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Neurology Flashcards

1
Q

How does cranial nerve XII deficit present?

A

Weakness on the ipsilateral side and protrusion of the tongue toward the affected side - CN XII = Hypoglossal nerve

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2
Q

How does cranial nerve XI deficit present?

A

Weakness with turning of head - CN XI = Spinal accessory nerve

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3
Q

How does cranial nerve X deficit present?

A

Focal: Aphonia dysphagia dysarthria - Systemic: (cardiac and GI most affected) - CN X = Vagus nerve

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4
Q

How does cranial nerve IX deficit present?

A

Dysphagia and dysarthria - CN IX = Glossopharyngeal nerve

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5
Q

How does cranial nerve VIII deficit present?

A

Positional vertigo - Tinnitus - Rarely hearing loss - CN VIII = Vestibulocochlear nerve

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6
Q

How does cranial nerve VII deficit present?

A

Complete or partial paralysis of the face - CN VII = Facial nerve

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7
Q

How does cranial nerve VI deficit present?

A

Medial turning of affected eye - CN VI = Abducens nerve

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8
Q

How does cranial nerve V deficit present?

A

Anesthesia of the forehead - Corneal drying - Decreased salivation - CN V = Trigeminal nerve

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9
Q

How does cranial nerve IV deficit present?

A

Vertical diplopia - CN IV = Trochlear nerve

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10
Q

How does cranial nerve III deficit present?

A

Outward and downward deviation of the eye - Ptosis of the eyelid - Dilation of the ipsilateral pupil in complete palsy -CN III - Oculomotor nerve

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11
Q

How does cranial nerve II deficit present?

A

Partial or complete blindness - CN II = Optic nerve

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12
Q

How does cranial nerve I deficit present?

A

Loss of smell - CN I = Olfactory nerve

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13
Q

Medication added to cholinesterase inhibitors in the treatment of Alzheimer’s?

A

Memantine

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14
Q

First line class of drugs used to treat Alzheimer

A

cholinesterase inhibitors

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15
Q

Beta amyloid plaques and neurofibrillary tangles?

A

Alzheimer’s findings on autopsy

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16
Q

Most common form of dementia?

A

Alzheimer’s disease

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17
Q

Slowly progressive impairment of memory reasoning and orientation?

A

Dementia

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18
Q

Common causes of delirium?

A

Medical illness - Sun downing - Substance intoxication or withdrawal - Sepsis

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19
Q

Short term/temporary confusion or altered mental state?

A

Delirium

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20
Q

Acute meningitis associated with a purpuric rash?

A

Meningococcal meningitis (N. Meningiditus)

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21
Q

Most common cause of Reye Syndrome?

A

Salicylates (e.g. aspirin Pepto Bismol etc.)

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22
Q

Rapidly progressive encephalopathy with hepatic dysfunction?

A

Reye Syndrome

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23
Q

In what disorder are negri bodies found in neurons?

A

Rabies

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24
Q

What are the most common symptoms of encephalitis?

A

Fever - Headache - Nausea - Vomiting - Altered mental status

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25
Q

Most common severe complication of measles?

A

Encephalitis

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26
Q

Viral meningitis is associated with predominance of what cell in the CSF?

A

Lymphocytes (Note: bacterial meningitis has neutrophils)

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27
Q

Name the sign: Inability to allow full extension of knee when hip is flexed 90 degrees.

A

Kernig’s sign

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28
Q

Name the sign: Flexion of hips on passive neck flexion.

A

Brudzinski’s sign

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29
Q

What disorder are fever, headache, neck stiffness with initially normal brain function most concerning for?

A

Meningitis

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30
Q

Treatment for Cerebral Palsy?

A

Speech physical and occupational therapy - Aspiration precautions - Anti-spasmodics

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31
Q

Non-progressive disorder characterized by spastic rigidity and slow writhing movements?

A

Cerebral Palsy

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32
Q

Treatment of acute exacerbations of MS?

A

Glucocorticoids

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33
Q

What ophthalmology disorder is seen frequently in patients with multiple sclerosis (MS)?

A

Optic Neuritis

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34
Q

Most common demyelinating disorder mainly in women age 20-50?

A

Multiple Sclerosis

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35
Q

Radiating electrical sensation down the spine with neck flexion seen in patients with multiple sclerosis?

