Neurology Flashcards
Imaging in stroke?
Non-contrast CT head
First line drug in myoclonic seizures (women)?
Leviteracitam
What is a Jacksonian movement and the it is observed?
Clonic movement travelling proximally
Frontal lobe epilepsy
Level at the spinal cord is affected in autonomic dysreflexia?
Above T6
Areas affected in the brain in Alzheimer’s disease?
Widespread cerebral atrophy
Cortex and hippocampus
Movements spared in MND?
Occular movement
Which intracranial bleed can present several weeks after injury?
Subdural haematomas
When should LP be performed in SAH?
12 hours post onset of headache
Dermatome of sciatic nerve?
S1
UMN tests?
UL: Hofman’s
LL: Babinski’s
Signs of idiopathic intracranial hypertension?
Papilloedema
6th nerve palsy
If suspected TIA and patient is on warfarin/DOAC?
ED for imaging to exclude haemorrhage
Horner’s syndrome?
Ptosis and constricted pupil
CN3 findings?
Down and out
Dilated pupil
Weber’s syndrome?
Crossed findings due to brain stem infarcts
Ipsilateral CN3 palsy
Contralateral hemiplegia or hemiparesis
Symptoms in subacute degeneration of the cord?
- Loss of proprioception and vibration sense (dorsal columns)
- Spasticity and brisk reflexes (lateral columns)
Risk factor for pontine haemorrhage?
Chronic HTN
Pontine haemorrhage symptoms and signs?
Reduced GCS
Quadraplegia
Miosis
Absent horizontal eye movement
Symptoms in neurogenic thoracic outlet syndrome?
Muscle wasting in hands
Numbness and tingling
Autonomic symptoms
Symptoms of autonomic dysreflexia?
Severe HTN
Sweating above level of the lesion
Agitation
Complication of autonomic dysreflexia?
Haemorrhagic stroke
After clinical diagnosis of spinal stenosis what is the next step?
MRI to confirm diagnosis and exclude other pathology
Lateral medullary syndrome (Wallenberg’s syndrome) symptoms?
Ipsilateral: Ataxia, nystagmus, dysphagia, facial numbness, CN palsy
Contralateral: Limb sensory loss
MND with worse prognosis?
Progressive bulbular palsy
Most common earliest symptom in spinal cord compression?
Back pain
What is angiomyolipoma associated with?
Tuberous sclerosis
First line management in atonic or tonic seizure in females?
Lamotragine
Which nerve does finger abduction?
Ulnar
Which nerve does finger extension?
Radial
Parsonage-Turner’s syndrome?
Peripheral neuropathy, complication of viral illness, resolves spontaneously
Type of scan required to view demyelinating lesions (as in MS)?
Contrast MRI
Gold standard test for venous sinus thrombosis?
MR venogram
Barthel index?
Scale that measures disability or dependence in activities of daily living in stroke patients
Lesions at T1?
Cause finger abduction weakness
Acute ischaemic stroke CT sign?
‘hyperdense artery’ sign
(usually visible immediately in contrast to changes in the parenchyma)
Management of SAH?
Coiling of aneurysm
Isolated seizure and normal EEG affect on driving?
Patients cannot drive for 6 months following a first unprovoked or isolated seizure if brain imaging and EEG normal
What artery supplies Broca’s area?
Middle cerebral artery (on dominant side of brain)
Relapsing remitting MS?
Acute attacks followed by periods of remission
(85%)
Secondary progressive MS?
Relapsing and remitting has deteriorated and patient has developed neuro signs and symptoms between relapses
Primary progressive MS?
Progressive deterioration from onset (10%, more common if older)
management if dent on head after injury?
Immediate CT ?depressed skull fracture
When is thrombectomy indicated in stoke?
6-24 hour window if potential to salvage brain tissue (limited infarct core volume)
Presentation of syringomyelia?
Cape-like loss of pain and temperature sensation duets compression of spinothalamic tract fibres
Strong association with Chari malformation
Acute intermittent porphyria presentation?
Abdominal, neurological and psych symptoms
Management of acute porphyria?
IV haem arginate / haematin
If not available give IV glucose
Electrolyte abnormality in SAH?
Hyponatrameia
Uhtoff’s phenomenon?
Neuro signs worse with increase in body temp (E.g worse vision when running)
Brown- sequadrad syndrome?
Spinal cord hemisection
Ipsilateral spastic paresis below lesion
Ipsilateral loss of proprioception and vibration sense
Contra lateral loss of pain and temp
Which PD drugs are associated with the highest chance of inhibition disorders out of the antiparkinsonian medications?
Dopamine receptor agonists
