrophy, polio
motor nerve roots: radiculopathy, Guillain barre syndrome
motor nerves: neuropathies, radiculopathies
neuromuscular junction disorder: myasthenia gravis
muscle disorders: myositis, myopathies
What is the primary cause of spinal muscular atrophy?
SMN1 gene mutation