A

Lhermitte’s phenomenon

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36
Q

Patients with Myasthenia Gravis have antibodies to what?

A

Acetylcholine receptors

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37
Q

Treatment for Myasthenia Gravis?

A

Pyridostigmine

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38
Q

Diagnostic test for Myasthenia Gravis?

A

Edrophonium (Tensilon) test

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39
Q

Proximal to distal motor weakness?

A

Myasthenia Gravis

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40
Q

Treatment for Guillain-Barre?

A

Intravenous immunoglobulins - Plasma exchange

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41
Q

Typical cerebral spinal fluid findings with Guillain-Barre?

A

Albuminocytologic dissociation

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42
Q

Most common organism causing Guillain-Barre?

A

Campylobacter jejuni

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43
Q

Ascending symmetrical paralysis/weakness with absent or decreased deep tendon reflexes?

A

Guillain-Barre Syndrome

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44
Q

Treatment for chorea + psychosis?

A

Haloperidol olanzapine or risperidone

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45
Q

Treatment for Huntington’s chorea?

A

Tetrabenazine

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46
Q

Mode of inheritance for Huntington’s?

A

Autosomal dominant

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47
Q

Inherited neurodegenerative disorder characterized by chorea?

A

Huntington’s

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48
Q

Rapid involuntary irregular jerking motion of the hands face and feet?

A

Chorea

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49
Q

What disorder has bradykinesia pill rolling tremor masked facies and cogwheel rigidity?

A

Parkinson’s

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50
Q

Preferred initial treatment for Parkinson’s after age 65?

A

Levodopa + carbidopa

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51
Q

Causes of intention tremors?

A

Multiple sclerosis - Brain trauma - Cerebellar disease

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52
Q

Tremor that increases in severity as it reaches its target?

A

Intention tremor

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53
Q

Treatment for essential tremors?

A

Propanolol and primidone

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54
Q

Tremor with movement but no tremor at rest?

A

Essential tremor

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55
Q

Tremor associated with caffeine intake anxiety and lithium therapy?

A

Physiologic tremor

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56
Q

Preferred first line treatment for Parkinson’s prior to age 65?

A

Dopamine agonists (bromocriptine - pramipexole - ropinirole)

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57
Q

What disorder has a resting tremor which goes away with movement?

A

Parkinson’s

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58
Q

When can an athlete return to play after one concussion?

A

After 1 week with no symptoms

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59
Q

When can an athlete return to play if they have suffered 2 or more concussions in one year?

A

The following season

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60
Q

Headaches irritability loss of memory or concentration after a concussion?

A

Post Concussive Syndrome

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61
Q

Concussions are characterized by what Glasgow Coma Score 30 min after injury?

A

13-15

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62
Q

Mild traumatic brain injury due to contact or acceleration/deceleration injury?

A

Concussion

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63
Q

Medical treatment for complex seizures?

A

Phenytoin

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64
Q

Medical treatment for partial seizures?

A

Carbamazepine or lamotrigine

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65
Q

Pathophysiology of vasovagal (neurocardiac syncope)?

A

Bradycardia - Vasodilation

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66
Q

Medical treatment for status epilepticus?

A

IV lorazepam may follow with IV phenytoin

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67
Q

Single nonstop seizure lasting longer than 5 minutes or frequent seizures without a return to baseline?

A

Status Epilepticus

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68
Q

Seizure in which body is stiff and rigid followed by limb jerking then a post ictal phase?

A

Tonic-Clonic Seizures

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69
Q

Medical treatment for absence seizures?

A

Ethosuximide or valproic acid

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70
Q

Seizure common in children in which patient is conscious but not aware (staring)?

A

Seizure common in children in which patient is conscious but not aware (staring)?

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71
Q

Seizure limited to part of one hemisphere with impaired consciousness?

A

Complex partial seizure

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72
Q

Seizure limited to part of one hemisphere with consciousness fully maintained?

A

Simple partial seizure

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73
Q

Acute medical treatment for increased intracranial pressure (ICP)?

A

Head elevation - Hyperventilation - Osmotic diuresis (mannitol)

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74
Q

Appearance of a subdural hematoma on a CT scan?

A

Crescent shaped

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75
Q

Vessels involved in a subdural hematoma?

A

Bridging veins

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76
Q

Most common cause of subdural hematoma?

A

Head trauma

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77
Q

Appearance of an epidural hematoma on a CT scan?

