Neurology Flashcards
MMSE classification
20-24: Mild
10-19: Modrate
<10: Severe
MAO inhibitors that should not be dosed at night
Selegiline
ADR of dopamine agonists
N/V
Orthostasis
Leg edema
Hallucinations
Somnolence
Compulsive behaviours
Drugs that can precipitate parkinsonism
Antipsychotics
Methyldopa
Flunarizine, cinnarizine, promethazine
Diltiazem, verapamil
ASMs
Antiemetics
Lithium
ADR of carbamazepine
- Dose dependent (GI, CNS toxicity e.g. ataxia, nystagmus)
- Blood dyscrasia
- Hepatotoxicity
- SJS/TEN
- Folate deficiency, peripheral neuropathy
- Osteopenia
- Hyponatremia
ADR of phenytoin
- Dose dependent (GI, CNS toxicity e.g. ataxia, nystagmus)
- Blood dyscrasia
- Hepatotoxicity
- SJS/TEN
- Folate deficiency, peripheral neuropathy
- Osteopenia
- Gingival hyperplasia
- Hirsutism
ADR of VPA
- Dose dependent (GI, CNS toxicity, e.g. ataxia, nystagmus)
- Thrombocytopenia
- Hepatotoxicity
- Pancreatitis
- Alopecia
- Weight gain
- Hyperammonemia
ADR of levetiracetam
- Somnolence
- Dizziness
- Asthenia
- Ataxia
- Dyskinesia
- Irritability
- Agranulocytosis
ADR of topiramate
- Somnolence
- Fatigue
- Impaired cognition
- Depression, mania
- Neutropenia
- Glaucoma
- Metabolic acidosis
- Kidney stones
Initiation dose for lamotrigine
With valproate: 25 mg EOD
With carbamazepine, pheSnytoin, phenobarbital, primidone: 50 mg OD
No other drugs: 25 mg OD
Double the dose every 2 weeks
When to offer ASMs?
- Epileptiform discharge on EEG
- Prior brain insult
- Structural abnormality on brain imaging
- Noctural seizures
- Suspected genetic epilepsy syndrome
When to stop ASMs?
Seizure free for 10 years
No ASM for 5 years
Definition of chronic migraine
At least 15 MHD and
At least 8 MMD
For at least 3 months
