NEUROLOGY Flashcards
Kluver Bucy syndrome
Bilateral damage to temporal lobes Especially the AMYGDALA
-Hyperphagia and pica
-Hyperorality
-Hypersexuality
-Visual Agnosia
-Confirmed By MRI
5HT3 Antagonist
-Work on chemoreceptor trigger zone of medulla
-cause; -QT PROLONGATION
-CONSTIPATION
Neuropathic pain
- BPH/or any cause of urinary retention»_space; Exclude Amitriptyline
- Renal impairment»_space; pregabalin preferred over gabapentin
- Narrow-Angle Glaucoma»_space; Exclude Duloxetine And Amitriptyline.
- Post-Herpetic Neuralgia»_space; Topical capsaicin
- Tramadol may be used as ‘rescue therapy’ for exacerbations of neuropathic pain
BETAHISTINE
Prevention in MENIERS DISEASE And in BPPV
Isolated ALEXIA Without AGRAPHIA
Infarction of pca which supplies splenium of CORPUS CALLOSUM disconnecting both lobes from each other
SAH
-Elvated ST SEGMENT
CATAPLEXY
Muscle weakness following STRONG EMOTIONS : buckling knees and collapses
Associated with Narcolepsy
Spinal cord columns
ANTERIOR: SPINOTHALAMIC
DORSAL COLUMN
LATERAL HORNS: CELL BODIES OF SYMPATHETIC
VENTRAL HORNS: MOTOR NEURONS
SUBACUTE COMBINED DEGENERATION OF SPINAL CORD
-Associated with recreational nitrous oxide use as it results in vitamin b12 deficiency
-ALSO Associated with folic acid supplementation
Lesions of anterior 2/3 of spinal cord
-Anterior spinal artery thrombosis
-Intramedullary spinal cord metastasis
-Syringomyelia affects pain and temp sensations ABOVE THE LESION NOT BELOW
Anterograde amnesia (inability to form new memories) after a STRESSFUL EVENT
Transient global amnesia
Progressive inherited conductive hearing loss with normal otoscope
Otosclerosis
Neuroleptic malignant
-Due to stopping of parkinsonian drugs or due to Antipsychotics
-Fever
-Muscle rigidity
-confusion
-htn tachycardia and tachpnea
-Raised creatine kinase and AKI
-RX: DANTROLENE
Hemiballism
Decreases when sleeping
-primarily affecting proximal muscles
Rx haloperidol
to differentiate between essential tremors and parkinson
SPECT
Best MRI for MS
MRI FLAIR
-Shows hyperintense lesions perpendicular to the corpus callosum called Dawsons fingers Also paraventicular plaques
HIGH SIGNAL T2 LESIONS
Ramsey Hunt
Ear pain FIRST
-ORAL ACYCLOVIR AND CORTICOSTEROIDS
Brain abscess
IV 3rd-generation cephalosporin + metronidazole
chronic spasticity in MS
-Baclofen (GABA AGONIST)
-Gababentin
Procyclidine, Benzhexol (trihexyphenidyl), Benzotropine
Anti muscarinic used for tremors in drug parkinsons
Rapidly Progressive Dementia , Myoclonus, Akinetic mutism
CJD
Gingival Hyperplasia
-AML
-PHENYTOIN
-CCB NIFEDIPINE
-CICLOSPORIN
OTOSCLEROSIS
10 Percent will have reddish blue tint on tympanic membrane exam
Restless leg syndrome
Exclude IDA
-Mssage and stretching exercises
-ROPINIROLE
Severe pain in arms and shoulders followed by weakness days later and wasting
Brachial Neuritis
PES CAVUS
-CMT
-FRIEDRICHS ATAXIA
SODIUM VALPROATE
VALPROATE
-Vomiting
-Alopecia
-Liver toxicity
-Pancreatitis Pancytopenia
-Retention of fat
-Oedema
-Ataxia
-Teratogenic tremors
-Enzyme inhibitor Enchephalitic hyperammonemic
SODIUM= HYPONATREMIA
MOTOR NEURON DISEASE
-RILUZOLE (ANTI GLUTAMATE)
USED IN ALS
-NON INVASIVE VENTILATION (BIPAP)
BEST SURVIVAL
-PERCUTANEOUS GASTROSTOMY
Folic acid in woman planning to be pregnant while on AED
5MG PER DAY BEFOREE CONCEPTION
Median longitudinal Fasiculus of intranuclear ophthalmoplegia
Located in paramedian area of midbrain and pons
Ipsilateral optic nerve atrophy
contralateral papilledema
FOSTER KENNEDY
-Anterior frontal lobe tumor
BILATERAL MYOCLONIC SEIZURES IN THE MORNING IN CHILD
JUVENILE MYOCLONIC EPILEPSY
-ASSOCIATED ABSENCE SEIZURES
Complications of Meningitis
-SENSORINEURAL HEARING LOSS
-Seizures
-Focal neurological deficit
-Brain abscess