A

Lens-shaped

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78
Q

Most common artery affected in an epidural hematoma?

A

Middle meningeal artery

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79
Q

Transient loss of consciousness after a lucid interval most often due to skull fracture?

A

Epidural Hematoma

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80
Q

Which brain tumor may present with endocrine signs and symptoms?

A

Pituitary tumor (may also occur with paraneoplastic syndrome e.g. SC lung CA)

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81
Q

Which brain tumor may present with cranial nerve palsy?

A

Brain stem tumor (may also occur with cerebral aneurysm and diabetic ischemic neuropathy)

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82
Q

Which brain tumor may present with visual hallucinations?

A

Occipital lobe tumor (may also occur with migraine and EtOH withdrawal)

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83
Q

Which brain tumor may present with seizures or sensory loss?

A

Parietal lobe tumor

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84
Q

Which brain tumor may present with lip smacking olfactory or gustatory hallucinations?

A

Temporal lobe tumor

85
Q

Which brain tumor may present with personality or intellectual change?

A

Frontal lobe tumor

86
Q

Most common primary tumors that spread to the brain?

A

Breast, lung, GI (colorectal) and kidney

87
Q

Disorder in which AV malformations in the brain are common?

A

Hereditary hemorrhagic telangiectasia (AKA: Osler-Weber Rendu Syndrome)

88
Q

List the causes of hemorrhagic stroke.

A

Uncontrolled HTN - SAH - Tumors - AV malformation - Anticoagulants - Thrombolytics

89
Q

Treatment for subarachnoid hemorrhage (SAH)?

A

Observation - Clip/coil - Seizure prophylaxis (anticonvulsants)

90
Q

Diagnostic test for subarachnoid hemorrhage (SAH)?

A

Non-contrast CT of head

91
Q

Worst headache ever followed by nausea vomiting and impaired consciousness?

A

Subarachnoid Hemorrhage

92
Q

Treatment for cerebral aneurysm?

A

Treatment for cerebral aneurysm?

93
Q

Diagnostic test for cerebral aneurysms?

A

Magnetic resonance angiography (MRA) or CT angiography (CTA)

94
Q

Diseases associated with cerebral aneurysms?

A

Ehlers-Danlos - Polycystic kidney disease - Coarctation of the aorta

95
Q

Loss of cerebellar function such as slurred speech vertigo ataxia and/or nystagmus?

A

Posterior stroke

96
Q

Contralateral paralysis motor function but still can wrinkle forehead?

A

Anterior stroke

97
Q

Reduced blood flow to the brain resulting in tissue damage?

A

Ischemic Stroke

98
Q

Treatment for carotid stenosis of 70-99%?

A

Cortaid endarterectomy

99
Q

Treatment for TIA in a patient with CAD who is in sinus rhythm?

A

Clopidogrel

100
Q

Initial treatment of TIA in a patient without CAD who is in sinus rhythm?

A

Aspirin (aspirin/dipyridamole better if available)

101
Q

Brief episode of focal neurologic symptoms such as hemiparesis loss of strength or sensation?

102
Q

Initial treatment for Bell’s Palsy?

A

Corticosteroids

103
Q

Facial paralysis occurring on the ipsilateral side as herpes zoster?

A

Ramsay Hunt Syndrome

104
Q

Unilateral facial paralysis most often caused by Herpes simplex virus?

A

Bell’s Palsy

105
Q

Hereditary peripheral neuropathy which affects both motor and sensory?

A

Charcot-Marie Tooth

106
Q

Acute treatment for Guillain-Barre Syndrome?

A

Plasma exchange - IV immune globulin

107
Q

Type of polyneuropathy that is predominantly motor?

A

Myelinating

108
Q

Type of neuropathy that is symmetric and initially sensory?

109
Q

Treatment for daily RLS (restless leg syndrome)?

A

Dopamine agonists (e.g. ropinirole) - If iron deficient: Iron replacement

110
Q

Conditions associated with restless leg syndrome (RLS)?

A

Parkinson’s - Iron deficiency anemia - Diabetes - Multiple Sclerosis - Pregnancy

111
Q

Spontaneous leg movements/paresthesias present at rest and relieved with movement?

A

Restless Leg Syndrome

112
Q

Medical treatment for peripheral neuropathy? (3)

A

Gabapentin pregabalin or amitriptyline

113
Q

Stocking glove distribution of chronic polyneuropathy?

