Neurology causes Flashcards
Causes of a high CSF protein in the presence of a normal CSF cell count
- Guillain–Barré syndrome
- Spinal cord tumour causing spinal block (Froin’s syndrome)
- Acoustic neuroma
- Lead encephalopathy
- Subacute sclerosing panencephalopathy
Aseptic meningitis causes
Systemic Diseases:
- Behçet’s Syndrome
Viral Causes:
- Enteroviruses (e.g., Coxsackievirus, Echovirus, Poliovirus)
- Arboviruses (e.g., West Nile Virus)
- Herpes Simplex Virus (HSV)
- Acute HIV infection
Fungal Causes:
- Cryptococcus (especially in patients with AIDS, acute lymphocytic leukemia, and lymphomas)
- Endemic fungi
Bacterial Causes:
- Partially treated bacterial meningitis
- Nocardia
- Mycobacterium Tuberculosis
- Lyme Disease
Parasitic Causes
Drug-Induced:
- Intravenous Immunoglobulin
Peripheral neuropathy causes
Drugs:
- Metronidazole
- Nitrofurantoin
- Isoniazid
- Amiodarone
- Hydralazine
- Dapsone
- Cisplatin
- Vincristine (Chemotherapeutic agent)
- Certain antiretrovirals (for HIV)
- Alcohol (Chronic misuse)
Acute Causes:
- Guillain-Barre Syndrome (motor)
- Porphyria (motor)
- Diphtheria (mixed)
Subacute Causes:
- Vitamin B12 deficiency (painful sensory, with severe later motor symptoms)
Toxins:
- Lead (motor)
Chronic Causes:
- Paraneoplastic syndromes (sensory)
- Monoclonal gammopathy of undetermined significance (MGUS - related to paraproteinaemia)
- Connective Tissue Diseases (mixed)
- Amyloidosis (mixed, with autonomic features and entrapments)
- Chronic kidney disease (Uraemia - mixed)
- Hypothyroidism (mixed)
- Diabetes Mellitus (mixed)
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
Differential diagnosis of brain ring-enhancing lesions
- Cerebral metastases
- Histoplasmosis
- Some primary brain tumours
The differential diagnosis for ring-enhancing lesions in the brain in a patient with HIV includes:
- Toxoplasmosis
- Primary CNS lymphoma,
- Mycobacterial infections,
- Cryptococcosis
- Bacterial or fungal abscesses.
Chorea
- Huntington’s disease
- Wilson’s disease
- Ataxia telangiectasia
- SLE, antiphospholipid syndrome
- Rheumatic fever (Sydenham’s chorea)
- Pregnancy (chorea gravidarum)
- Neuroacanthocytosis
- Thyrotoxicosis
- Polycythemia rubra vera
- CVD
- Drug-induced (oral contraceptive pill, L-dopa, antipsychotics)
- CO poisoning (can also cause parkinsonism)
Absent ankle jerks, extensor plantars
- Subacute combined degeneration of the cord
- Motor neuron disease
- Friedreich’s ataxia
- Syringomyelia
- Taboparesis (syphilis)
- Conus medullaris lesion (cauda equina syndrome)
Causes of stroke in young (≤35 years of age) individuals
- Cerebral haemorrhage
- Meningoencephalitis
- Neoplasm
- Carotid or vertebral dissection
- Migraine
- Inflammatory conditions (vasculitis, antiphospholipid syndrome, isolated cranial angiitis, Takayasu’s disease)
- Structural arterial disease (Fibromuscular dysplasia)
- Cerebral vein thrombosis
- Thrombophilic states
- Cardiac causes (severe hypertension, AF, rheumatic heart disease, mechanical valves, cardiomyopathy, septal defects, PFOs)
- Haematological (polycythaemia, thrombocythemia, paroxysmal nocturnal haemoglobinuria, sickle cell anaemia)
- Mitochondrial disease, e.g. MELAS
Causes of dural sinus thrombosis
- Infections of the face, ear, and sinuses
- Hereditary thrombophilic states
- Hyperviscosity states
- Oral contraceptive pill/pregnancy
- Behçet’s disease
Proximal muscle weakness
- Cushing syndrome
- Acromegaly
- Thyroid disease
- Polymyositis
- Dermatomyositis
- Polymyalgia rheumatica
- Osteomalacia
- Myasthenia gravis
- Electrolyte imbalance
- Drug-induced
- Muscular dystrophy
Headache
- Nicorandil
- Amlodipine
- Sulphasalazine
- Ivabradine
- Carbamazepine
- Isosorbide mononitrate
Confusion
- Amantadine
- Digoxin
Tremor
- Antipsychotics
- Lithium
- Ciclosporin
- Sodium valproate
Psychosis
- Levodopa
- Corticosteroids
Parkinsonism
- Metoclopramide
- Antipsychotics
Slurred speech
- Antipsychotics
- Phenytoin
May exacerbate myasthenia gravis
- Penicillamine
- Quinidine, procainamide
- Beta-blockers
- Lithium
- Phenytoin
- Antibiotics (gentamicin, macrolides, quinolones, tetracyclines)
Conditions that cause upper motor neuron (UMN) and lower motor neuron (LMN) signs
- ALS (motor)
- B12 deficiency with subacute combined degeneration of the cord (motor+ sensory)
- Cervical myelopathy (motor+ sensory)
- Syringomyelia (LMN = arms, UMN = legs, motor+ sensory)
- Friedreich ataxia (ataxia+ motor+ sensory)
- Syphilis (motor+ sensory)
- Hyperthyroidism (motor+ sensory)
Causes of sensorineural deafness
Unilateral:
* Meningioma
* Acoustic neuroma
* Granuloma
* Metastasis
Bilateral:
* Degenerative (presbycusis)
* Aminoglycosides
* Amphotericin
* High-dose loop diuretics
* Mumps
* Rubella
Causes of serotonin syndrome
Causes of abdominal pain and neuropathy
- Acute intermittent porphyria (AIP)
- Lead poisoning
- Arsenic poisoning
- Guillain–Barré syndrome
- Polyarteritis nodosa
- Diabetic ketoacidosis
- Intra-abdominal malignancy
- Sarcoidosis
- Alcohol abuse
Drugs that can lower seizure threshold
- Antibiotics: Imipenem, penicillins, cephalosporins, metronidazole, isoniazid
- Antihistamines
- Antipsychotics
- Antidepressants: Bupropion, Tricyclics
- Baclofen
- Fentanyl
- Ketamine
- Lidocaine
- Lithium
- Meperidine
- Propoxyphene
- Theophylline
Most common sites for hypertensive intracranial hemorrhage
- Putamen (part of basal ganglia) (44%)
- Thalamus (13%)
- Cerebellum (9%)
- Pons (9%)
- Other cortical areas (25%)
Causes of autonomic neuropathy
- Diabetes
- Chronic renal failure
- AIDS
- Primary amyloidosis
- Porphyria
- Parkinson’s disease
- Guillain-Barré syndrome
Causes of third nerve palsy
- Posterior communicating artery aneurysm
- Mononeuritis multiplex
- Myasthenia gravis
- Multiple Sclerosis
- Vascular lesions
- Meningitis
- Ophthalmoplegic migraine
