Neurology

Question 1

Trigeminal neuralgia defintion as per international headache association

Answer 1

a unilateral disorder

brief electric shock-like pains, abrupt in onset and termination, limited to one or more divisions of the trigeminal nerve

the pain is commonly evoked by light touch, including washing, shaving, smoking, talking, and brushing the teeth (trigger factors), and frequently occurs spontaneously
small areas in the nasolabial fold or chin may be particularly susceptible to the precipitation of pain (trigger areas)

the pains usually remit for variable periods

Question 2

Red flags in someone presenting with unilateral sudden severe pain that has triggers (trigeminal neuralgia)

Answer 2

As per NICE

Sensory changes

Deafness or other ear problems

History of skin or oral lesions that could spread perineurally

Pain only in the ophthalmic division of the trigeminal nerve (eye socket, forehead, and nose), or bilaterally

Optic neuritis

A family history of multiple sclerosis

Age of onset before 40 years

Question 3

MGT of trigeminal neuralgia

Answer 3

carbamazepine is first-line

failure to respond to treatment or atypical features (e.g. < 50 years old) should prompt referral to neurology

Question 4

Nerves of the lower limb

Answer 4

https://upload.medbullets.com/topic/112016/images/lower_extremity_innervation.jpg

Question 5

common peroneal nerve lesion

Answer 5

most characteristic lesion is foot drop.

Other features include:
weakness of foot dorsiflexion

weakness of foot eversion

weakness of extensor hallucis longus

sensory loss over the dorsum of the foot and the lower lateral part of the leg

wasting of the anterior tibial and peroneal muscles