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FOCP > Neurology > Flashcards

Neurology Flashcards

1
Q

What can a CN 3 palsy cause?

A

Ptosis, large pupil, eyes down and out

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2
Q

What does CN 4 palsy cause?

A

Diplopia on looking Down and in

Head tilting for compensation

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3
Q

What does a CN 5 palsy cause?

A

Nystagmus

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4
Q

What can cause horizontal nystagmus?

A 
Vestibular lesion (chronic: towards affected side, acute: towards normal)
Cerebellar lesion (towards lesion)
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5
Q

What can cause nystagmus in abducting eye?

A

MS

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6
Q

What can cause nystagmus with tinnitus, hearing loss and balance loss?

A

CN 8 lesion

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7
Q

What is a sign of a CN 5 palsy?

A

Open mouth, jaw deviates towards lesion

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8
Q

What is lost first in a CN 5 palsy?

A

Corneal reflex

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9
Q

What does an upper facial motor neuron lesion cause?

A

Drooping and weakening in lower 2/3rds of face (because forehead has bilateral representation in the brain)

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10
Q

What does a lower facial motor neurone lesion cause?

A

Drooping and weakness in half of the face

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11
Q

What is a sign of a CN 10 palsy?

A

Palate deviates to normal side

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12
Q

What does a CN 12 lesion cause?

A

Deviation of tongue to affected side

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13
Q

What can affect all CN nerves?

A

DM, MS, stroke, tumours, syphilis, meningitis, sarcoidosis, SLE

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14
Q

What can cause a CN 1 lesion?

A

Trauma, resp infection, frontal love tumour

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15
Q

What can cause a CN 2 lesion?

A

Monocular blindness: MS, giant cell arteritis

Binocular blindness: DM, ms, neurosyphilis

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16
Q

What can cause a CN VI lesion?

A

Wernicke’s encephalopathy, pontine stroke

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17
Q

What can cause sensory CN V problems?

A

Trigeminal neuralgia, skull fracture, acoustic tumour, herpes zoster, nasopharyngeal cancer

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18
Q

What can cause CN VII lesions?

A

LMN: Cerebellar pontine tumours, Bell’s palsy, otitis media, skull fracture
UMN: stroke

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19
Q

What can cause a CN VIII lesion?

A

Noise damage, acoustic neuroma, meinere’s disease, pagat’s

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20
Q

What can affect CN VIII, then CN V, VI, IX, X?

A

Cerebellar pontine tumours

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21
Q

What can affect CN III, IV, VI?

A

Tumours, wernicke’s aphasia, stroke, MS

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22
Q

What can affect CN III, IV, Va, and VI?

A

Cavernous sinus thrombosis, sup. orbital fissure

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23
Q

What can affect CN IX, X, XI?

A

Jugular Foramen lesions

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24
Q

Where can a lesion cause Broca’s aphasia?

A

Infero lateral on dominant frontal lobe

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25
Q

Where can a lesion cause Wernicke’s aphasia?

A

Posterior superior dominant temporal lobe

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26
Q

Where can a lesion cause nominal aphasia?

A

Posterior dominant temperoparietal lobe

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27
Q

What can occur to speech in case of cerebellar disease?

A

Drunken, slurred speech, irregular in volume and staccato like
Ataxia of vocal muscles

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28
Q

What can extra pyramidal lesions do to speech?

A

Soft, indistinct, monotonous speech

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29
Q

What can a pseudo bulbar palsy do to speech?

A

Spastic, umn lesion

Nasal, effort full speech

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30
Q

What can a bulbar palsy(guillan barre, MND, or facial nerve palsy) do to speech?

A

Nasal quality

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31
Q

What can cause dressing dyspraxia?

A

Non dominant hemisphere lesions

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32
Q

What can cause gait dyspraxia?

A

Bilateral frontal lesions, posterior temporal lesions, hydrocephalus

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33
Q

What can cause Constructional dyspraxia?

A

Non dominant hemisphere lesions, hepatic encephalopathy

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34
Q

What is athetosis and what’s it caused by?

A

Sinuous writhing movements, caused by lesions in putamen

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35
Q

What’s pseudo athetosis, and what’ sit caused by?

A

Athetoid movements in patients with proproceptive sense loss

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36
Q

What is chorea and what’s it caused by?

A

Chorea is dance like, jerky, writhing movements

Caused by huntingtons, stroke(basal ganglia lesions) hyperthyroidism, Wilson’s, streptococci,

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37
Q

What is hemiballismus and what’s it caused by?

A

Uncontrolled, unilateral flailing motions of proximal limbs

Contalateral subthalmic lesions

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38
Q

What are the signs of cerebellar ataxia?

Hint: what you might get after an open sleigh accident

A 
D- dysdaidokinesia
A-Ataxia, 
S-slurred speech
H-Hypotonia, weakness
I-Intention tremor
N-Nystagmus
G-Gait disturbance (broad based, stamping)
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39
Q

What do corticospinal and internal capsule lesions cause?

A

Contralateral hemiparesis

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40
Q

What does hemiparesis, epilepsy, reduced cognition and homonymous hemianopia suggest?

A

Cerebral lesions

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41
Q

What does hemiparesis with contralateral cranial nerve palsy suggest?

A

Brain stem lesion on the side of CN palsy

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42
Q

What are the signs seen in a cord lesion?

A

Paraparesis or tetraparesis, UMN signs below the lesion, LMN signs above the lesion
Dissociated sensory loss eg fine touch without pain

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43
Q

Which tracts carry pain, crude touch and temp?

A

Anterolateral (spinothalamic)

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44
Q

Which tracts carry proprioception and fine touch?

A

Dorsal columns

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45
Q

What are the signs of UMN lesions?

A

Increased tone, visible in rapid movements,
Hyperreflexia
Affects groups of muscles,

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46
Q

What are the signs of LMN lesions?

A

Wasting, fasiculations, flaccid muscles, weak or absent reflexes, ankle remains plantar

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47
Q

What can occlusion of the carotid artery cause?

A

Can cause infarction of ant 2-3 of cerebral hemisphere and basal ganglia

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48
Q

The occlusion of which artery can cause akinetic mutism (due to cingulate gyri being affected), weak, numb, contralateral leg and arm with facial sparing?

A

Ant. Cerebral

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49
Q

The occlusion of which artery can cause contralateral homonymous hemianopia with macular sparing?

A

Post. Cerebral artery

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50
Q

What can an occlusion of the middle cerebral artery cause?

A 
Contralateral hemiparesis
Hemisensory loss
Homonymous hemianopia
Viso spatial deficits
Dysphasia
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51
Q

The occlusion of what artery can cause locked in syndrome?

