Neurology Flashcards
DVLA rules post TIA or stroke
Cannot drive for 1 month
Definitive diagnostic test for acoustic tumours?
MRI of cerebellopontine angle with contrast
Features of a midbrain space occupying lesion
Unequal pupils, unable to move eyes up/down, amnesia
Features of a frontal space occupying lesion
Dysinhibition, expressive dysphasia, Personality changes, anosmia, grasp reflex
Features of a parietal space occupying lesion
Visuospacial, sensory, language
Features of a temporal lobe space occupying lesion
Memory, verbal, personality, receptive dysphasia
Features of Friedrich’s ataxia
Autosomal recessive, presents in childhood, ataxic gait, optic atrophy, cardiac abnormalities, pes cavus, absent lower limb reflexes, weakness/wasting
Donepazil contraindications
Bradycardia
First line treatment of absence seizures in girls/women of childbearing age
Ethosuximide
Do cerebellar strokes present with ipsilateral or contralateral symptoms?
Ipsilateral
5 year old with head injury. Dilated left pupil which is deviated laterally and downwards. Ptosis is also present. Which cranial nerve is affected?
Third cranial nerve (Oculomotor)
68 year old women, tingling sensation in her left cheek bone and painful rash in same area. Reduced sensation across cheek bone and upper lip. Which cranial nerve?
Fifth cranial nerve (trigeminal)
28 year old woman has unequal pupils. The larger pupil does not constrict to light but does constrict when a light is shone in the other eye.
Optic neuritis
Medication to help slow disease progression in someone who has recently been diagnosed with MS?
Linoleic acid supplementation
Triceps reflex nerve root?
C7-C8
Biceps reflex nerve root?
C5-C6
Left femoral nerve damage features?
Weakness of the quads and iliopsoas muscle (weakness of hip flexion and knee extension) and decreased/absent patellar reflex
Ipsilateral pyramidal weakness and ipsilateral loss of joint position/vibration sensation. Contralateral loss of pain/temperature sensation.
Brown Sequard syndrome or hemisection of the spinal cord.
Diagnostic criteria for migraine
At least 5 headache attacks that last 4-72 hours + 2 of the following: unilaterl, throbbing/pulsating, worsened by movement, moderate or severe intensity
Management of patients with TIA?
Aspirin 300mg and to be seen by stroke team within 24 hours
What is hemiballismus
Flailing, ballistic undersired movements of the limbs. It can occur as a result of stroke, traumatic brain injury, space occupying lesion, non-ketotic hyperglycaemia
Inclusion criteria for PSP
Onset >40 years; gradually progressive; vertical supranuclear palsy and prominent postural instability with tendency to fall in the first year of disease onset.
A patient has drooping and weakness of the left side of the face and is unable to raise the left eyebrow?
7th cranial nerve (facial)
List the cranial nerves
I = olfactory
II = Optic
III = Oculomotor
IV = Trochlear
V = trigeminal
VI = Abducens
VII = Facial
VIII = vestibulocochlear
IX = glossopharngeal
x = Vegas
XI = accessory
XII = Hypoglossal
Treatment of asymptomatic carotid dissection?
Medical management: antiplatelets or anticoagulation. If cannot be anticoagulated consider stenting
Right incongruous homonymous hemianopia - where is the lesion?
Left optic tract
Peripheral neuropathy - which drug?
Simvastatin
62 year old, vertigo, vomiting, nystagmus on left gaze and ataxia, paralysis of left palatal movement, left partial ptosis, reduced pain and temp on right side of body. Where is the most likely site of this lesion?
Posterior inferior cerebellar artery
81 year old, sensory loss over the whole of the right side of the body. No other symptoms or signs.
Lacunar infarct- can be pure motor or pure sensory or mixed
Locked in syndrome -where is the problem?
Basilar artery
Investigation for suspected GBS?
Lumbar puncture
First line treatment for primary generalised epilepsy in young man?
Valproate
