Neurology Flashcards
Herpes Simplex Encephalitis Management
IV Fluids and Acyclovir
Roth Spots on Retina + Headaches + Decreased Consciousness
Carbon Monoxide Poisoning
Weakness Increases with Activity
Myasthenia Gravis
Weakness decreases with Activity
Lambert-Eaton Myasthenic Syndrome (LEMS)
Anti-GM1 antibody associated with
- Guillain-Barré syndrome
- Multifocal Motor Neuropathy
Anti-GQ1b Antibody associated with
Miller Fischer Syndrome
Post Partum + Seizures + Papilloedema
Cerebral Venous Thrombosis
Meningitis with Brainstem involvement
Listeria
Meningitis seen in elderly, diabetics and alcoholics
Listeria
Lymphocyte Predominant Meningitis
- Nocardia
- Mycobacterium
Unilateral Hearing loss + Tinnitus + Trigeminal Neuropathy
Vestibular Schwanoma
NICE Recommendation for preventing secondary Cerebral infarction
Clopidogrel
Teenager + Early Morning Seizures + Myoclonic Jerks
Juvenile Myoclonic Epilepsy
Management of Torticollis
Botox Injection
Juvenile Myoclonic Epilepsy Management
Levetiracetam
Facial Weakness + Winged Scapula + Elevated CK
Facioscapulohumeral Muscular Dystrophy
Normal Creatine Kinase + Muscle Weakness in Quadriceps
Inclusion body Myositis
Neurogenic Detrusor activity management
- PRV <100 → Oxybutinin
- PRV >100 → Intermittent self catheterization
Unable to Walk due to weakness but Cycling can be done
Lumbar Canal Stenosis
Anti Tubercular medication causing sensory neuropathy
Isoniazid
Fingolimod Mechanism of Action
Sphingosine 1 Phosphate receptor modulator
MRI Finding of Subacute Combined Degeneration of spinal cord
Increased T-2 Weighted signal in the posterior column
Management of Essential Tremors
Propranolol or Topiramate
Inferior quadrantanopia caused by
a lesion in the parietal lobe (Opposite side)
Superior quadrantanopia caused by
a lesion in the temporal lobe (Opposite side)
Management of Tourette Syndrome
Risperidone
Hypodense areas in both temporal lobes seen in MRI
Herpes Simplex Encephalitis
Trigeminal Neuralgia Management
Carbamazepine
Raised CSF proteins (Albumino-cytological dissociation)
Gullian-Bare Syndrome
Oligoclonal bands seen in
Multiple Sclerosis
Raised Lactate in CSF seen in
Mitochondrial Encephalopathy with Lactic Acidosis
Nerve affected in Foot Drop
Common Peroneal Nerve
Nerve affected in Weakness of Knee Extension and Hip Flexion
Femoral Nerve
Nerve affected in weakness of Hip adduction
Obturator Nerve
Changes in Personality and Behaviors but no memory defect
Fronto-Temporal Dementia
Seizure + epigastric aura + fear + lip smacking
Temporal Lobe Epilepsy
Seizure + vertigo + hallucinations
Parietal Lobe Epilepsy
LMN signs in arms + UMN signs in legs
Motor Neuron Disease
EMG Finding in Motor Neuron Disease
Reduced number of action potentials with increased amplitude.
EMG Shows - Dive bomber effect” (waxing and waning potentials).
Myotonic Dystrophy
EMG Finding in Polymyositis and Dermatomyositis
Small short-duration motor unit potentials.
Specific Area for Hemiballism
Subthalamic Nucleus of Basal Ganglia
Specific Area for Huntingtons
Caudate Nucleus of Basal Ganglia
Commonest Causes of Young Onset Stroke
- Carotid Artery Dissection
- Cardio Embolism
Triad of Carotid Artery Dissection
- Unilateral Headache
- Ipsilateral Horners Syndrome
- Contralateral Visual Disturbance
Migraine + Recurrent Ischaemic Events
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL)
Gene for CADASIL
Chromosome 19 NOTCH 3
Wernicke’s Aphasia Site of Lesion
Superior Temporal Gyrus
Brocas Aphasia Site of Lesion
Inferior Frontal Gyrus
Brown-Séquard Syndrome Mnemonic
I LOST PALS
I → Ipsilateral:
LO → Loss of proprioception and vibration.
S → Spastic paralysis
T → Loss of fine touch.
