Neurology

Question 1

characteristics JME juvenile myoclonic epilepsy

Answer 1

presents in adolescence with progression from myoclonic seizures to generalized tonic-clonic seizures; this disorder is genetic and can be worsened by sleep deprivation; seizures typically occur on wakening

Question 2

why can’t migrain patients take both ergotamine and triptans at the same time

Answer 2

can cause severe vasoconstriction when taken together causing elevated BP, MI, or stroke –> prolonged vasospasm from overactivation of the 5-HT receptor so you have to wait 24 hours to give it; the triptan on its own causes vasoconstriction an decreased neurogenic inflammation

Question 3

Migrain Tx and prophylaxis

Answer 3

Tx: NSAIDs, triptans, acetaminophen, antiemetics, ergots
prophylaxis: topiramate, divalproex sodium, TCAs, B-blockers (propanolol)

Question 4

limited upward gaze, ptosis, upper eylid retraction, pupillary abnormalities = ?

Answer 4

parinaud syndrome (dorsal midbrain syndrome)

Question 5

s/p stroke with contralater hemianesthesia that can be accompanied by transient hemiparesis, athetosis, or ballistic movements and dysesthesia (hypersensitive to pain) of the area affected by the sensory loss

Answer 5

thalamic stroke (Dejerine-Roussy syndrome) caused by a stroke involving VPL nucleus of the thalamus

Question 6

when you think of alzheimer’s initiate which med?

Answer 6

anticholinesterase inhibitors like donepazil