Neurology Flashcards
How is BPPV diagnosed and how is it treated?
Dx: Dix-Hallpike maneuver
Tx: Epley maneuver
What are the classic signs of Menieres Disease
Vertigo, Tinnitus, Hearing loss
List 5 differentials for dizziness?
- BPPV
- Vestibular Neuritis
- Menieres Disease
- Presyncope
- Migraine
Parkinsons disease, Hypoglycemia, stroke, MS
When would a CT be warranted for CC: dizziness?
Hx head trauma, focal neuro signs, vertical or multi-directional nystagmus, CV risk factors
How do Tension Type Headaches differ from cluster headaches?
TT: episodic HA lasts mins - days. Typically bilat, pressing or tightening quality (not pulsating), pain does not worsen with activity, no nausea associated
Cluster: episodic/chronic attacks with periods of no pain lasting >1month. Severe, brief attacks (<3hrs). Pain typically unilateral occurring on the same side during a clustered period. May be provoked by alcohol, histamine or nitro
When is a headache diagnosed as a migraine?
When it is associated at least 2 of following: N/V, light sensitivity, interference with activities
If preceding symptoms/aura = Migraine with aura
Dx criteria: at least 2 attacks that last 4-72hrs with at least 2 of the following:
- unilateral
- pulsating
- mod-severe quality
- aggravated by or avoidance of physical activity
- N/V
- photo/phono phobia
How is medication overuse headache diagnosed?
If ergots, triptans, combo analgesics, codeine or opioids are used for >10days in a month OR use of:
Tylenol or NSAIDs for >15days in a month
What are some headache red flags?
- First or Worst
- Thunderclap
- Papiledema
- Worse in am with or without emesis
- Vision loss
- Fever, recent illness
When can migraines be classified as chronic?
Migraine without aura at least 15 headache days/month for longer than 3 months duration
What are the classic signs of temporal arteritis?
- Onset of headache >50 years,
- at temporal region,
- visual disturbances,
- jaw claudication (pain with chewing),
- unexplained fever, anemia, fatigue, weight loss,
- high ESR/CRP
How are infantile spasms characterized?
Onset at 3m-2years, sudden movements, ie head falling forward, arm flaxen, knees drawn up to chest
When can epilepsy be diagnosed?
When the patient has >1 seizure secondary to an underlying condition of the brain
What is Lennox-Gastaut Syndrome?
rare form of epilepsy consisting of multiple seizure types, including: cognitive impairment & drop seizures
What are the 4 types of generalized seizures?
- Tonic Clonic (Grand Mal): 1-2mins, rigid (tonicity) and jerking (clonicity), possible cyanosis, possible prodrome and generally postictal after
- Absent (Petit Mal): 2-15 secs, abrupt eye staring, flutters, rolling
- Myoclonic: rapid brief muscle contractions, usually bilat
- Atonic (drop seizures): abrupt loss of muscle tone/posture, sudden collapse, usually med resistant, will often require helmet use
What are some risk factors for developing bells palsy?
- Fam hx of bells palsy
- Pregnancy (especially 3rd trimester or 1st wk PP)
- Immunocompromised
- Diabetes
- Age > 30
- Exposure to cold temperatures
- URTI
- Chronic HTN
- Obesity
- Migraines
