NEUROLOGY Flashcards
What is the first line treatment for focal seizure?
carbamazepine or lamotrigine
What is the first and second line treatment for general seizures?
1st-sodium valporate
2nd- lamotrigine
What happens in a myoclonic fit?
Sudden limb or trunk jerks where the patient will fall suddenly
What is a jacksonian march and what type of fit does it link to?
An aura where the motor activity spreads from one limb to the rest of one half of the body and is seen in frontal focal type fits
During what fit is lipsmaking/ rubbing hands together/chewing movements seen?
A temporal focal fit
Investigations for epilepsy?
Bloods: U+E, FBC, CRP, LFT, serum Calcium, blood Glucose ECG (rhythm, conduction, QT interval) MRI or CT – focal brain lesion? EEG – classification not diagnostic Video telemetry
What drug makes myoclonic seizures worse?
Carbamazepine
What is parkinson’s?
Nuerodegenerative loss of dopamine secreting cells from the substantia nigra
What cells are seen in parkinson’s?
Lewy bodies
What are differential diagnosis for parkinson’s?
lewy body dementia, pick disease and wilson’s disease
What are the 3 signs of Parkinson’s?
Bradykinesia, rigidity, tremor
Is Parkinson’s unilateral or bilateral?
Unilateral
What are wider symptoms of parkinsons?
Depression, phobias, anxirty, dementia, constipation, increased urninary frequency
What is the management for parkinson’s ?
Levodopa (doesn’t treat tremor)
Dopamine agaonists- Pramipexole+ropinirole
COMT inhibitors- Entacapone and tolcapone
Tremor treatment- Amantadine
What gene is linked to MS?
HLA-DR2
What is Lhermitte’s sign and what is it seen in?
Tingling pins and needles running doen the back and neck when bending the neck forward
It is seen in MS
What is MS?
Autoimmune demylination of the CNS
What is the treatment for MS?
Mild- dimethyl, alemtuzumab (monoclonal antibodies)
Relapse- methylprednisolone
Spasticity- gabapentin
Urgency urinating- self- catherterization
Tremor- botulinum
What does an CSF in MS show?
Oligoconal IgG
What type of hypersensitivity of myathenia gravis?
Type 2
What epi does myasthenia gravis have?
women-20-30 and males >50
What is myathenia gravis?
An autoimmune destruction of ach receptors
What is the treatment for myasthenia gravis?
Corticosteroid- Prednisolone
Acheticholinesterase inhibitors- Pyridostigmine
Remove the thymus surgically
What is the treatment for MND?
Riluzole inhibits glutamate release to slow progression
Non-invasive ventilation and feeding
What is the main cause of meningitis in babies?
E.coli and B strep
What is the main cause of meningitis in children and adults
Nisseria meningitis and strep pnumoniae
What tumours can cause spinal cord compression?
Lung, breast, kidney and prostate
SCC treatment?
Dexamethasone for odeama and surgical decompression
What is the management of guillian barre syndrome?
IV immunoglobulins, plasma exchange
What are the causes of guillian barre syndrome?
Camplylobacter, HIV, EBV, CMV, zoster
What are tests for carpel tunel?
phalen’s and tinnels
What is used to treat neural pain?
Amitriptyline
What is encephalitis?
Inflammation of the brain parenchyma
What causes encephalitis?
Herpes simplex, arbovirus, CMV and EBV
What is the treatment for encephalitis?
Aciclovir for 14 days
What is the treatment for shingles?
Aciclovir or Valaciclovir
What is the management of migraines?
Avoid triggers, avoid oral contraception
NSAID use and acupuncture
Severe- Triptan such sumatriptan
What is the treatment for trigeminal neuralga?
Carbamazepine, gabapentin, microvascular decompression
What is migraine prophylaxis?
B blocker, acupuncture, topiramate
What is the treatment of cluster headaches?
Subcutaneous sumatriptan
What helps prevent cluster headaches?
Verapamil, lithium, corticosteroids
Is the Huntington’s gene dominant or recessive?
Dominant
What repeats in the genes for Huntington’s?
CAG (36+ is positive)
What are the signs and symptoms for Huntington’s?
Dementia, Personality change, depression, abnormal eye movements and poor coordination