A

Pontine

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52
Q

What is subclavian steal syndrome and what is it caused by?

A

Subclavian artery stenosis causes retrograde blood flow to be stolen by subclavian artery
Causes brain ischaemia after use of arm

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53
Q

What are the causes for an acute, single episode of headache?

A

Meningitis, encephalitis, acute glaucoma, sinusitis, head injury, tropical illness, low pressure headache, venous sinus thrombosis

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54
Q

What are the signs and symptoms of acute glaucoma?

A

Reduced vision, nausea, vomiting, visual haloes

Reduced acuity, cloudy cornea, dilated non responsive pupil, red congested eye

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55
Q

What can cause recurrent headaches?

A

Migraines
Cluster headaches
Trigeminal neuralgia
Mollaret’s meningitis

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56
Q

What can cause subacute headaches?

A

Giant cell arthritis

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57
Q

What can cause chronic daily headaches?

A 
Tension headaches
Analgesia rebound
Raised intracranial pressure
Symptom of depression,
Cervicogenic (from cervical spondylosis0)
Chronic or transformed migraine
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58
Q

What are the symptoms of a cluster headache?

A

Sharp, severe pain behind eye, unilateral, eye becomes bloodshot and watery, lid swells, facial flushing, rhinorrhea, Ptosis

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59
Q

What are the symptoms of trigeminal neuralgia?

A

Sharp, stabbing, short lasting unilateral pain in the distribution of trigeminal nerve.

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60
Q

What are the causes of trigeminal neuralgia?

A

MS, CN V nerve root compression, zoster

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61
Q

What are the symptoms of migraine?

A

Episodic headache, usually with visual or auditory aura, unilateral throbbing pain around head usually associated with triggers, photophobia, nausea, vomiting, allodonia- everything causes pain

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62
Q

What are the causes of black outs?

A 
Vasovagal stuff
Epilepsy
Hypoglycaemia
Pain
Drop attack
Situational (cough, micturition)
Arrhythmias
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63
Q

What is vertigo and what are the associated symptoms?

A

Feeling of movement, always worsened by movement
Difficulty walking, better when still, nausea, vomiting
Hearing changes and tinnitus suggest CN VII issues

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64
Q

What are the causes of vertigo?

A 
Benign postural vertigo
Acute labyrinthitis
Ménière's 
Acoustic neuroma
Trauma
Zoster
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65
Q

What can cause conductive deafness, and how can it be tested?

A

Glue ear, wax build up, otosclerosis, otitis media

Bone conduction is better than ear conduction

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66
Q

How can sensineural deafness be tested?

A

If unilateral, weber is negative contralateral to affected ear

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67
Q

What can cause chronic sensineural hearing loss?

A

Environmental noise damage

Presbyacusis

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68
Q

What can cause sudden sensineural deafness?

A

Noise damage, gentamicin, acoustic neuroma, TB, mumps, MS, strokes

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69
Q

What can cause tinnitus?

A

Hearing loss, septic otitis media, hyper excitability of focal nerve, wax, noise damage, presbycusis
Aspirin
Divorce, retirement, redundancy,

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70
Q

What are the symptoms of cord compression?

A

Weakness in legs, incontinence,

LMN signs at the level of lesion, UMN signs below lesion

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71
Q

What are the presenting complaints for a neurology history?

A 
Dizziness, firs, syncope,
Paraesthesiae, weakness, loss of sensation,
Speech disturbance, dysphagia, 
Headache
Tremor
Balance
Memory and cognition
Vision and hearing
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72
Q

What are the causes of cord compression?

A

Secondary carcinoma, myeloma, tumour, disk collapse, hematoma, vasculitis

MS, syphilis, spinal artery thrombosis

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73
Q

What are the symptoms of a conus medullaris lesion?

A

Early urinary retention and constipation, mixed UMN and LMN signs, leg weakness, back pain, erectile dysfunction

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74
Q

What are the symptoms of a cauda equina lesion?

A

Sensory loss in. Root distribution, reduced anal tone, asymmetric, irregular areflexic, atrophic paralysis of legs, radicular leg pains do back pain

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75
Q

What can cause unilateral foot drop?

A

DM, common peroneal nerve palsy, MS, stroke and prolapsed disc

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76
Q

What can cause weak legs with no sensory loss?

A

MND, polio, parasagittal meningioma

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77
Q

What can cause chronic spastic paraparesis?

A

MS, chord tumour, MND, syringomyeloma, parasites

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78
Q

What can cause chronic flaccid paraparesis?

A

Peripheral neuropathy, myopathy

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79
Q

What can cause absent knee jerks and plantar reflexes?

A 
Combined cervical and lumbar lesions
MND
Freidrich's Atasia
Subacute cord degeneration
Taboparesis
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80
Q

What is an extra pyramidal gait and what can it be caused by?

A

Shuffling, stamping gait with swinging arms,

Parkinson’s

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81
Q

What is an apraxic gait and what can cause it?

A

Wobbly gait, like someone who’s never ice skated before,

Normal pressure hydrocephalus or multi infarct states

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82
Q

What is an ataxic gait and what can cause it?

A

Wide based gait, increased falls, can’t walk heel to toe
Caused by: cerebellar lesions- MS,alcohol, post. Fossa. Tumours
Proprioception loss- peripheral neuropathy

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83
Q

What can cause a resting tremor?

A

Parkinson’s

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84
Q

What can cause an intention tremor?

A

Cerebellar lesions

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85
Q

What can cause a postural tremor?

A

Anxiety, beta agonists, thyrotoxicosis

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86
Q

What are tics?

A

Brief, repeated movements that can be suppressed for awhile. Associated with Tourette’s

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87
Q

What is a myoclonus?

A

Sudden involuntary focal or generalised jerks arising from brain stem, cord or cerebral cortex

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88
Q

What are four main causes of a stroke?

A

Small vessel occlusion of cerebral arteries
Cardiac thromboembolism
Artherothromboembolism
CNS bleeds

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89
Q

What signs can be seen in a brain stem stroke?

A

Quadriplegia, disturbances In gait and vision, locked in syndrome,

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90
Q

What can be seen in a lacunar stroke?

A

Ataxic hemiparesis, purely visual, purely sensory or sensorimotor loss, dysarthria/clumsy hand

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91
Q

What are the immediate actions to be taken for a patient with stroke?

