Neurology Flashcards
Parietal Lobe lesion deficits (5)
Sensory inattention
Astereognosis (inability to identify objects purely by touch)
Apraxias (difficulty in planning motor function)
Inferior homonymous quadrantinopia
Gerstmann’s syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation
Occipital lobe lesion deficits (3)
Cortical blindness
homonymous hemianopia (with macular sparing)
Visual agnosia
Temporal Lobe Lesion (4)
Auditory agnosia
Superior homonymous quadrantinopia
prosopagnosia (difficulty recognising faces)
Wernickes aphasia - word substituion, neologisms but speech remains fluent
Frontal lob lesions (5)
Disinhibition Expressive aphasia - located on the posterior aspect of the frontal lobe, in the inferior frontal gyrus. Speech is non-fluent, laboured, and halting Perseveration Anosmia Inability to generate a list
Cerebellar lesions
Midline lesions: gait and truncal ataxia
Hemisphere lesions: intention tremor, past pointing, dysdiadokinesis, nystagmus
Medial thalamus and mammillary bodies of the thalamus
Wernicke and Korsakoff syndrome
Substantia Nigra of the basal ganglia
PD
Subthalamic nucleus of the basal ganglia
Hemiballism
Striatum (caudate nucleus) of the BG
Huntingtons chorea
Amygdala
Kluver-Bucy syndrome (hypersexuality, hyperorality, hyperphagia, visual agnosia
Organic causes of miosis (small pupil)
Argyll-robertson pupil - accomodation is preserved Old age COngenital Pontine haemorrhage Horners syndrome
Drug causes of miosis (small pupil)
Opiates
PArasympathetics - pilocarpine
Organophosphate toxicity
Neuropathic pain first line
Amitryptiline, duloxetine, gabapentin or pregabalin
Trigeminal neuralgia first line
CBZ
GBS monitoring
FVC
GBS prognosis
20% have permanent disability
5% die
Causes of macroglossia (5)
Hypothyroidism Acromegaly Amyloidosis DMD mucopolysaccharidosis (e.g. Hurler syndrome)
Peripheral neuropathy predominant motor
Guillain-Barre syndrome
porphyria
lead poisoning
hereditary sensorimotor neuropathies (HSMN) - Charcot-Marie-Tooth
chronic inflammatory demyelinating polyneuropathy (CIDP)
diphtheria
Peripheral neuropathy predominant sensory
diabetes uraemia leprosy alcoholism vitamin B12 deficiency amyloidosis
Ab against pre-synaptic voltage gated calcium channel in the peripheral nervous system
Lambert Eaton myasthenic syndrome
A/w small cell lung and breast Ca
Anti-Hu paraneoplastic features
A/w small cell lung Ca and neuroblastomas
painful sensory peripheral neuropathy
Cerebellar syndrome
Encephalomyelitis
Anti-Yo paraneoplastic features
A/w ovarian and breast Ca
Cerebellar syndrome
Anti-GAD paraneoplastic features
a/e colorectal, breast and small cell lung Ca DIffuse hypertonia (stiff persons syndrome)
Anti-Ri paraneoplastic features
A/w breast and samll cell lung Ca
Ocular opsonus-myoclonus
Purkinje cell Ab paraneoplastic features
Breast Ca
peripheral neuropathy
Contrlateral hemiparesis and sensory loss, lower>upper limb - likely artery
Anterior cerebral
Contralateral hemiparesis and sensory loss upper>lower - inc face
Contralateral homonymous hemianopia
Aphasias
Middle cerebral artery
Contralateral homonymous hemianopia with macular sparing
Visual agnosia
Posterior cerebral artery
Ipsilateral CN III palsy
Contralateral weakness of upper and lower extremity
Webers syndrome - bracnhes of posterior artery that supply midbrain
Ipsilateral: facial pain and temperature loss
Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus
Posterior inferior cerebellar artery
Amaurosis fugax
opthalmic/retinal artery
Locked in syndrome
basilar artery
Lacunar stroke
present with either isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia
strong association with hypertension
common sites include the basal ganglia, thalamus and internal capsule
Sodium valproate SEs (10)
HypoNa pancreatitis hepatitis Thrombocytopenia Teratogenic Nausea Inc appetite and weight gain Ataxia Tremor Alopecia - regrowth may be curly
Migraine pregnancy
first line paracetemol
Aspirin 300mg or ibuprofen 400mg second line in 1st and 2nd trimester
Drug causes of gingival hyperplasia
Phenytoin
CCBs - esp nifedipine
Ciclosporin
Condition causing gingival hyperplasia
AML
Temporal lobe epilepsy HEAD
Hallucinaitons
Epigastric rising/Emotional
Automatisms - lip smacking/grabbing
Deja vu/Dysphasia post ictal
Frontal lobe epilepsy
Head/leg movements
Posturing
Post ictal weakness
Parietal lobe epilepsy
parasthesia
Occipital lobe epilepsy
floaters/flashers