A

Diabetic neuropathy and renal failure related neuropathy due to chronic uremia

114
Q

Initial diagnostic test for peripheral neuropathy?

A

Electromyography (Nerve conduction study) (aka EMG and NCS)

115
Q

Symmetric distal sensory loss burning or weakness?

A

Peripheral Neuropathy

116
Q

Treatment for Complex Regional pain syndrome?

A

Anti convulsants (e.g. gabapentin) - Tricyclic antidepressants (e.g. Amitriptyline - Agents to increase bone mineral density (e.g. alendronate)

117
Q

Unilateral burning pain in a cyanotic cool extremity may be associated with urinary urgency?

A

Complex Regional Pain Syndrome (AKA: Reflex Sympathetic Dystrophy)

118
Q

Preferred prophylaxis for cluster headache?

119
Q

Acute treatment for cluster headaches?

A

Subcutaneous or intranasal sumatriptan and inhaled 100% oxygen

120
Q

Unilateral Ptosis Miosis and Anhydrosis?

A

Horner Syndrome

121
Q

Are males or females more likely to suffer from cluster headaches?

122
Q

Headache with unilateral periorbital pain with rhinorrhea and conjunctival injection?

A

Cluster headaches

123
Q

Migraine prophylaxis?

A

Beta blockers unless > 60 y.o. asthmatic or smoker (commonly propranolol) - Verapamil - Tricyclic antidepressants

124
Q

Acute treatment for Migraines?

A

NSAIDs or “Triptans” (e.g. sumatriptan)

125
Q

Most common type of migraine aura?

A

Visual: Bright spots

126
Q

Unilateral throbbing headache with or without an aura?

127
Q

1st line Treatment for Tension headache?

A

Non- Aspirin NSAIDs

128
Q

Episodic bilateral headache with pericranial muscle tenderness and normal neuro exam.

A

Tension headache

129
Q

A previously healthy elderly patient with no past medical history presents with acute onset altered mental status to the emergency room. What do you suspect?

A

Delirium - Consider underlying causes such as: Sepsis (UTI common)

130
Q

What class of medications is often used to treat Alzheimer’s patients?

A

Cholinesterase inhibitors

131
Q

What is the difference between delirium and dementia?

A

Delirium is an acute syndrome caused by a medical condition - Dementia is a long-term impaired memory disease process such as Alzheimer’s

132
Q

What finding on autopsy confirms the diagnosis of Alzheimer’s?

A

Beta amyloid plaques and neurofibrillary tangles

133
Q

What is the most common cause of dementia in an adult after the age of 60?

A

Alzheimer’s

134
Q

A 94 year old male, hospitalized for a UTI, becomes confused and is seeing things in his room every evening. What type of delirium do you suspect?

A

Sun downing

135
Q

What is the GCS for a patient who only responds to your verbal commands, is confused and localizes to pain?

A

GCS = 12 Responsive to verbal = 3 - Confused = 4 - Localizes pain = 5

136
Q

What is the GCS for a patient who does not open his eyes, does not respond to verbal commands, and has no motor response?

A

GCS = 3 Does not open eyes = 1 - Does not respond to verbal = 1 - No motor response= 1

137
Q

What is the Glasgow Coma Score (GCS) for a patient who has spontaneous eye-opening, is oriented and obeys commands?

A

GCS = 15 Spontaneous eye-opening = 4 - Oriented = 5 - Obeys commands= 6

138
Q

What is the classic triad of meningitis?

A

Nuchal rigidity - Headache - Fever (Note: nuchal rigidity and headache without fever is suggestive of subarachnoid hemorrhage)

139
Q

Negri bodies are pathognomonic for what disease process?

140
Q

Which organisms most commonly cause bacterial meningitis in neonates?

A

Group B Streptococcus and E. Coli

141
Q

A child with the flu is given Tylenol for his fever and Pepto-Bismol for his upset stomach. He is noted by the parents to become confused and lethargic. What do you suspect?

A

Reyes syndrome (Pepto-Bismol has salicylates)

142
Q

What is the difference between encephalitis and meningitis?

A

Impaired mental status in encephalitis

143
Q

What are the two most common causes of community acquired meningitis?

A

Streptococcus pneumoniae - Neisseria meningitidis

144
Q

What is the recommended treatment for a patient with multiple sclerosis having a severe attack?