A 
Maintain airway,
BP, pulse and ECG
Blood glucose
CT
Thrombolysis,
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92
Q

Name five differential diagnosis for stroke

A 
Epilepsy
Intracranial tumours
Hypo/hyperglycaemia
Encephalopathy (wernicke's or hepatic)
Subdural haemorrhage
Head injury
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93
Q

What prevention methods should be used for stroke?

A

Primary: control RF-lose weight, quit smoking

Secondary(aft stroke): anti platelets

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94
Q

Name 7 cardiac causes for stroke

A 
MI
Valve replacement
Cardiac surgery
AF
Paradoxical systemic emboli
Valve vegetarians
External cardio version
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95
Q

What are the causes of a TIA?

A

Hyper viscosity,
Emboli
Vasculitis

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96
Q

What are the differentials for a TIA?

A

Migraine aura, focal epilepsy, hypoglycaemia, hyperventilation

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97
Q

What is a subarachnoid haemorrhage and what is it caused by?

A

Spontaneous billed in the subarachnoid space caused by a ruptured berry aneurysm

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98
Q

Where are berry aneurysms most likely to form?

A

Junction of post communicating artery and int. carotid
Junction of ant. Communicating and ant. Cerebral artery
Bifurcation of middle cerebral artery

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99
Q

What are the signs and symptoms of a subarachnoid haemorrhage?

A

Thunderclap headache,

Neck stiffness

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100
Q

What are the complications of a subarachnoid haemorrhage?

A

Rebleeding, formation of another aneurysm, cerebral ischaemia, hyponatremia, hydrocephalus

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101
Q

What are the signs of a sagittal venous thrombosis?

A

Vomiting, headache, papilloedema, reduced vision, seizures

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102
Q

What are the symptoms of a transverse sinus thrombosis?

A

Headache, mastoid pain, seizures, papilloedema

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103
Q

What are the signs of a sigmoid sinus thrombosis?

A

Cerebellar signs, CN palsies

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104
Q

What are the signs of an internal petrosal sinus thrombosis?

A

CN Vand VI palsies, temporal and retro orbital pain

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105
Q

What are the signs of a cavernous sinus thrombosis?

A

Seizures, oedematous eye lids, painful opthalmoplegia, headache, proptosis

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106
Q

What are the signs of a cortical vein thrombosis?

A

Thunderclap headache, cortical deficits, encephalopathy, focal seizures

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107
Q

Name 5 common causes of intracranial vein thrombosis

A 
Pregnancy
Birth control pills
Intracranial abnormalities
Head injury,
Recent LP
Malignancy in the brain
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108
Q

What are the signs and symptoms of a subdural haemorrhage?

A

Insidious physical and intellectual slowing, past trauma, raised intracranial pressure, sleepiness, personality change, seizures, fluctuating consciousness, headache

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109
Q

What is the pattern seen in patients with extradural/epidural haemorrhage?
6 steps

A

1) Injury
2) No loss of consciousness-lucid period
3) Increasing headache, hemiparesis, vomiting, confusion, fits
4) Reducing Glasgow coma scale, bilateral limb weakness
5) Brain stem compression- breathing becomes irregular and depressed
6) Death

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110
Q

What are the 8 signs of delirium?

A 
D-disordered thinking
E-euphoric, fearful, angry or depressed
L-language impairment
I-inattentive
R-reversal of sleep wake cycle
I-illusions, delusions or hallucinations
U-unaware/disorientated
M-memory loss
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111
Q

What are the causes of delirium?,

A

Drugs: levodopa, alcohol withdrawal, opiates, anticonvulsants
Systemic infection: UTI, pneumonia, malaria
Hypoxia
Deficiency: Nicotinic, B12 or thiamine
Metabolic: Uraemia, liver failure
Epilepsy
Head injury, brain tumours, raised IC pressure, stroke, MI

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112
Q

What is the presentation of vascular dementia?

A

Stepwise deterioration of cognition with signs of vascular causes

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113
Q

What defines Lewy body dementia?

A

Presence of Lewy bodies in brain stem and neocortex

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114
Q

What are the signs seen in frontotemporal dementia?

A

Executive impairment, hyper orality, early preservation of episodic memory, personality change, stereotyped behaviour, emotional unconcern

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115
Q

Describe the typical timeline for dementia?

A

Visospatial disturbances, gets lost often, cognitive impairment, memory, verbal impairment

Later: agnosia, mood impairment, irritability, psychosis

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116
Q

What are the causes of seizures?

A

Cortical scarring, developmental problems, stroke, trauma, haemorrhage, space occupying lesion, infection (syphilis, encephalitis), SLE, tuberous sclerosis, sarcoidosis, PAN, vascular malformations, metabolite changes

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117
Q

What is the aura of a seizure?

A

The part of the seizure that the patient can remember

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118
Q

What is the classic presentation of a simple partial seizure?

A

Awareness is unimpaired, focal motor, sensory or psychic symptoms

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119
Q

What is the presentation of a complex partial seizure?

A

Aura, impaired awareness,
Most commonly due to temporal lobe lesion- post ictal confusion is seen
If due to frontal lobe, rapid recovery

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120
Q

What is the presentation of an absence seizure?

A

Stops suddenly in whatever they’re doing, for less than ten seconds, then picks up from where they left off. Typically presents in childhood

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121
Q

What is the presentation of a tonic clonic seizure?

A

Two phases, limbs stiffen then jerk. One can present without the other. Loss of consciousness, post ictal confusion and drowsiness

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122
Q

What’s the presentation of a myoclonic seizure?

A

Sudden jerk of face, limb or trunk

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123
Q

What’s the presentation of an akinetic or atonic seizure?

A

No loss of consciousness, sudden loss of muscle gone causing falls

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124
Q

What is the triad of the classic Parkinson’s presentation?

A

Tremor, usually in one hand more than the other
Increased tone or muscle rigidity
Bradykinesia or hypokinesia

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125
Q

What are the clinical features of multiple sclerosis?

A

Dysaesthesia, paraesthesia, incontinence, anorgasmia, trigeminal neuralgia, loss of vibratory sense, urinary retention, spastic weakness, myelitis

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126
Q

What is the cause of multiple sclerosis?

A

T-cell immune response attacks CNS and causes demyelination in multiple places which manifests as progressive symptoms

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127
Q

What are the signs of a space occupying lesion?

A

Seizures
Personality change
Raised intracranial pressure
Evolving focal neurology

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128
Q

What are the causes of space occupying lesions?

A

Tumour, primary, secondary, abscess, aneurysm, cyst, subdural haematoma and granuloma’s

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129
Q

Name some primary brain tumours

A

Meningioma, astocystoma, glioma, olgiodendroma, ependymoma

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130
Q

What is idiopathic inter cranial hyper tension and describe the classical presentation?

