Neurology Flashcards by Miranda King

Pathophysiology of Migraine

Cerebral vessel dilation results in inflammation

Problem spreads across the cortex

How well did you know this?

Not at all

Perfectly

Prophylaxis of Migraine

1st - B-blocker

2nd - Amytriptyline

How well did you know this?

Not at all

Perfectly

When does aura usually occur in migraine?

Usually before onset of headache

How well did you know this?

Not at all

Perfectly

Management of Tension Headache

Simple analgesics

How well did you know this?

Not at all

Perfectly

Trigeminal Autonomic Cephalgia

What is included?

Cluster Headache
Tension Headache
Paroxysmal Hemicrania
SUNCT

How well did you know this?

Not at all

Perfectly

Presentation of Cluster Headaches

Associations

Unilateral headache around the eye, last 45-90 minutes

Occur near sleep, usually young men

How well did you know this?

Not at all

Perfectly

Management of Cluster Headache
Acute
Cover

Oxygen, triptan

Course of steroids should cover the cluster

How well did you know this?

Not at all

Perfectly

Epidemiology of Paroxysmal Hemicrania

Older women

How well did you know this?

Not at all

Perfectly

Management of Paroxysmal Hemicrania

Indomethacin 50mg 3 times a day

How well did you know this?

Not at all

Perfectly

What is SUNCT

Short lived - seconds 
Unilateral headache 
Neuralgiform 
Conjunctival injections
Tearing

How well did you know this?

Not at all

Perfectly

Management of SUNCT

Gabapentin

How well did you know this?

Not at all

Perfectly

Associations of Meningioma

NF Type II

Breast Cancer

How well did you know this?

Not at all

Perfectly

Meningioma on CT

Densely enhancing lesion surrounded by oedema

Signs often due to large amount of oedema as opposed to the tumour

How well did you know this?

Not at all

Perfectly

Management of meningioma

Surgery - often needs pre-surgical embolisation

+ Radiotherapy

How well did you know this?

Not at all

Perfectly

Oligodendrial tumours on CT

Calcifications

How well did you know this?

Not at all

Perfectly

Site of oligodendrial tumours

Cerebral cortex

How well did you know this?

Not at all

Perfectly

Management of oligodendrial tumours

Radiotherapy and PVC chemotherapy

How well did you know this?

Not at all

Perfectly

Spread of astrocytoma

Usually white matter tracking

How well did you know this?

Not at all

Perfectly

Grading of Astrocytoma

I - truly benign
II - low grade
III - anaplastic
IV - gliobastoma multiforme

How well did you know this?

Not at all

Perfectly

Management of Astrocytoma

Consideration

PVC chemotherapy

Can only perform surgery if there is a cyst present

How well did you know this?

Not at all

Perfectly

Epidemiology of Brain Germ Cell Tumours

Usually under 12 years old

Male

How well did you know this?

Not at all

Perfectly

Non-germinatous germ cell tumorus

Yolk sac
Teratoma
Choriocarcinoma

How well did you know this?

Not at all

Perfectly

Management of Germinoma

Radiotherapy + Cisplatin

How well did you know this?

Not at all

Perfectly

Collision tumours =

Astrocytoma + Oligodendrial Tumours

How well did you know this?

Not at all

Perfectly

Presentation of sagittal venous thrombosis

Headaches and seizures

Presentation of transverse venous thrombosis

Focal CNS signs

Presentation of cavernous venous thrombosis

Headache and proptosis

Management of dural sinus venous thrombosis

Anti-coagulation - heparin | ENT referral to determine cause

Causes of intracerebral haemorrhage

AVM Hypertension Cocaine

Investigation of intracerebral haemorrhage

CT angiography

Posterior cerebral artery stroke (2)

Contralateral homonymous hemianopia WITH macular sparing Visual agnosia

Management of TIA

Bloods ECG Carotid Doppler - Suspect referral to TIA clinic indicated

Location of lacunar infarcts

Basal ganglia Thalamus Brain stem

Presentation of lacunar infarcts (3)

1 of following: Unilateral weakness face/arm/leg Pure sensory stroke Ataxic hemiparesis