A

Plasma exchange

145
Q

A patient was found to have oligoclonal bands on lumbar puncture. What do you suspect?

A

Multiple sclerosis

146
Q

A young woman with history of optic neuritis presents with left foot weakness and difficult walking. What is your suspected diagnosis?

A

Multiple sclerosis

147
Q

What type of progression occurs in patients with cerebral palsy?

A

Generally none, however, some patients can later develop involuntary movements

148
Q

What procedure can help with myasthenia gravis in patients under the age of 60?

A

Thymectomy

149
Q

What tests are used to diagnose myasthenia gravis?

A

Edrophonium or Tensilon test and antibodies to acetylcholine receptor and tyrosine kinase

150
Q

A young woman presents to the office with bilateral eye ptosis and difficulty keeping her head erect. What do you suspect?

A

Myasthenia gravis

151
Q

What is the treatment of choice for Guillain-Barre?

A

Plasma exchange, intravenous immunoglobulin, and supportive care in the ICU for severe cases

152
Q

A 55 year old male begins to get weakness in all four of his limbs. He has no past medical history and recently had a flu shot. What do you suspect?

A

Guillain Barre

153
Q

At what age is Huntington’s disease most commonly diagnosed?

A

Age 40 to 50 years old - The defining symptom is chorea

154
Q

What childhood disease process may be diagnosed with the onset of chorea?

A

Rheumatic fever

155
Q

What adult disease process is most commonly diagnosed with the onset of chorea?

A

Huntington’s Disease

156
Q

What disease processes have an intention tremor?

A

Multiple sclerosis, cerebellar disease and strokes

157
Q

What is an intention tremor?

A

There is no tremor at rest, however with movement the tremor starts and increases in severity as a hand moves closer to its target

158
Q

What medication class is used to treat Parkinson’s disease in patients younger than 65 or without advanced disease?

A

Dopamine agonist, such as bromocriptine

159
Q

What disease condition has a resting tremor that goes away with movement?

A

Parkinson’s

160
Q

What is a resting tremor?

A

A tremor that is seen at rest but goes away with movement

161
Q

What is the most common cause of tremor in a healthy young adult?

A

Caffeine is the most common cause of physiologic action tremors

162
Q

What is the Glasgow Coma Score (GCS) range found in patients with concussions?

A

13 to 15 GCS Ranges from 3 (worst) to 15 (normal)

163
Q

A football player is post-concussion and is having frequent headaches, a fuzzy feeling and difficult concentrating. What is the next step?

A

MRI of the brain (CT if suspect acute bleed)

164
Q

How long after a second concussion in the same season should a player have to wait before resuming sports?

A

They are out for the rest of the season

165
Q

How long after the first concussion should a player be made to wait?

A

One week without any symptoms

166
Q

Define status epilepticus

A

A single nonstop seizure lasting longer than 5 to 10 minutes or frequent seizures without a return to baseline

167
Q

What is the main treatment for patients with neurogenic syncope?

A

Patient awareness and education

168
Q

What is the Bezold-Jarisch reflex?

A

Transient loss of consciousness due to a reflex response of vasodilation and/or bradycardia

169
Q

What medication used to treat epilepsy requires regular blood draws to monitor therapeutic levels?

170
Q

What is the acute treatment for an active grand mal seizure?

A

Benzodiazepines (lorazepam)

171
Q

What is the treatment choice for simple partial and complex partial seizures?

A

Carbamazepine

172
Q

What is the difference between simple partial and complex partial seizures?

A

Impaired consciousness in complex partial but not in simple partial

173
Q

What is the recommended treatment for a subdural bleed that is causing symptoms?

A

Burr holes or craniotomy

174
Q

A man is hit in the head and knocked unconscious. He gets up after a minute and feels fine, in 20 minutes he is drowsy with headache. What do you suspect?

A

Epidural hematoma

175
Q

A man hits his head but he appears unhurt. In the two weeks since, he has had persistent headaches and lightheadedness. What do you suspect?

A

Subdural hematoma

176
Q

What artery is most commonly involved in epidural bleed?

A

Middle meningeal artery

177
Q

CT of the brain demonstrates blood in crescent shaped appearance. What do you suspect?

A

Subdural hematoma

178
Q

CT of the brain demonstrates blood in a biconvex lens shaped appearance. What do you suspect?