A

Patients, typically obese women, present with symptoms suggesting they have a space occupying lesion, eg, papilloedema, blurred vision, CN VI palsy, enlarged blind spot and blurred vision

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131
Q

What are idopathic intercranial hypertension a usually caused by?

A

Secondary to sinus venous thrombosis or drugs

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132
Q

What are the symptoms of a facial nerve palsy?

A 
Bell's palsy
Drooling
Speech problems
Taste changes
Smile changes 
Changes in muscles of facial expression,
Leaking eyelids
Unilateral facial weakness
Hypersensitivity to sound
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133
Q

What causes carpel tunnel?

A

Trapping of median nerves

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134
Q

What are the signs of carpal tunnel?

A

Weakness of pollicis longus and sensory loss in radial 3.5 fingers

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135
Q

What are the signs and symptoms of ulnar nerve palsy?

A

Can’t cross fingers, claw hands, weakness of ulnar wrist flexors, sensory loss to ulnar 1.5 fingers

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136
Q

What are the signs and symptoms of radial nerve palsy?

A 
Wrist and finger drop when arm is pronated and elbow is flexed
Variable sensory loss
Muscles affected
Brachioradials
Extensors
Supinator
Triceps
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137
Q

What do brachial plexus lesions present as?

A

Pain/paraesthesia in affected arm

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138
Q

What can a lateral cutaneous nerve of thigh palsy cause?

A

Anterolateral burning thigh pain

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139
Q

What do sciatic nerve lesions cause?

A

Foot drop and weakness of muscles below knee and hamstrings. Sensory loss of lateral below knee

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140
Q

What are the signs of a common peroneal nerve lesion?

A

Foot drop, weakness of foot inversion, eversion, loss of sensation of dorsal foot

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141
Q

What do you see in a tibial nerve lesion?

A

Inability to tip toe, foot drop, inability to invert foot, loss of sensation of sole of foot

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142
Q

What are the causes of poly neuropathies?

Remember : vitamin c

A

Vascular-rheumatoid arthritis, wegener’s
Infective- guillan barré, lymes, syphilis, HIV
Toxic- drugs, alcohol, lead
Autoimmune- guillain barré
Metabolic- DM, sarcoidosis
Inherited syndromes-Charcot Marie tooth
Nutritional- vit b1, b12, e and folate deficiency, high vit b6
Cancer- paraneoplastic syndromes, rubra Vera

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143
Q

What is the presentation of sensory poly neuropathy and name some causes

A

Loss of sensation of extremities in a glove and stocking pattern, paraesthesia, burning, trauma to extremities can suggest loss of function
Renal failure, DM, leprosy

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144
Q

What is the classic presentation of motor poly neuropathy and name some causes

A

LMN lesion signs, flaccidity, absent or repressed weaknesses, reduced power, ascending (sometimes rapidly) muscle weakness along the limbs which can progress to difficulty breathing
Guillain-Barré
Charcot-Marie-Tooth syndrome
Lead poisoning

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145
Q

What is motor neurone disease?

A

Degenerative disease causing neuronal loss in CN nerve nuclei, motor cortex and ant. Horn cells

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146
Q

What differentiates motor neurone disease from multiple sclerosis?

A

There is no loss of sphincter tone in MND

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147
Q

What’s the difference between motor neurone disease and myasthenia gravis?

A

No loss of eye function in MND

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148
Q

What are the four presentations of MND?

A

AMyotrophic lateral sclerosis: split hand sign, upper motor signs, weakness and LMN wasting
Progressive muscular dystrophy: Ant horn cell lesion only. Affects distal muscles before proximal
Progressive bulbar palsy: affects CN IX - XII
Primary lateral sclerosis: betz cells in motor cortex are affected. Cause mainly umn signs with leg spasticity. No cognitive decline.

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149
Q

What are the signs of bulbar palsy?

A

LMN lesion in tongue, fasciculation in tongue, normal jaw jerk, flaccid tongue, speech is quiet, nasal or hoarse

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150
Q

What are the causes of bulbar palsy?

A

MND, guillain barré, polio, myasthenia, brain stem tumours

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151
Q

What can cause pseudo bulbar palsy?

A

Lesions bilaterally above mid pons

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152
Q

What are the signs and symptoms of pseudo bulbar palsy?

A

UMN lesion of muscles of swallowing and talking- slow, deliberate speech, increased jaw jerk, increased palatine and gag reflex, weeping or giggling that is mood incongruent

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153
Q

What differentiates myopathies and neuropathies?

A

Myopathy:
Gradual onset, on proximal muscles
Specific muscle groups, oddly firm muscles

Neuropathy: rapid onset
Paraesthesia, bladder problems

154
Q

What are muscular dystrophies and name three

A

Progressive, genetic, degenerative diseases of muscle weakness
Duchenne’s
Fascioscapulohumeral
Becker’s

155
Q

What is Myasthenia Gravis?

A

Autoimmune disorder caused by attack of Nicotinic acetylcholine receptors by antibodies

156
Q

What is the presentation of myasthenia?

A 
Increased muscle weakness on fatigue
Order of effect: ocular, bulbar,facial, neck, limb, girdle, trunk
Ptosis
Snarl on smiling
Diplopia
157
Q

What is syringomyelitis caused by and what are the classical presentations?

A

Blocked csf

UMN leg signs, hemi-atrophy of legs, claw hand, hand wasting, horner’s ,sensory loss (dissociated), asymmetric body

158
Q

What is the swinging light reflex seen in?

A

Demyelination disease

159
Q

What are the causes of postural hypotension?

A

Hypovolemia, autonomic dysfunction and adrenal gland dysfunction

160
Q

For prolonged seizures, what is the first line of treatment?

A

Rectal diazepam

161
Q

What is hyperacusis?

A

Increased hearing sensitivity

162
Q

What is hyperacusis caused by?

A

Stapedius palsy

163
Q

What can cause a stapedius palsy?

A

Bell’s palsy

164
Q

What is Bell’s palsy treated with?

A

Prednisolone and. Acyclovir

165
Q

What worsens a benign essential tremor?

A

Stress, cold and caffeine

166
Q

What kind of tremor does Parkinson’s cause?

A

Resting tremor

167
Q

What do Brudzinski’s and kernig’s sign suggest?

A

Meningeal irritation

168
Q

What causes cubital tunnel syndrome and what is used to test it?

A

Ulnar nerve trapping in elbow,

Tested by crossing middle finger over index finger

169
Q

What movements test the ulnar nerve?

