Neurology Flashcards
anterior cerebral artery stroke
contralateral hemiparesis and sensory loss
middle cerebral artery stroke
contralateral hemiparesis and sensory loss
aphasia (communication difficulties)
contralateral homonymous hemianopia
posterior cerebral artery stroke
contralateral homonymous hemianopia with macular sparing visual agnosia (can see but cant recognise)
Webers syndrome artery and affects?
branches of posterior cerebral that supply the mid brain
ipsilateral CNIII palsy (eye down and out)
Contralateral weakness of limbs
Wallenburg syndrome artery and affects?
posterior inferior cerebellar
ipsilateral facial pain and temperature loss
contralateral torso/limb pain and temperature loss
Anterior inferior cerebral artery stroke (lateral pontine syndrome)
ipsilateral facial pain and temperature loss
contraleteral torso/limb pain and temperature loss
ipsilateral facial paralysis and deafness
retinal/opthalmic artery stroke
amaurosis fugax- painless LOV
basilar artery stroke
locked in syndrome
lucinar strokes (occlusion of single deeper artery- strong ass. with hypertension)
isolated hemiparesis or sensory loss
limb ataxia
first line treatment for generalised seizures?
sodium valproate
enhanced production of GABA
Treatment of primary generalised epilepsy if child bearing age/pregnant?
lamotrigine
inhibits Na+ entry
treatment for focal/partial seizures
carmazepine or lamotrigine (inhibit Na+ entry) add on Gabapentine (inhibits Ca2+ entry)
what kind of seizures do you see in hippocampal sclerosis?
complex partial seizures
What are the main goals of antiepileptic drugs?
decrease excitatory neurotransmitter release (Glutamate, Ach)
increase inhibitory neurotransmitter release (GABA, Glycine)
What is primary generalised epilepsy?
tonic clonic seizures
neuropathic pain?
gabapentin
pregabalin
(inhibit Ca2+ entry)
Main Se of sodium Valproate?
weight gain
teratogenic
hair loss
fatigue
treatment of delayed ischeamic defecits?
nimodipine
CCB- vasodilator
Dorsal column function and components?
ascending sensory information
fasiculus gracilus
fasiculus cuneatus
fine touch, pressure vibration
brown sequard syndrome?
ipsilateral motor level ipsilateral dorsal column (fine touch, vibration, pressure) contralateral spinothalmic (crude touch, pain, temperature)
Where is the primary somatosensory coretx?
post central gyrus in parietal lobe
Where is the primary motor cortex?
pre central gyrus in frontal lobe
where is the visual cortex?
occipital lobe
Where is the auditory cortex?
temporal lobe
ankle reflex
S1,2
knee reflex
L3,4
biceps reflex
C5,6
triceps reflex
C7,8
Stocking and glove sensory loos?
implies length dependant neuropathy
What are pyramidal symptoms?
pyramidal weakness
increased spasticity and tone
increased DTR
What are the common signs in pyramidal symptoms?
clasp knife response- sudden decrease in resistance at a joint
babinskis sign- big toe extension and toe abbduction
pronator drift- cant maintain palms up with arms out and eyes shut
what are some key cerebeller symptoms?
ataxia (lack of voluntary coordination of muscle movements) balance and walking problems speech problems swallowing vision
What are some common signs in cereberller lesions?
cerebeller gait (broad based and unsteady) intention tremor nystagmus past pointing pendular reflexes
CN IV palsy?
diplopia
CN VII palsy?
facial weakness
what is internuclear opthomoplagia?
affected eye cant adduct and the other eye will nustigmus will abducting
Spasticity treatment?
physio and baclofen
tinzanidine
Sensory treatment?
gabapentin (anticonvulsant)
amitriptyline (antidepressant)
oxybutynin class and use?
anticholinergic
bladder dysfunction in MS
urge incontinence
first line tx in relapsing remmitting MS?
tecfidera
treatment of myasthenia gravis?
anticholinesterase inhibitor- pyridostigmine thyectomy immunosuppresion- azathiopine acute- steroids emergency- plasma exchange
nerve pain tx?
Amitryptaline / gabapentin
epilepsy treatment?
partial seizures- carbamazapine (enzyme inducer avoid pill) then lamatrogine
complex- sodium valproate, levetiracetapam
epilepsy treatment in pregnancy?
lamatrogine
acute management of cluster headache?
100% O2
sc or nasal triptan
cluster headache prophylaxis?
verapamil, prednisilone
inheritance of DMD?
x linked recessive
Key features and age of onset of DMD?
delay in motor development muscle weakness and wasting
onset 3-4 yrs
treatment of neuropathic pain?
TCAs: amityiptyline, duloxetine, gabapentin, pregabalin
Treatment for localised neuropathic pain?
topical capsaicin
What causes parkingsons?
loss of dopamine producing neurones in the substantia niagra
