Neurology Flashcards
Causes of peripheral neuropathy
Vascular (vasculitis) Infective (syphillis) Toxic (alcohol, lead, Mercury) Autoimmune (GBS, CIDP) Metabolic (B12, folate, diabetes, uraemia) Idiopathic Neoplastic (paraprotein associated)
Congenital (CMT, Freidreich’s)
Drugs (vincristine, vinblastine, phenytoin)
Causes of proximal muscle weakness
Congenital:
DM2 myotonic dystrophy
Becker’s muscular dystrophy
Duchenne muscular dystrophy
Acquired:
Infective (HIV, Lyme, influenza)
Toxic (alcohol)
Autoimmune (polymyositis, SLE, RA, sarcoid)
Metabolic (hypothyroidism, hyperthyroidism, Addison’s, Cushing’s, hypokalaemia)
Drug (steroid, statin)
Causes of carpel tunnel syndrome
Idiopathic Hormonal: Pregnancy, OCP Endocrine: Obesity, Diabetes, myxoedema, acromegaly Trauma Tophaceous gout, amyloidosis Chronic renal failure Rheumatoid arthritis
Differential diagnosis of peripheral nerve lesion (eg. ulnar/radial/medial)
- by definition, excludes all UMN causes
Local joints - RA Generalised peripheral neuropathy MND or polio Plexus lesion Nerve root lesion - ulnar C8-T1 - radial C6-C8 - medial C6-T1
Differential diagnosis of Parkinson’s Disease
Essential tremor (head involved) Vascular PD Drug induced PD Parkinson’s plus syndromes - PSP - MSA
Trinucleotide Repeat Disorders
Freidrich’s ataxia GAA Cr 9
DM1 myotonic dystrophy CGT Cr 19
Huntington CAG Cr 4
Associations of Friedreich’s ataxia
Hypertrophic cardiomyopathy Optic atrophy Diabetes mellors Sphincter dysfunction Sensorineural deafness
Causes of Horner’s Syndrome
First neurone: Lateral medullary syndrome (stroke) Demyelination - MS Syringomyelia Spinal cord rumour (mass)
Preganglionic Neurone: * before superior cervical ganglion Pancoast tumour Thoracic outlet syndrome - cervical rib Mediastinal mass - SVCO Cervical lymphadenopathy Thyroid mass Neck surgery
Postganglionic neurone:
Carotid aneurysm
Carotid dissection
Cranial Nerve Origins
Midbrain:
I II III IV
Pons:
V VI VII VIII
Medulla:
V IX X XI XII
Cranial nerve syndromes:
V VII VIII - CPA
III IV V1 VI - cavernous sinus
IX X XI - jugular foremen lesion
IX X XII - bulbar palsy
Causes of pes cavus
Unilateral
Fracture malunion Burns Sequalae of compartment syndrome Polio Spinal trauma Spinal cord tumour
Bilateral
Friedreich ataxia Muscular dystrophy Spinal muscular atrophy Cerebral palsy Syringomyelia Hereditary spastic parapesis Spinal cord tumour
Differential diagnosis for MND
Syringomyelia
Cervical myelopathy
UMN
HIV myelopathy
Spinal cord tumour
LMN Multifocal motor neuropathy CIDP Spinal muscular atrophy Oculopharyngeal muscular dystrophy Spinobulbar muscular atrophy Syphilitic amyotrophy Old poliomyelitis
Early onset recessive ataxia
Ataxia telengiectasia
Abetalipoproteinaemia
Refsum disease
Friedreich ataxia
NF1
Optic glioma Cafe au lait spots Freckling Peripheral neurofibromas Iris hamartomas (Lisch nodules) Learning disability
Complications of NF1
Aqueduct stenosis Orthopaedic - scoliosis - pseudoarthrosis of tibia and fibula - sphenoid wing dysplasia Malignancy - nerve sheath tumours - pelvic rhabdomyosarcomas - GI neurofibromas - phaeochromocytoma - duodenal carcinoid - glomus tumours of nail bed Vascular - renal artery stenosis - cerebral vascular disease Interstitial lung disease