Contralateral
PALS → Pain And Loss of temperature
Wasting and Weakness of Hand + Loss of Pain and Temperature
Syringomyelia
Ptosis + Miosis
Horners Syndrome
Ptosis + Mydriasis
3rd Nerve Palsy
Headache + 3rd Never palsy + Dilated Pupil
PCA Aneurysm
3rd Never palsy sparing the pupil
Ischemic Oculomotor Palsy
Frontal Lobe Epilepsy features
Post Ictal weakness + Jacksonian march
Temporal Lobe Epilepsy features
Hallucination
Epigastric Rising
Automatism
GBS respiratory assessment marker
Vital Capacity
Anisocoria more evident in Light than dark seen in
Holmes-Adie Syndrome
Anisocoria + Loss of Deep Tendon Reflex
Holmes-Adie Syndrome
Arnold-Chiari Malformation type of Nystagmus seen
Downbeat
Palpable Nodule + Seizures Diagnosis
Cysticercosis
Test for confirming brainstem death
Oculi-vestibular reflex
Acoustic Neuroma + Unilateral Hearing loss effects which other nerve
Trigeminal - Loss of Corneal Reflex
Psychiatric Symptoms + Myoclonic Jerk + Rapidly progressive dementia
Creutzfeldt-Jakob disease
Young + Hypokalemia + paralysis
Periodic Paralysis
Ophthalmoplegia + Ataxia + Areflexia
Miller Fisher Syndrome
Multifocal Motor Neuropathy associated Antibody
Anti GM1 antibody
Headache Increased by standing and relieved by lying down.
Spontaneous Intracranial Hypotension
Feature to distinguish between true seizures and pseudo seizures
Lateral Tongue bite
Statin causing Peripheral Neuropathy
Simvastatin
Meningitis after cold and cough symptoms + working with children
Enterovirus Meningitis
Antiepileptic with renal stones as side effect
Topiramate
Cape Like distribution anesthesia seen in
Syringomyelia
Neck pain + Headache exacerbated by cough + Cape like anesthesia
Chiari Type 1 Malformation
Global Wasting of Intrinsic muscles of hand site of lesion
T1 nerve root
MRI finding of Subacute Combined Degeneration
Increased T2 Weighted signals in posterior column
MRI finding of Multiple Sclerosis
Diffuse Patchy white matter lesion on T2 Weighted images
Kyphoscoliosis + Bilateral Pes Cavus + LMN wekaness
Charcot-Marie-Tooth Disease
Downbeat Nystagmus associated with
Arnold-Chiari Malformation
Post Delivery + Dehydration + Seizures
Saggital Sinus Thrombosis
Which Immunoglobulin is most important for GBS
IgA
Differentiate Myasthenia from Lambert Eaton Clinically
Areflexia and Autonomic Symptoms
Ptosis + dysphagia + atrophy of temporalis
Myotonic Dystrophy Type 1
Cluster Headache prophylaxis
Verapamil
Creutzfeldt-Jakob disease MRI Finding
Increased Signal in pulvinar of thalamus
MRI Shows String of Bead appearance
Fibromuscular Dysplasia
Management of Multiple Sclerosis acute attack
Prednisolone 0.5 gm 1-0-0 x 5 days
Confirmatory test for Creutzfeldt-Jakob disease
RT- QulC on Lumbar Puncture
Weakness of Triceps, Brachioradialis and Extensor Digitorum
Radial Nerve
Young tremor + Heart Disease
Wilsons Disease
INO Side identification
Same as side of eye which can’t adduct
Saturday Night Palsy location
Radial Nerve at Spiral Groove
Headache + Word finding difficulty seen in
Migraine with Aura
Drugs that commonly cause deterioration in myasthenia gravis
• D-penicillamine
• Neuromuscular blocking agents, eg succinylcholine
• Aminoglycoside and fluoroquinolone antibiotics
• Antiarrhythmics, eg quinidine, procainamide
• B-blockers, eg propranolol
Ropinirole Mechanism of Action
Dopamine receptor agonist
CSF shows increased opening pressure and decreased glucose
TB meningitis
Intrathecal synthesis of IgG seen in
Multiple Sclerosis
High ESR and pain in jaw along with headache
Giant Cell Arteritis
Satiety Center in brain is located at
Ventero Medial Nucleus
Sedative safest in Parkinsonism patients
Lorazepam
Management of Alzheimers Disease
- Donepezil
- Rivastigmine
Reduce Dyskinesia in parkinson patient on L-Dopa
Amantadine
Increased T2 signal in frontal lobe white matter in MRI
Pick’s Disease
DOC for Management of Muscle Weakness in Lambert Eaton
Amifampridine
Which CNS Cells are mainly destroyed in Osmotic demyelination
Astrocytes (Undergo apoptosis)
Genetic risk factor for Alzheimer’s Disease
APO E4 allele
Genetic risk factor for Alzheimer’s Disease
APO E4 allele
Anti Epileptic with least risk of heart block
Primidone
HIV + Neuro symptoms + single brain lesions with homogenous enhancement
Primary CNS lymphoma
High altitude cerebral edema management
Descent + Dexamethasone
Medications to Avoid in Dementia Patients
Anti Psychotics (Olanzapine)
Parkinson’s medicine for gambling person
Procyclidine
HIV patient with MRI brain shows Dilated Periventricular Spaces
Cryptococcal Infection