Neurology Brief Flashcards
Describe trigeminal neuralgia.
Paroxysmal attacks of severe intense burning pain in the trigeminal distribution.
What is the first-line medical treatment for trigeminal neuralgia?
Carbamazepine.
What is the second-line medical treatment for trigeminal neuralgia?
. 1st line: Carbamazepine
2nd line: Gabapentin and amitriptyline
What is the most common virus causing trigeminal neuralgia?
Herpes Zoster Virus (HZV or varicella).
Do you know two important case scenarios related to trigeminal neuralgia?
1. Paroxysmal attacks of pain at face + redness
- Paroxysmal attacks of pain at face + history of redness at face
- Paroxysmal attacks of pain at face + redness = varicella neuralgia.
- Paroxysmal attacks of pain at face + history of redness at face = post-herpetic neuralgia.
1st line of TTT of trigeminal neuralgia……………….
1st line of TTT of bipolar in pregnancy………….…..
1st line of TTT of epilepdy in pregnancy…..………..
1st line of TTT of complex partial seizure…………..
1st line of TTT of trigeminal neuralgia………………. carbamazipine
1st line of TTT of bipolar in pregnancy………….….. carbamazipine
1st line of TTT of epilepdy in pregnancy…..……….. carbamazipine
1st line of TTT of complex partial seizure………….. carbamazipine
Carbamazepine is also linked to fetal abnormalities, but not with intellectual impairment, and should not be used during pregnancy.4
Lamotrigine poses a lower risk during pregnancy and can be prescribed to breastfeeding mothers, with 2.7% of babies having congenital abnormalities; however, it has limited efficacy in preventing mania.
Lithium is the most effective mood stabiliser,6 with demonstrated efficacy in the prophylaxis of postpartum relapse,7 and should be considered for women with seveare bipolar disorder. RACGP
MCC/ MC RF of intra-cranial Hge…
HTN
A condition where weakness starts at lower limbs and ascends upward, often associated with a history of gastrointestinal infection or vaccination.
Guillain-Barre Syndrome (GBS).
CSF findings in GB$……………………………………..
cyto- albuminous dissociation
How is Guillain-Barre Syndrome (GBS) treated?
Plasmapheresis or IVIG.
enzypenicilin for propholayxis
TTT of GB$ with affected respiratory ms………….
plasmapheresis
Most imp monitoring of pt with GB$ ………………..
Most imp monitoring of pt with GB$ ……………….. lung vital capacity (spirometry)
Pt with ptosis, diplopia & muscle weakness after periods of activity which improves with rest………
Dx: myasthenia gravis
What is the most important sign in a patient with Guillain-Barre Syndrome (GBS)?
Areflexia.
Describe Myasthenia Gravis.
A condition characterized by ptosis, diplopia, and muscle weakness that improves with rest.
Most common cp………MG
drooping eyelid
Most common tumour associated ……MG
thymoma
Most imp inv……..MG NO longer done
Most imp inv……..edrophonium test
Drug of choice……MG
physostigmine and neostigmine
pt with prolonged use of cortisone develops ms weakness…
pt with prolonged use of cortisone develops ms weakness… Dx: steroid- induced myopathy
Pt with sudden severe headache then develops nausea& vomiting…
Dx: Sub-Arachnoid Hge (SAH)
What is the most common association with Myasthenia Gravis?
Thyrotoxicosis.
What is the most common complication of Myasthenia Gravis?
Respiratory impairment.
How is Subarachnoid Hemorrhage (SAH) managed?
Coiling or restenting (Endovascular therapy).