Neurology 2

Question 1

what is focal neurology?

Answer 1

the effect of the brain injury

Question 2

what is hemiplaegia?

Answer 2

a complication with the motor cortex
weakness in limbs and face
increased tone and increased reflexes

Question 3

motor cortex problems may affect what else?

Answer 3

swallowing - dysphagia

speech - dysarthria

Question 4

what is hyperparasthesia?

Answer 4

excessive physical sensitivity
caused by a problem with the sensory cortex
pain syndromes

Question 5

what hemisphere of the brain dominates speech?

Answer 5

left

broca/wenickes area

Question 6

dyspraxia - problems with sequencing may arise from what area of the brain?

Answer 6

frontal lobe

left hemisphere

Question 7

what is hemianopia?

Answer 7

loss of vision

Question 8

what is ataxia?
where does it come from?
what can it cause?

Answer 8

loss of co ordination
stems from cerebellum
intention tremor/cerebellar gait

Question 9

what is the function of the basal ganglia?

what can go wrong with them?

Answer 9

control movement
increased tone
slowness of action - bradkykineasia, tremor

Question 10

what is a stroke?

Answer 10

disorder of vascular supply to the brain

Question 11

what are strokes commonly caused by?

Answer 11

infarction - artherosclerosis/cardiac emboli

10 % haemorrhage

Question 12

types of infarction?

Answer 12

TIA

completed stroke - persisting neurological defecit

Question 13

what is the main factor for a stroke caused by a bleed?

Answer 13

hypertension

usually more severe

Question 14

what do clinical features of a stroke depend on?

Answer 14

site of infarction

Question 15

what are some clinical signs of a stroke?

Answer 15

hemiplegia
hemianopia
dysarthia/dysphasia
dysphagia
dyspraxia
cognitive impairment
confusion/seizure/impaired consciousness

Question 16

what do you use to diagnose a stroke?

Answer 16

CT

Question 17

what are the outcomes of a stroke?

Answer 17

33% death
33% significant disability
33% recovery

Question 18

what kind of surgery can be done on a stroke patient?

Answer 18

carotid endarterectomy

Question 19

what is the long term treatment for a stokes patient?

Answer 19

antiplatelets/ warfarin if AF/ NOAC

address high bp/cholesterol/smoking/diabetes

Question 20

types of rehab treatment on offer to strokes patients?

Answer 20

occ therapy
physio
speech therapy
dieticians
social workers

Question 21

what type of nutritional support can stroke patients get?

Answer 21

naso gastric tube

percutaneous endoscopic gastronomy

Question 22

what is parkinsons disease?

Answer 22

degeneration of dopaminergic neurones in the basal ganglia

underlying cause is unclear

Question 23

what are some clinical features of parkinsons disease?

Answer 23

bradykinesia - slow movement/initiation/reduced movement range
rigigity - increased muscle tone
tremor - low frequency
slow speech
mask like face
shuffling gait and falls
swallowing problems
difficulty with fine motor tasks

Question 24

what are the medical treatments of parkinsons disease?
surgical treatments?
rehab treatments?

Answer 24

• dopaminergic drugs - direct replacement/agonists
• stereotactic
• physio and occ therapy

Question 25

what is essential tremor?

Answer 25

often hereditary
may be unilateral
worse on action
annoying/embarassing rather than disabling
improves with alcohol

Question 26

what drugs can be used to treat essential tremor?

Answer 26

beta blocker

primidone

Question 27

what is multiple sclerosis?

Answer 27

auto immune destruction of CNS

loss of myelin - demyelination

Question 28

what is the epidemiology of MS?

Answer 28

predominently caucasians / Northern Europeans/ more likely women over men/mean age onset @30 years

Question 29

Clinical features of MS?

Answer 29

depends on area of myelination
loss of vision in one eye - double vision
changes in sensation
ataxia
weakness
initial recovery common

Question 30

what are the two forms of MS?

Answer 30

• Relapsing/Remitting - diff areas affected at diff times/ partial or complete recovery in between
• Chronic Progressive - Cumulative damage - loss of mobility/incontinence/pressure sores/fatigue/dementia

Question 31

what investigations are used to diagnose MS?

Answer 31

clinical
lumbar puncture
MRI

Question 32

how to treat acute episodes of MS?

Answer 32

high dose steroids

reduce relapse rate with B interferon

Question 33

how to treat ongoing MS?

Answer 33

rehab and support

symptom control - anti spasmosdics, catherterisation

Question 34

what is peripheral neuropathy?

Answer 34

loss of peripheral nerve function

• generalised - glove and stokcing, multiple causes - diabetes mellitus/drug side effect
• specific nerve/nerve roots - often pressure effect - trauma/tumour

Question 35

what are the effects of loss of peripheral nerve function?

Answer 35

loss of sensation

loss of power

Question 36

what is bells palsy?

Answer 36

lower motor neurone palsy of facial nerve
thought to be viral
oral steroids within 72 hours improve outcome
need eye care

Question 37

what is motor neurone disease?

Answer 37

destruction of motor neurones
70 in 100000
more common in males

Question 38

what are some clinical features of motor neurone disease?

Answer 38

limb weakness

swallowing problems

Question 39

how to diagnose motor neurone disease?

Answer 39

clinical

neurophysiology

Question 40

how to treat motor neurone disease?

Answer 40

medications have limited value

mainly supportive - feeding tubes

Question 41

what is the prognosis for motor neurone disease?

Answer 41

prognosis of 5 years