Presentation of basilar artery stroke

Locked in syndrome

Presentation of lateral medullary stroke

Ipsilateral facial spinothalamic loss | Contralateral body spinothalamic loss

Artery blocked in lateral medullary syndrome

Posterior inferior cerebellar artery

Anterior cerebral artery stroke

Contralateral hemiparesis and sensory loss | Lower limb MORE

Syringomyelia =

= fluid filled cyst in spinal cord

Pathophysiology and Presentation of Syringomyelia

Destruction of spinothalamic neurons | - Sensory loss and loss of upper limb reflexes

Management of syringomyelia | - Include investigation

VP or LP shunt | Seen on MRI

Mechanisms of Hydrocephalus (3)

Over-production of CSF Reduced absorption of CSF Compensatory e.g. fronto-temporal dementia

Causes of hydrocephalus (4)

Arnold-chiari Dandy-walker complex Haemorrhage Tumour

Types of Partial Seizures

Simple | Complex

Presentation of simple partial seizures

No loss of consciousness, no post-ictal phase

Presentation of complex partial seizures

Impaired consciousness | May have post-ictal phase

Temporal lobes - what do you see in epilepsy?

Complex phenomena

Parietal lobes - what do you see in epilepsy?

Sensory phenomena

Occiptal lobes - what do you see in epilepsy?

Visual phenomena

Frontal lobes - what do you see in epilepsy?

Motor phenomena

Pathophysiology of epilepsy

Abnormal, spontaneous and intermittent electrical activity - tends to stay in the lobe Can spread = generalisation

What to avoid in myclonic and atonic seizures?

Carbamazepine | Oxacarbazepine

Types of Generalised Seizure

Myoclonic Atonic Tonic-clonic Absence

EEG findings in generalised seizures

Generalised spike wave abnormalities

Presentation of mononeuritis multiplex

Unilateral neuropathy Thenar wasting = must involve two separate nerve areas

Investigation findings in spontaneous intracranial hypotension

MRI - meningeal enhancement | LP - low pressure

Genetics of Charcot Marie Tooth Disease

Duplication error on Ch 17 | Causes synaptic problems

Presentation of Charcot MT Disease (3)

Pes cavus Foot drop Distal limb wasting

Problem in pseudobulbar palsy

UMN lesion | Will be bilateral if lesion above the pons

Presentation in pseudobulbar palsy

Slow speech Tongue movement Increased jaw jerk

Contraindication in brain abscess

Don't do an LP

Management of brain abscess

IV ceftriaxone and metronidazole

What do you need to diagnose MS?

Two distinct sensory deficits

What shouldn't you use in Lewy Body Dementia?

Neuroepileptics | Make it worse

Presentation of Lewy Body Dementia

Visual hallucinations | Parkinsonism

Findings in fronto-temporal dementia

Atrophy of lobes Pick bodies Neurofibrillary tangles

Association of fronto-temporal dementia

ALS

Presentation of fronto-temporal dementia

Personality change | Aphasia

Presentation of cervical myelopathy

Clumsy hands Paraesthesia Usually bilateral - progresses in severity

UMN signs in MND

Reflex changes | Spasticity

LMN signs in MND

Wasting

Specific signs in ALS

Thenar wasting

Specific signs in progressive bulbar palsy

CN IX-XII presentations

Specific signs in PLS

UMN signs | Pseudobulbar palsy

Specific signs in progressive muscular atrophy

Distal muscles

Pathophysiology of progressive muscular atrophy

Lesion only affects the anterior horn cells

Management of trigeminal neuralgia

Carbamazepine

Investigation of choice for narcolepsy

Multiple sleep latency test

CSF finding in narcoplepsy

Hypocretin

Middle cerebral artery stroke presentation (3)

Contralateral hemiparesis and sensory loss Upper limb MORE Contralateral homonymous hemianopia Aphasia

What artery is blocked in Weber's Syndrome? | What does this supply?

Posterior cerebral artery branches which supply the midbrain

Anterior inferior cerebellar artery stroke presentation (2)

Ipsilateral facial paralysis and deafness | Contralateral weakness of upper and lower limb

Acetylcholinesterase inhibitors

Donepezil Galantamine Rivastigmine

NMDA Antagonist | When used

Memanitine | Severe alzheimer's as adjuvant or monotherapy

Initial medication in parkinson's

Levodopa

Dopamine agnoists used in parkinson's

Cabergoline Bromocriptine Ropinirole Apomorphine

Side effect of levodopa (3)

Dyskinesia Palpitations Postural hypotension

Management of essential tremor

Propranolol

Medication used in Huntington's Disease

Tetrabenazine