179
Q

Which modality is better for diagnosis of a brain tumor? CT - MRI or nuclear medicine test

180
Q

What do an aneurysm, AVM and brain tumor all have in common?

A

They can all lead to hemorrhagic stroke and blood in the cerebral spinal fluid

181
Q

A patient in ER has the “worst headache ever”. CT of the brain is negative but you’re concerned about a subarachnoid hemorrhage. What is the next step?

A

Lumbar puncture

182
Q

What is the treatment for a cerebral aneurysm?

A

Intracranial coiling or clipping

183
Q

What syndrome is often associated with arteriovenous malformations in the brain

A

Osler-Weber-Rendu syndrome

184
Q

What are the common signs seen in a patient with a subarachnoid hemorrhage post rupture?

A

Nuchal rigidity and meningeal signs

185
Q

A patient with polycystic kidney disease has sudden onset of the “worst headache ever”. What is the suspected cause?

A

Ruptured cerebral aneurysm

186
Q

A patient status post TIA has a carotid ultrasound which shows a lesion of 79% in the left internal carotid. What is the recommended therapy?

A

Carotid endarterectomy

187
Q

A patient that had a TIA and has a history of coronary disease should be placed on what antiplatelet therapy?

A

Clopidogrel

188
Q

What test should be ordered to determine the source of a TIA in a patient with an irregular heartbeat?

A

Echocardiogram will determine the source, EKG will only demonstrate atrial fibrillation

189
Q

What is the mainstay of treatment for bell’s palsy?

190
Q

Define Ramsay Hunt syndrome.

A

Herpes zoster plus bells palsy

191
Q

A 23 year old female presents with facial droop, ptosis and a change in her taste sensation. She has no other focal findings. What is your suspected diagnosis?

A

Bell’s palsy

192
Q

What medication is used to treat restless leg syndrome?

A

Treatment is like Parkinson’s using dopamine agonists like pramipexole

193
Q

A trial of what medication should be given to all patients with restless leg syndrome?

A

Trial oral iron therapy

194
Q

An obese patient with peripheral neuropathy may benefit from what medication to help with the neuropathy and weight loss?

A

Topiramate

195
Q

A woman complains of aching pain in her legs that is deep inside. It is worse at night when she lays still and feels better when she moves her legs around. What is the likely diagnosis?

A

Restless leg syndrome

196
Q

The patient with Charcot-Marie-Tooth has both motor and sensory loss. What type of sensory loss do they have?

A

Loss of proprioception and loss of vibration

197
Q

A 12 year old has difficulty running. On exam she has distal muscle weakness, diminished proprioception and vibration as well as hammer toes. What is your suspicion?

A

Charcot-Marie-Tooth

198
Q

What type of neuropathy often presents in a stocking glove distribution?

A

Axonal (sensory) Peripheral neuropathy

199
Q

A 24 year old male is complaining of increasing symptoms from complex regional pain syndrome and is taking Neurontin. What is the next step in his management?

200
Q

A patient with a history of trauma has severe burning pain, cyanosis and cool skin to his left arm. X-rays show patchy demineralization of the bone. What condition do you suspect?

A

Complex regional pain syndrome also known as reflex sympathetic dystrophy

201
Q

What medication used in the treatment of tension headaches often has an abuse potential?

A

Opiates are commonly used to treat tension headaches

202
Q

In regards to activity, what is the difference between a migraine and a cluster headache?

A

Migraine sufferers prefer quiet and laying down while cluster headache patients are restless and tend to pace

203
Q

What medication is used as prophylaxis for cluster headaches?

A

Calcium channel blockers such as verapamil

204
Q

A 44 year old male presents with a severe unilateral headache that seems to be located behind his eye. What type of headache do you suspect?

A

Cluster headache

205
Q

What 3 symptoms define Horner syndrome?

A

Ptosis - Miosis - Anhydrosis

206
Q

What is the difference between a migraine headache and a TIA regarding symptoms?

A

TIA will never have aura. Migraine can have aura and, in severe cases, transient loss of motor function

207
Q

Red wine is a common trigger for what type of headache?

A

Migraine headache

208
Q

A 30 year old female presents with a unilateral throbbing headache that was preceded by a colorful aura. What medication is recommended?

A

Sumatriptan

209
Q

What medication can be used to prevent tension headaches?

A

Tricyclic antidepressants such as amitriptyline

PANCE (9 decks)

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