-Brain herniation/Hydrocephalus
Cape like loss of pain and temp sensation with motor weakness and sparing Posterior column
Syringomyelia
Vitreous Hemorrhage and Cerebellar ataxia
VON HIPPEL LINDAU
-Retinal and cerebellar hemangioblastomas
SAH COMPLICATIONS
-REBLEEDING
-VASOSPASM
-HYDROCEPHALUS
-SIADH HYPONATREMIA
-SEIZURES
HTN BRADYCARDIA RESPIRATORY DEPRESSION
CUSHING TRIAD
DRUGS CAUSING TINNITUS
-ASPIRIN/NSAIDS
-AMINOGLYCOSIDES
-LOOP DIURETICS
-QUININE
Essential tremor with ASTHMA
PRIMIDONE (BARBITURATES) ANTICONVULSANTS
PHENYTOIN
DECREASES VITAMIN K LEADS TO BLEEDING
SJS
Can happen in 3 PLACES
-PHENYTOIN
-PHENOBARBITAL
-PENICILLIN
-LAMOTREGINE
-ALLOPURINOL
-CARBAMAZEPINE
-ERYTHROMYCIN
-SULFA DRUGS
Breast feeding with AED
AEDs are generally safe during breastfeeding
-Taking vitamin K With PHENYTOIN
Migraine Aura
-Occur in one third
-Lasts 5-60 minutes and are progressive
-Transient hemianopic disturbance or scintillating scotoma
Triggered by COCs, dehydration, menstruation
-COCs PLUS MIGRAINE INC. RISK FOR STROKE
IDIOPATHIC INTRACRANIAL HYPERTENSION
DRUGS:
-COCs
-STEROIDS
-TETRACYCLINE
-RETINOIDS, VIT. A
-LITHIUM
IDIOPATHIC INTRACRANIAL HYPERTENSION
RX:
-WEIGHT LOSS
-CARBONIC ANHYDRASE INHIBITORS
-TOPIRAMATE: causes weight loss and carb anhydrase inhibitor
-Repeated LPs
-Optic nerve fenestration or SHUNT
BLEEDING IN BRAIN CRESCENTRIC IN SHAPE AND NOT LIMITED TO SUTURE LINES
-IF HYPERDENSE: ACUTE SUBDURAL
-IF HYPODENSE: CHRONIC SUBDURAL
Fluctuating consciousness and alcoholism and LEFT LATERAL GAZE PALSY
Subdural hematoma
Narcolepsy
-LOW OREXIN (HYPOCRETIN)
-HYPERSOMNOLENCE
-CATAPLEXY
-SLEEP PARALYSIS
-HALLUCINATIONS
DAYTIME STIMULANTS , NIGHT TIME SODIUM OXYBATE
IV PHENYTOIN
-Causes Hypotension and Bradyarrhythmias
Onset of migraine in middle age then frequent recurrent TIAs and STROKES
CADASIL
patient on procyclidine
Patient on Dopamine antagonists (anti-psychotics) can develop rigidity due to dopamine blockade between pathways from brainstem to basal ganglia. Hence they are given prn procyclidine in case this happens. This is therefore a clue he was on an antipsychotic and that he was likely aware he was becoming rigi
DD
OPTHALMOPLEGIA + ATAXIA + AREFLEXIA= MILER FISHER
OPHTHALMOPLEGIA+ ATAXIA + ENCEPHALITIS= WERNICKEs
MENIEREs
-Acute attacks= PROMETHAZINE/ PROCHLORPERAZINE
-Prevention= BETAHISTINE
Saturday night palsy
-RADIAL nerve palsy IN THE AXILLA
-WRIST DROP
-FINGER EXTENSION WEAKNESS
TOPIRAMATE
-WEIGHT LOSS
-RENAL STONES
-SECONDARY ANGLE CLOSURE GLAUCOMA
-PARATHESIA
TRANSIENT GLOBAL AMNESIA
TRANSIENT EPILEPTICAL AMNESIA
TEA: -MOTOR AUTOMATISMS
-SHORTER IN DURATION
-Hx OF NEUROLOGICAL DISEASE Eg.; STROKE
PALATAL MYOCLONUS
a specific feature of hypertrophic olivary degeneration. This is caused by a lesion in the triangle of Guillain and Mollaret (triangle linking the inferior olivary nucleus, red nucleus and the contralateral dentate nucleus). An MRI brain is the gold standard imaging for this lesion.
Acute Disseminated Encephalomyelopathy
-POST INFECTIOUS MOTOR OR SENSORY DEFICIT
-POORLY DEFINED Hyperintensities in SUBCORTICAL WHITE MATTER
Difference bet NEUROLEPTIC MALIGNANT SYND. AND SERETONIN SYNDROME
-Seretonin synd.: HYPEREFLEXIA AND CLONUS , DILATED PUPILS , CAUSED BY SSRIs ,
THROMBOLYSIS AND THROMBECTOMY
-confirmed occlusion of the proximal anterior circulation demonstrated by computed tomographic angiography (CTA) or magnetic resonance angiography (MRA)
Nuclei of Hypothalamus
ANTERIOR= COOLING
POSTERIOR= HEATING
VENTROMEDIAL= SATIETY CENTER (if removed pt. becomes hungry and gains weight)
-LATERAL INJURY MAKES YOU LEAN
-PARAVENTRICULAR = OXYTOCIN SUPRAOPTIC= SYNTHESIS OF ADH
AUTOINDUCTION
FOUND IN CARBAMAZEPINE CAUSES RETURN OF SEIZURES AFTER STARTING CARB. BY 3/4 WEEKS