A

Crossing middle and index fingers

Spreading extended fingers open horizontally

170
Q

What muscle does Crossing middle and index fingers test?

A

Dorsal interossei

171
Q

What muscle does Spreading extended fingers open horizontally test?

A

Dorsal interossei and abductor digiti minimi

172
Q

What movements test the radial nerve?

A

Move wrist towards thumb laterally

With palm facing downwards, bend wrist up towards forearm

173
Q

What muscle does Moving wrist towards thumb laterally test?

A

Capri radialis longus

174
Q

What movements test the median nerve?

A

Moving thumb across palm to tough the base of the little finger
With palm facing sideways, keeping hand in this position against resistance
With palm facing upwards, bend wrist towards forearm

175
Q

What should be checked in case of prolonged seizures?

A

Phenytoin levels to show evidence of poorly controlled epilepsy

176
Q

If the patient has fallen from a height what manoeuvre should be done?

A

Jaw thrust

DO NOT DO head told chin lift as it may cause further damage in case of a c spine injury

177
Q

Which nerve runs around the neck of the fibula?

A

Perineal nerve

178
Q

What can damage the perineal nerve.?

A

Neck of fibula fractures

179
Q

How can the perineal nerve be tested?

A

Bending foot towards the knee

180
Q

What does repeat incidents of neurological disturbance suggest in a patient with hypertension?

A

TIA

181
Q

How can statins cause myopathy?

A

Raised creatinine kinase

182
Q

What is the most common rotator cuff injury?

A

Rupture of supraspinatus

183
Q

What is used to symptomatically treat migraines?

A

Propanolol

184
Q

What are the signs of a basal skull fracture?

A

Bruising behind ears
Peri orbital ecchymosis
Rhino/otorrhoea
Haematotympanum

185
Q

What movement tests the tibial nerve?

A

Point toes and place sole of feet together

186
Q

What movement tests the inferior gluteal nerve?

A

With straight leg, bury foot into couch

187
Q

What can cause acute single episodes of headaches?

A

Subarch. Haemorrhage, acute-closure glaucoma, Acute meningis, vasodilator drugs

188
Q

What can cause acute recurrent headaches?

A

Migraines, cluster headaches, Neuralgia (trigeminal and post-herpatic), sinusitis, acute-closure glaucoma

189
Q

What can cause subacute single episodes of headache?

A

Raised ICP, idiopathic intracranial hypertension, Infections (TB meningitis, cerebral abscess)

190
Q

What is the classic presentation of raised intracranial pressure?

A

Poorly localized headache, worse in the morning, worsened by coughing or stooping, focal neuralgias, seizures, nausea, weightloss

191
Q

What is the classic presentation of a neuralgia?

A

Focal, sharp, stabbing, knife like pain over the distribution of the nerve. Allodonia. Pain may be percipitated by actions like combing hair and shaving

192
Q

What is the classic presentation of temporal arthritis?

A

New onset headache in patients >55, jaw tenderness and jaw (and tongue) claudication

193
Q

What is the definition of syncope?

A

Loss of consciousness due to cerebral hypoperfusion

194
Q

What is the definition of a seizure?

A

Pathological electric conduction in the brain causing symptomatic problems

195
Q

What is the prodromal phase of a seiizure?

A

Change of mood or aura

196
Q

What occurs in the tonic phase of a seizure?

A

Loss of consciousness, cyanosis, falls, spasm of all muscles

197
Q

What occurs in the clonic phase of a generalized seizure?

A

Jerking of limbs and trunk, tongue biting

198
Q

What occurs in the post ictal phase of a genralized seizure?

A

Flaccidity, confusion, headache, amnesia

199
Q

What are the features of focal seizures from the temporal lobe?

A

Bnormal behaviour, Emotional disturbance, memory change (Deja vu or jamais vu) dream-like states, hallucinations of smell, taste or sound

200
Q

What are the features that suggest an epileptic seizure rather than syncope?

A

Little to no warning of the attack, tongue biting, synchronised jerking of limbs, confusion, cyanosis (instead of pallor) onset when lying on bed

201
Q

What can cause reccurrent dizzy spells?

A

Arrhytmia, mediacation, postural hypotension, hyperventilation, cerebrovascular/vertebrobasilar insufficiency

202
Q

What are the four main causes of falls?

A

Accidents, illness, mutliple risk factors, loss of consciousness

203
Q

What are the common central causes of vertigo?

A

Migraine, MS, brainstem ischaemia or infarction

204
Q

What are the common peripheral causes of vertigo?

A

Meniere’s diseae, trauma, benign paroxymal positional vertigo, vestibular neuritis, drugs (gentamicin, anticonvulsants)

205
Q

What are the risk factors for falls?

Alcohol is most common toxin, damaging both the CNS (ataxia, seizures, cognitive symptoms) and the PNS (neuropathy). P

A

Disease (alzheimer’s, parkinson’s)
Disability (instability, gait vision or cognition impairment)
Drugs (polypharmacy)

206
Q

What is the most common toxin to the nervous system?

A

Alcohol

207
Q

What can alcohol do to the nervous system?

A

CNS: Ataxia, seizures, cognitive symptoms
PNS: Neuropathy

208
Q

What drugs can cause ataxia?

A

Pheytoin, carbamazipine, benzodiazepines, ciclosporins, Fluorouracil

209
Q

What drugs can cause dizziness and vertigo?

A

Aspirin, antihistamines, Enalapril, Flecainide

210
Q

What drugs can cause epilepsy?

A

Aminophyline, fentanyl, phenothyiazides, tricyclics

211
Q

What drugs can cause headaches?

A

Statins, Sildenafil, Glyceril trinitrate

212
Q

What drugs can cause memory impairment?

A

benzodiazepines, Isoniazid, Corticosteroids, Chlorpromazine

213
Q

What drugs can cause myopathy?

A

Statins, corticosteroids, Guanethidine, Bretyliu tosilate

214
Q

What drugs can cause parkinsonism

A

Neuroleptics, prochlorperazine

215
Q

What drugs can cause peripheral neuropathy

A

Amiodarone, metronidazole, statins, Isoniazis, procainamide, Cimetidine

216
Q

What drugs can cause tremor

A

Salbutamol, tricyclics, Tetrabutaline

217
Q

What drugs can cause syncope?

A

Antihypertensives, levodopa, antiarrhythmics

218
Q

Name four autosomal dominant neurological disorders

A

Myotonic dystrophy, neurofibromatosis type 1 and 2, huntington’s, tuberous sclerosis

219
Q

Name 3 autosomal recessive neurological disorders

A

Wilson’s disease, friedreich’s ataxia, tay-Sachs disease

220
Q

Name 3 X-linked recessive diseases

A

Duchenne’s becker’s muscular dytrophies,

Fragile X syndrome

221
Q

What does Kernig’s sign test for?

