``` A--> E O2 if sats low secure airway treat shock and seizures assess GCS fbc, glucose, u&E, tox screen, ABG, clotting check CSF leak HX palpate neck radiology ```

Neurology Flashcards by Zi Mistry

status epilepticus

BLS 
lorazepam
2nd dose after 10 mins, beware of respiratory arrest, need crash trolley
rectal alternative
buccal midazolam

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if fitting continues in status..

phenytoin infusion
then diazepam infusion
dexamethasone
GA
oral drugs when seizures controlled

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cauda equina

urgent MRI

urgent surgical depression

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thoracic disc protrusion

confirm on MRI
reset
NSAIDS, physio
surgery

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cervical myelopathy

MRI

laminectomy

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head injury

A--> E
O2 if sats low
secure airway
treat shock and seizures
assess GCS
fbc, glucose, u&amp;E, tox screen, ABG, clotting
check CSF leak
HX
palpate neck
radiology

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extradural bleed

stabalise pt
transfer to qmc
airway
need clot evacuation

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acute hydrocephalus

furosemide/acetazolamide
isosorbide
shunting
remove tumors

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stroke

MDT
education
CT brain
thrombolysis upto 4.5 hours clear time of onset and no bleeding on CT
ALTEPLASE
aspirin 300 for 2 weeks
clopidogrel 75 
heparin/warfarin

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malignant MCA

hemicraniotomy

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intracranial haemorrhage

reverse anticoags
stop antiplatelet
neurosurgery/ITU
DVT prophylaxis
(enoxaparin day 3 of ischaemic stroke)

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stroke rehab

nutrition
cognition
skin
physio (baclofen)
SALT
home modification - OT

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secondary stroke prevention

control CV RFs
antiplatelet - clopidpgrel
warfarin in AF

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carotid stenosis

internal carotid endartectomy

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TIA MX

control RFs
clopidogrel 75, aspirin 300, reduce to 75 after 2 weeks
dipyridamole
warfarin if AF
endartectomy if stenosis >70%

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ABCD2

stroke risk post TIA

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sudden onset headache differential

SAH
meningitis
venous sinus thrombisis
bleed 
migraine

SAH

neuro referral
well hydrated, nimodipine
coil/stent

SDH

can spontaneously resolve
burr holes
craniotomy
neuro referral

tension headache

simple analgesia
massage
ice pack
relax
tcas

migraine

NSAIDS
triptans
ergotamine
botox
warm/cold packs
rebreathing

migraine prevention

remove triggers
1st line: propanolol, amytriptiline, topiremate, calcium channel blockers
2nd line: valproate, pizotifen, gabapentin, pregablin, ACEIs, NSAIDS

cluster headache

O2
sumatriptan/nasal spray
prevent w/steroid injection/intranasal chilli/verapamil, lithium, melatonin

temporal arteritis

STEROIDS
one year minimum
gradually reduce dose
biopsy
calcium, vit d, bisphosphonates

neuro tumors

dexamethasone anticonvulsants if epilepsy surgery stereotactical radiotherapy

meningitis

benzylpenecillin/cefotaxime if penecillin allergic

herpes simplex encephalitis

IV aciclovir seizures with anticonvulsants decompressive craniotomy occasionally

partial seizure

1. carbemaz/lamotrigine | 2. lvetiracetam/valproate

general seizure

1. valproate | 2. lamotrigine

absence

ethosuximide/valproate

• Short courses of high dose steroids, such as IV methylprednisolone 1g/day for 3 days o Occasionally high dose oral o Speed up recovery but don’t influence long term outcome o Shouldn’t be used more than twice a year • Symptom management key o E.g. amitriptyline for neurological pain

MS spasticity

baclofen, diazepam, dantrolene, phhysion, cannabinoid, tizanidine

MS tremor

botox

MS bladder probs

toletridone | self catheterisation

disease modifying in MS

``` Vitamin D interferons mabs glatiramer/mitoxantrone azathioprine (check tmpt) ```

Parkinsons

``` levodopa dopamine agonist apomorphine, anticholinergic MAOBI COMT I ```

Dementia

MDT | plan ahead

Alzheimers

ACHesteraseIs antiglutamatergic (memantine) target b amyloid folic acid + B vitamins

ventilate IV IG plasma exchange no steroids

shingles

aciclovir 5 times a day for 7 days

post herpetic neuralgia

TCAs, topical lidocaine/gabapentin