Neurology Flashcards
What is Hoover’s sign as it pertains to Somatisation disorder?
Hoover’s sign is the test used to help differentiate organic v non-organic / functional leg paresis
You place a hand under the affected leg while asking them to lift the unaffected leg against resistance - you will feel counter pressure in the ‘affected’ leg due to involuntary hip extension
When should phenytoin levels be checked?
Phenytoin levels do not need to be checked routinely but should be checked if suspect toxicity or if change of dose.
Need to check TROUGH levels so just before dose is due.
What is the classical presentation for normal pressure hydrocephalus?
Normal pressure hydrocephalus is an important differential to consider in patient’s presenting with confusion / memory loss as it is a REVERSIBLE cause of dementia.
It is caused by reduced resorption of CSF through the arachnoid villi.
Presents with WACKY, WET, WOBBLY
1. Cognitive disturbance / memory loss
2. Urinary incontinence
3. Wide, unstable gait (may present quite similar to parkinsons gait)
Management is ventricloperitoneal shunting
Which medications may cause peripheral neuropathy?
Nitrofurantoin
Metronidazole
Amiodarone
Isoniazid
Vincristine
In what ways does the classical presentation of migraines differ in children versus adults?
In children migraines are more likely to be *Bilateral *Last for shorter periods and have *Gastrointestinal disturbance / abdo pain associated
What DMARDs are available for those with MS?
Natalizumab - can reduce freq and severity of relapses by ~ 68%
Beta interferon (reduces relapses by ~ 30%)
The efficacy of cannabinoids is still debated
IF THE PATIENT HAS BEEN UNABLE TO WALK FOR 6 MONTHS THEN DMARDS ARE UNLIKELY TO BE EFFECTIVE
If there is disease progression despite treatment then normally that treatment should be stopped
Which patients with epilepsy would NOT be suitable to management under primary care and would require secondary care?
Any child / adolescent
Any adult with special needs
Any adult with ongoing seizures or with specific care needs e.g planning a pregnancy/
** Only adults with stable, well-controlled epilepsy should be managed in primary care **