A

Meningeal irritation seen in mengism ( due ti infection, blood in subarachnoid space or utis)

222
Q

Describe kernig’s test

A

Lie patient supine, flex hip and knee of one leg, slowly extend knee. Kernig’s sign is positive when when extension is resisted by spasm in the hamstrings, and the other limb may flex at the hip and knee.

223
Q

How does one test for neck stiffness?

A

Lie patient down and lex neck to chest. Hold the position and check for anytensing or spasms of neck muscles

224
Q

What can cause a hemiplagic gait?

A

Unilateral UMN lesion

225
Q

Describe a hemiplagic gait?

A

leg extension at the knee and ankle and circumduction at the hip, such that the plantar flexed foot describes a semicircle as the patient walks because one leg is spastic

226
Q

What can bilateral UMN lesions do to the gait

A

Cause a scissor like gait due to spasticity

227
Q

What can cause bizarre gaits?

A

Huntingtons, non-organic disorders

228
Q

Define dyarthria

A

Disturbed articulation

229
Q

Define dysphoni?

A

Impairment of voice or sound production from the larynx

230
Q

What can cause a pseudobulbar (spastic) palsy to speech?

A

bilateral UMN lesion

231
Q

What can cause a bulbar speech palsy

A

LMN lesion of CN

232
Q

What causes the nasal sound in bulbar speech?

A

Wakened palate

233
Q

What can cause difficulty in pronouncing consonants in pseudobulbar speech?

A

Spastic tongue

234
Q

What can cause difficulty in lingual sounds in bulbar speech?

A

Weakness of the tongue

235
Q

What can cause fatiguing speech?

A

Myasthenia gravis

236
Q

What can cause dysphonia?

A

Laryngitis or damage to recurrent laryngeal nerve ( or vagus nerve)

237
Q

What does damage to the broca’s are cause?

A

Maintained comprehension but telegraphic speech. Expressive (motor) dysphasia

238
Q

What does damage to the wernicke’s are cause?

A

Receptive (sensory) dysphasia

Poor comprehension, fluent but meaningless speech

239
Q

Where can damage to the brain cause comprehension aphasia?

A

Arcuate fasciculus

240
Q

What is global aphasia?

A

All the aphasias! Expressive and receptive aphasia

241
Q

What can dominant parietal lesions affecting the supramarginal gyrus cause?

A

Dyslexia, dysgraphia and dyscalculia

242
Q

Where is the precentral gyrus?

A

Post. frontal lobe

243
Q

What does the precentral gyrus do?

A

voluntary movement

244
Q

What does the area anterior to the precental gyrus do?

A

emotions and personality, social behaviour and cognition and expressive language. Contains frontal eye fields and cortical centre for micturition

245
Q

What can a frontal lobe lesion do?

A

Personality change (disintrest), cognitive impairment (memory, attention and concentration), expressive aphasia (dominant lobe) loss of emotional responsivenss, conjugate gaze deviation to the side of the lesion, primitive reflexes, urinary incontinence

246
Q

What does the temporal lobe do?

A

Memory and perception of smell

opticradiation, auditory perception

247
Q

What can a temporal lobe lesion do?

A

focal epilepsy, contralateral upper quadrantonopia, receptive aphasia, memory impairment

248
Q

What does the postcentral gyeus do?

A

Conscious sensation

249
Q

Where is the postcentral gyrus?

A

Parietal lobe

250
Q

What does the parietal lobe do?

A

optic radiations pass through, conscious sensation

Dominant-language, nondominant-spatial awareness

251
Q

What can lesions tothe parietal lobe cause?

A

Dyslexia, dysgraphia, dyscalculia, apraxia, primitive reflexes, contralateral lower quadrantonopia, altered sensation

252
Q

What does the occipital lobe do?

A

VISION

253
Q

What can damage to the occiput do?

A

Visual field defects, visual agnosia,impaired visual perception, visual hallucinations

254
Q

What is parosmia?

A

Pleasant odours are percieved as unpleasant

255
Q

What can cause Ansomia?

A

Trauma, resp infection, parkinsons, huntingtons, local compression or invasion by skull base tumour

256
Q

What nerve sends input to the lacrimal, sublingual and submandibular salivary glands?

A

nervus intermedius, facial nerve

257
Q

What nerve receives, taste sensations from the ant. 2/3rd of the tongue?

A

chorda tympani, facial nerve

258
Q

what are the central sensory connections to CNV and what do they do?

A 
spinal trigeminal tract (pain and temp)
Mesencephalic nucleus (unconscious proprioception), principal sensory nucleus (touch, joint proprioception)
259
Q

What can cause CNV pathology?

A

Zoster, trauma, cancer, lesions in the caverous sinus

260
Q

What is hypoguesia or ageusia?

A

Impairment or loss of taste

261
Q

What is hyperacusis?

A

Unpleasantly loud hearing

262
Q

What can occur in CN VII lesions?

A

Hyperacusis, hypoguesia, aguesia, involuntary emotional responses, nasolabial fold flattening, mouth drooping

263
Q

What does the glossopharyngeal nerve do?

A

Carries taste and from post 2/3rd of tongue and sensation from pharynx and tonsils

264
Q

What does the Vagus nerve do?

A

important sensory information but also innervates upper pharyngeal and laryngeal muscles.

265
Q

What can bilateral CNX lesions cause?

A

Bulbar and pseudobulbar palsies

Nasaul regurgitation of fluids and nasal air escape when cheeks are puffed out

266
Q

What are the two components of the accesory nerve(and what do they do)?

A

Cranial which runs along with the vagus, and spinal which innervates the trapezius and sternocleidomastoid

267
Q

What can cause unilateral IX an X nerve lesions?

A

Skull base fracture, skull base tumour (eg meningioma), lateral medullary syndrome

268
Q

What can cause a recurrent laryngeal nerve lesion?

A

Post-thyroid surgery, aortic arch aneurysm, lung metastasis, mediastinal lymphoma

269
Q

What can cause bilateral X nerve lesions?

A

Bulbar palsy (MND), pseudobulbar palsy (MS, cerebrovascular disease)

270
Q

What can cause head drop?

A

Wasting of the sternocleidomastoids, seen in MND, myasthenia, myopathies and dystrophies

271
Q

What can cause deviation of upper vertebral body of the scapula towards the spine?

