Neurology

Question 1

Peripheral neuropathy - examination

Answer 1

1. pressure sensation 10g monofilament pressure at big toe
2. vibration using 128 hZ
3. pin prick sensation
4. ankle reflex

Question 2

Peripheral neuropathy - history and score

Answer 2

1. unsteadiness in walking
2. burning pain at feet at rest/night
3. prickling/tingling sensation
4. numbness

each question 1 point
score =>1 –> Peripheral neuropahty
treatment: amitriptyline

Question 3

TIA - recurrence assessment within 24 hours

Answer 3

ABCD2 score (like melanocytic skin screen)

1. Age > 60 (1)
2. BP > 140/90 (1)
3. Clinical features
   a. unilateral weakness (2)
   b. slurred speech, no weakness (1)
4. duration of TIA
   a. > 60 min (2)
   b. 10-59 min (1)
5. Diabetes (1)

if high score —>

• Aspirin 300mg
• CT head
• keep in hospital