Neurology

Question 1

What drugs to avoid in lewy body dementia?

Answer 1

Typical antipsychotics eg. Haloperidol, risperidone

Can cause irreversible parkinsonism

Question 2

Treatment for trigeminal neuralgia?

Answer 2

Carbamazepine

Question 3

When and what to offer in shingles?

Answer 3

Paracetamol if needed.

Offer antiviral (aciclovir, famciclovir, valaciclovir) within 72hrs of rash if:

• > 50 yrs old
• Immunocompromised
• Moderate/severe rash or pain
• If non-truncal involvement

Question 4

Mixed upper and lower motor neuron signs in patient?

Answer 4

ALS

Amyotrophic lateral sclerosis

Question 5

Differences between neurofibromatosis and tuberous sclerosis

Answer 5

Both are neurocutaneous disorders associated with seizures
NF:
- cafe au lait spots (though may be seen in TS)
- phaeochromocytoma
- axillary/groin freckles
- acoustic neuroma and other CNS tumours in NF2

TS:

• shagreen patches
• ash leaf spots (depigmentation)
• subungal fibromata

Question 6

Parkinson’s plus syndromes?

Answer 6

Parkinsonian features with associated features
Progressive supranuclear palsy
Problems with vertical gaze

Multi system atrophy
Loss of autonomic function

Corticobasal degeneration
Myoclonus
Alien limb
Drug resistant