A

Wasting of the lower muscle fibres of the scapula

272
Q

What can cause deviation of upper vertebral body of the scapula away from the spine?

A

Wasting of the upper muscle fibres of the scapula

273
Q

What can a unilateral lower motor XII nerve lesion do to the tongue?

A

Deviation of the tongue on protrusion (to normal side), unilateral wasting of the tongue

274
Q

What can bilateral lower motorXII nerve lesions do to the tongue?

A

Wasting of the tongue globally, fasciculation of the tongue

275
Q

Compare bulbar and pseudobulbar palsies

A

Bulbar palsy is a LMN, with dysrthria, dysphagia and weakness, wasting and fasciculations of the tongue. Jaw jerk and emotional liability are absent.

Pseudobulbar palsy is caused by an UMN lesion, with dysarthria, DYSPHONIA and dysphagia and conical, spastic tongue. Jaw jerk is brisk and emotional liability is absent

276
Q

What can an UMN XII do?

A

Pseudobulbar palsy

277
Q

What is the typical structure of a motor examination?

A

Inspection, tone, reflexes, movement and power, co-ordination

278
Q

What is the typical structure of an MSK examination?

A

Look, feel, move(Stress),Special tests

279
Q

What is a fasciculation?

A

Irregular ripples or twitches seen under the skin overlying muscles at rest.

280
Q

How can fasciculations be elicited in MND

A

Flicking the overlying skin

281
Q

What are myoclonic jerks?

A

Sudden shock-like contrations of one or more muscles (focal or diffuse)and occur singly or repetitively
EG the jerk when falling asleep

282
Q

What can cause myoclonic jerks?

A

Epilepsy, diffuse brain damage, dementias

283
Q

Define a tremor

A

oscillatory movement about a joint or group of joints caused by repeated rhythmic alternating contractions and relation of muscles

284
Q

What does a physiological tremor look like?

A

Fine, fast, postural tremor

285
Q

What can cause a physiological tremor?

A

Anxiety

286
Q

What are the causes of fine, fast tremors?

A

Hyperthyroidism, excess alcohol/caffeine, salbutamol and anxiety

287
Q

What does an action tremor look like?

A

Course, violent tremors associated with lesions of the red nucleus and subthalamic nucleus

288
Q

What can cause an action tremor?

A

Cerebrovascular disease, MS, essential tremor

289
Q

What is an intention tremor and what is it caused by?

A

Absent at rest, maximal on movement, emphasized by finger-nose test,seen in cerebellar damage

290
Q

Describe the parkinsonian tremor

A

Coarse resting tremor, resembling pill rolling, worse at rest and reduced on movement

291
Q

What are the symptoms of a CNI lesion?

A

Ansomia, parosomia

292
Q

What are the symptoms of a CNII lesion?

A

Partial sight, blindness, scotoma, hemianopia, Anisocoria, lost pupillary light reflexes

293
Q

What are the symptoms of a CNIII lesion?

A

Impaired or lost accomadation reflex

294
Q

What are the symptoms of a CNIII, IV and VI lesion?

A

Strabismus, diplopia, nystagmus

295
Q

What are the symptoms of a CNV lesion?

A

Impaired or lost fascial sensation and cornial reflex, weakness of muscles of mastication, Jaw jerk increased in UMN lesions

296
Q

What are the symptoms of a CNVII lesion?

A

Ageusia, Facial weakness

297
Q

What are the symptoms of a CNVIII lesion?

A

impairedhearing, nystagmus and vertigo

298
Q

What are the symptoms of a CNIX lesion?

A

Loss of pharyngeal sensation

299
Q

What are the symptoms of a CNX lesion?

A

Impaired palatine movements

300
Q

What are the symptoms of a CNXI lesion?

A

Weakness of neck movements

301
Q

What are the symptoms of a CNXII lesion?

A

Dysarthria and dysphagia

302
Q

Define dystonia

A

Twisting, repetitive movements and sometimes tremor caused by Sustained muscle contractions

303
Q

What is the difference between chorea and athetosis?

A

CHorea is sharp, irregular, jerking movements, where as athetosis is more slow, and sinous

304
Q

What is a Ballism and what causes it?

A

Violent flinging movements caused by proximal muscle contractions

305
Q

What can cause flaccidity?

A

LMN lesions, cerebellar disease, phases of cerebral or spinal shock, when the paralysed limbs are atonic prior to developing spasticity.

306
Q

What is spasticity?

A

Veliocity dependent resistance to passive movement

307
Q

What is rigidity and what can cause it?

A

Sustained muscle contraction,

Parkinsons and other extrapyramidal coditions

308
Q

What is a clonus?

A

Rhythmic contractions evoked by sudden stretch of muscles. Can be normalif unsustained.

309
Q

Whatis a tendon reflex?

A

Involuntary Contraction of a muscle in response to stretch, mediated by a reflex arc

310
Q

What can cerebellar damage to to reflexes

A

Pendular reflexes

311
Q

What can cause inverted reflexes

A

Combines spinal cord and root pathology

eg cervical myeloradiculopathies

312
Q

What can cause babinski’s?

A

UMN lesion

313
Q

What is the cremasteric reflex used for?

A

to test the level of spinal cord lesions

314
Q

What level does the cremasteric reflex test?

A

L1 and L2

315
Q

What level does the biceps reflex test?

A

c5 (C6)

316
Q

What level does the triceps reflex test?

A

C6&7

317
Q

What level does the supinator reflex test?

A

c5 (C6)

318
Q

What level does the ankle reflex test?

A

S1

319
Q

What level does the knee jerk reflex test?

A

L3-4

320
Q

What level does the abdominal reflex test?

A

T8-T12

321
Q

What level does the plantar/babinski reflex test?

A

S1-S2

322
Q

What are the primitive reflexes?

A

Snout, grasp, palmomental and glabellar tap

323
Q

What can cause the primitive reflexes?

A

Present in neonates and infants, disappeear as NS matures.

Seen in adults with severe acquired brain damage (from trauma, anoxia of disease)

324
Q

What do unilateral and palmomental reflexes suggest?

A

Contralateral frontal lobe pathology

325
Q

What causes positive glabellar tap?

A

Parkinson’s

326
Q

Define paresis

A

Partial paralysis

327
Q

Define plegia

A

Complete paralysis

328
Q

Define monoplegia

A

Involvement (paralysis) of one limb

329
Q

Define Hemiplegia

A

Paralysis of half of the body

330
Q

Define paraplegia

A

Paralysis of the legs

331
Q

Define Tetraplegia

A

Paralysis of all four limbs

332
Q

What are the patterns of motor dysfunction

A

Paralysis or weaknes, Dyskinesia, hypokinesie or hyperkinesia, dysraxia, impairment of co-ordination

333
Q

Define Dyspraxia

A

Loss of learned movement patterns

334
Q

What are the causes of LMN lesions?

