Neurology Crash Course Flashcards
What is the most appropriate management?
IV phenytoin
Status epilepticus
Convulsive seizure lasting >5mins recurring seizures without recovery
Status epilepticus management
What management?
Urgent CT head
Stroke - classification
Stroke management
Face Arm Speech Time HASU - hyperacute stroke unit CT head within an hour If bleed - neurosurgical opinion, BP control and monitoring If ischaemic - within window? 4.5 hours? Thrombolysis/thrombectomy (slightly longer time) + aspirin 300mg
Most likely diagnosis?
Charcot Marie tooth
Charcot Marie tooth
Collection of hereditary peripheral neuropathies due to an inherited mutation
Multiple subtypes with different mutations
Slowly progressive, distal calf atrophy, pes cavus, clumsy walking, weakness, sensation reduced + positive fH
Peripheral neuropathy - polyneuropathy
L46 SO4 E3
EYE MOVEMENTS
What is the cause?
3rd nerve palsy
Usually eye down and out, usually ptosis also
Third nerve palsy
Oculo-motor nerve damage
Innervates the eyelid, extra-ocular muscle and pupil
Damage anywhere leads to a down and out eye with or without pupillary dilatation
Concerning for cerebral aneurysm
DOT - dilated pupil
HAM - constricted pupil
Dilated vs constricted pupil
MRI spine - suspected inflammatory lesion in the lower thoracic spine
No compression or vascular abnormality
Imaging of the brain shows multiple areas of demyelination
LP - oligoclonal band +
Most likely diagnosis?
Multiple sclerosis
MS
Chronic autoimmune condition characterised by demyelination
Immune-mediated inflammatory disease, which affects the CNS
Can affect multiple sites
Typically a relapsing/remitting pattern
Aided by MRI
Myelopathy
MS treatment
IV methylprednisolone
Managing MS
Acute headache treatment?
Sumatriptan
Topiramate and propranolol help to…
Prevent headache
Migraine
Headache red flags
Worse on lying, sudden/severe, worse on standing, recent trauma, fever, meningism, previous malignancy, papilloedema
Headache overview
20/30 MOCA
CT head - diffuse cerebral atrophy, mild burden of small vessel disease but no mass/infarct/bleeding
Most likely cause of cognitive impairment?
Based on history - HTN and vascular disease
Predominant memory loss, no previous stroke and low burden
Alzheimer’s likely
Dementia overview
ADLs affected
Alzheimer’s most common for dementia
Dementia aetiology overview
Most important info to give to the patient?
The drug may cause impulse control disorder
Parkinson’s
Loss of dopaminergic neurones within the substantia nitrates
Characterised by Parkinsonism (Bradykinesia, resting tremor, rigidity, postural instability)
Boost dopamine levels
Parkinson’s treatment overview
Impulse control disorder with dopamine agonists
