Neurology 2 Flashcards
What is focal neurology?
the effect of brain injury
neurology affecting the motor cortex?
contralateral weakness/ hemiplegia of limbs or face increased tone/stiffness increase reflexes dysphagia- swallow dysarthia- speech
neurology affecting the sensory cortex?
contralateral
loss of sensation
neglect
occasionally hyperaesthesia/ pain syndromes
neurology affecting speech area?
dominant hemisphere- usually left
brocas/ wernickes area
causes speech problems
neurology affecting higher level?
dominant hemisphere- usually left
frontal lobe- sequencing problems - dyspraxia
neurology affecting cerebellum?
loss of coordination
ataxia- intention tremor, cereballar gait
speech affected
dysarthia
neurology affecting basal ganglia?
control of movement
increase tone
slowness of action- bradykinesia
tremor
What is a stroke?
disorder of the vascular supply to the brain
what are strokes due to?
infarction
atherosclerosis
cardiac emboli re. atrial fibrillation
haemorrhage
What are the different types of infarction?
TIA- transient ischaemic attack
completed stroke- persisting neurological deficit
What is a haemorrhage stroke?
bleed
usually more severe than infarction
hypertension main risk factor
What are the clinical features of a stroke?
hemiplegia hemianopia dysarthia/ dysphasia cognitive impairment dyspraxia impaired consciousness confusion seizure
hwo is a stroke diagnosed?
CT scan
what surgical treatment may be required post stroke?
required within 2 weeks for infarcts/ TIAs
carotid endarterectomy
what treatment is required long term for stroke?
treatment re. infarction:
anti platelets, warfarin, and other anticoagulants
adress BP, cholesterol, smoking, diabetes
what tube may be used for patients re. swallowig problems- short term?
nasogastric tube
what tube may be used for patients re. swallowing problems long term?
PEG
percutaneous endoscopic gastrostromy
What is parkinsons disease?
degeneration of dopaminergic neurones in the basal ganglia
what are clinical features of parkinsons disease?
bradykinesia- slowness of movement rigidity- increased muscle tone termor- low frequency slow speech mask like face shuffling gait and falls difficulty with fine motor tasks swallowing problems
what treatment can be used re. parkinsons?
dopaminergic drugs
direct replacement- Levadopa
what surgical treatment can be used re. parkinsons?
stereotactic surgery
What are features of a essential tremor?
hereditary
unilateral
worse with action
improves with alcohol
what is the treatment re. essential tremor?
beta blockers
primodone
What is multiple sclerosis?
auto immune destruction of CNS
loss of myelin
more common in women
onset- 30 years old