A

Peripheral neuropathies, ant. horn damage (poliomyelitis, MND), radiculopathies

335
Q

What can caues UMN lesions?

A

MS, cerebrovascular disease, spinal disease

336
Q

What can cause myopathies?

A

Heritable dystrophies, alcohols, lead

337
Q

What is ideational dyspraxia?

A

Patient can understand the task but can’t perform it

338
Q

What is ideomotor dyspraxia?

A

Patient performs the task in a bizarre manner

339
Q

What can cause ideomotor and ideational apraxia?

A

Frontal or prietal lesion

340
Q

What is constructional apraxia?

A

Difficulty drawing a figure

341
Q

What is constructional apraxia caused by

A

Parietal disturbance

342
Q

What is dressing apraxia associated with?

A

Spatial disorientation and neglect

343
Q

What can cause dressing apraxia?

A

Dominant hemisphere parietal lesions

344
Q

What pathway conveys vibration?

A

Medial lemniscus

345
Q

Define brown sequard syndrome

A

Half of the spinal cord is damaged, leading to ipsilateral loss of of muscle strength, vibratory and proprioceptive sense, and contralateralloss of pain and temp

346
Q

What is alternating analgesia?

A

Loss of pain and temp on face ipsilaterally and loss of pain and temp on the opposite side of body

347
Q

What can cause alternating analgesia?

A

Damage to CNV and spinothalamic tract, caused by brainstem lesions

348
Q

What do thalamic lesions cause?

A

Burning pain and patchy sensory impairment contralaterally

349
Q

what is stereoagnosis?

A

Loss of tactile recognition

350
Q

What are the genetic causes of polyneuropathies?

A

Refsum’s, Charcot-marie-tooth, hereditary

351
Q

What drug and toxins can cause polyneuropathies?

A

Alcohol, statins, amiodarone, metronidazole, perhexilline, phenytoin, lead, asrenic, mercury, solvents, carbon disulphide, herbicides, pesticides

352
Q

What vitamin deficiencies can cause polyneuropathies?

A

B1, b6, b12, E

353
Q

What infections can cause polyneuropathies?

A

Leprosy, HIV, diphtheria

354
Q

What inflammatory conditions can cause polyneuropathies?

A

Guillan-barre, chronic idiopathic demyelinating polyneuropathy, connective tissue disoders (RA, SLE, SS, poly arthritis nodosa)

355
Q

What systemic medical conditions can cause polyneuropathies?

A

Sarcoidosis, DM, acromegaly, renal failure, hypothyroidism, critical illness

356
Q

What malignancies can cause polyneuropathies>

A

Cancer, lymphoproliferative disease

357
Q

What tests can be used too assess median nerve function?

A

Form a ring with thumb and ring finger and try tto pull them apart (oppens pollicis), test thumbs vertically upwards movement against resistence (abductor pollicis brevis)
Altered sensation over thumb, first and second fingers, and lateral half of ring finger

358
Q

What tests can be used to assess radial nerve function?

A

Weakness of arm extensors
sensory loss over dorsum of the hand
Loss of triceps reflex

359
Q

What tests assess ulnar nerve function

A

Abduction and adduction of the fingers - ask patients to spread apart fingers against resistance
Hold piece of paper between fingers and try to pull it out
Claw of benediction
sensory oss on ulnar side of the hand

360
Q

What are the common features of carpal tunnel?

A

More common in women, paraesthesia and or pain in the hand (little finger sparinga)
May radiate up the elbow
occurs usually at night - may wake the patient
Thenar muscle wasting
Patient may hang hand and arm out of the bed for relieffrom sleep

361
Q

What are the causes of carpal tunnel syndrome?

A

Idiopathic, pregnancy, carpal tunnel, rA, Distal radial fracture, hypothyroidism, amyloidosis, nephrotic syndrome

362
Q

What can cause peroneal nerve palsies?

A

Head of fibula fractures, compressed by pandages or plaster of paris, or repeated kneeling/squatting

363
Q

What do peroneal palsies cause

A

Foot drop

364
Q

What can trap the lateral cutaneous nerve of thigh?

A

inguinal ligament

365
Q

WHat does lateral cutaneous nerve of thigh trapping cause?

A

Paraesthesia in the thigh

366
Q

What is subacute combined cord degeneration?

A

Subacute myelopathy with damage to posterior column and corticospinal tracts caused by b12 deficiency

367
Q

What occurs in subacute cord degeneration?

A

Sensory impairment (proprioception and vibration), pain and temp lost in a glove and stocking pattern. Spasticity, extensor plantar reflexes, loss of reflexes

368
Q

What urine tests should be used to confirm a diagnosis of diabetic neuropathy?

A

glucose

369
Q

What urine tests should be used to confirm a diagnosis of diabetic ketoacidosis?

A

Ketones

370
Q

What urine tests should be used to confirm a diagnosis of myeloma?

A

Bence Jones protein

371
Q

What urine should be used to confirm a diagnosis of poryphyria?

A

Porphobilinogen

372
Q

What blood tests should be used to confirm a diagnosis of stroke?

A

Hb, clotting, thrombophilia screen, antiphospholipid antibodyAntinuclear factor and dsDNA, glucose, serum lipid and cholestrol,

373
Q

What blood tests should be used to confirm a diagnosis of peripheral neuropathy?

A

Vitamin B12, rheumatoid factor, LFTs, urea creatinine, glucose, drug and toxin screen

374
Q

What blood tests should be used to confirm a diagnosis of Myasthenia gravis

A

AcH receptor andd muscle-specific kinase antibodies, Edrophonium test

375
Q

What blood tests should be used to confirm a diagnosis of epilepsy?

A

Calcium, drug toxin screen, phenytoin levels, valproate,

376
Q

What neurophysiology test should be used to confirm a diagnosis of epilepsy?

A

ECG, EEG

377
Q

What neurophysiology test should be used to confirm a diagnosis of Stroke?

A

ECG

378
Q

What neurophysiology test should be used to confirm a diagnosis of MS?

A

Visual evoked potential

379
Q

What neurophysiology testshould be used to confirm a diagnosis of MND?

A

EMG

380
Q

What neurophysiology testshould be used to confirm a diagnosis of Myasthenia gravis?

A

single fibre EMG

381
Q

What radiological test should be used to confirm a diagnosis of MS

A

MR brain scan

FOCP (12 decks)

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