Neurology 2 Flashcards
what is focal neurology?
the effect of the brain injury
what is hemiplaegia?
a complication with the motor cortex
weakness in limbs and face
increased tone and increased reflexes
motor cortex problems may affect what else?
swallowing - dysphagia
speech - dysarthria
what is hyperparasthesia?
excessive physical sensitivity
caused by a problem with the sensory cortex
pain syndromes
what hemisphere of the brain dominates speech?
left
broca/wenickes area
dyspraxia - problems with sequencing may arise from what area of the brain?
frontal lobe
left hemisphere
what is hemianopia?
loss of vision
what is ataxia?
where does it come from?
what can it cause?
loss of co ordination
stems from cerebellum
intention tremor/cerebellar gait
what is the function of the basal ganglia?
what can go wrong with them?
control movement
increased tone
slowness of action - bradkykineasia, tremor
what is a stroke?
disorder of vascular supply to the brain
what are strokes commonly caused by?
infarction - artherosclerosis/cardiac emboli
10 % haemorrhage
types of infarction?
TIA
completed stroke - persisting neurological defecit
what is the main factor for a stroke caused by a bleed?
hypertension
usually more severe
what do clinical features of a stroke depend on?
site of infarction
what are some clinical signs of a stroke?
hemiplegia hemianopia dysarthia/dysphasia dysphagia dyspraxia cognitive impairment confusion/seizure/impaired consciousness
what do you use to diagnose a stroke?
CT
what are the outcomes of a stroke?
33% death
33% significant disability
33% recovery
what kind of surgery can be done on a stroke patient?
carotid endarterectomy
what is the long term treatment for a stokes patient?
antiplatelets/ warfarin if AF/ NOAC
address high bp/cholesterol/smoking/diabetes
types of rehab treatment on offer to strokes patients?
occ therapy physio speech therapy dieticians social workers
what type of nutritional support can stroke patients get?
naso gastric tube
percutaneous endoscopic gastronomy
what is parkinsons disease?
degeneration of dopaminergic neurones in the basal ganglia
underlying cause is unclear
what are some clinical features of parkinsons disease?
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
what are the medical treatments of parkinsons disease?
surgical treatments?
rehab treatments?
- dopaminergic drugs - direct replacement/agonists
- stereotactic
- physio and occ therapy
what is essential tremor?
often hereditary may be unilateral worse on action annoying/embarassing rather than disabling improves with alcohol
what drugs can be used to treat essential tremor?
beta blocker
primidone
what is multiple sclerosis?
auto immune destruction of CNS
loss of myelin - demyelination
what is the epidemiology of MS?
predominently caucasians / Northern Europeans/ more likely women over men/mean age onset @30 years
Clinical features of MS?
depends on area of myelination loss of vision in one eye - double vision changes in sensation ataxia weakness initial recovery common
what are the two forms of MS?
- 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
what investigations are used to diagnose MS?
clinical
lumbar puncture
MRI
how to treat acute episodes of MS?
high dose steroids
reduce relapse rate with B interferon
how to treat ongoing MS?
rehab and support
symptom control - anti spasmosdics, catherterisation
what is peripheral neuropathy?
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
what are the effects of loss of peripheral nerve function?
loss of sensation
loss of power
what is bells palsy?
lower motor neurone palsy of facial nerve
thought to be viral
oral steroids within 72 hours improve outcome
need eye care
what is motor neurone disease?
destruction of motor neurones
70 in 100000
more common in males
what are some clinical features of motor neurone disease?
limb weakness
swallowing problems
how to diagnose motor neurone disease?
clinical
neurophysiology
how to treat motor neurone disease?
medications have limited value
mainly supportive - feeding tubes
what is the prognosis for motor neurone disease?
prognosis of 5 years
