Neurology for neurosurgeons Flashcards

1
Q

What is the difference between delirium and dementia?

A

Delirium is an acute confusional state, has motor signs, slurred speech, altered consciousness, hallucinations, and EEG shows pronounced diffuse slowing.

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2
Q

When would you do a brain biopsy for dementia?

A

For an unexplained neurodegenerative process, preferably those with focal abnormality on MRI.

In those without focal abnormality brain biopsy should be performed within an investigative protocol

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3
Q

What is the difference between common migraine and classic migraine?

A

Classic Migraine is with aura/neurological deficit. resolves in less than 24 hours (complicated migraine resolves in less than 30 days!)

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4
Q

How do you treat refractory cluster headache?

A

Percutaneous RF ablation of sphenopalatine ganglion
ONS
hypothalamic DBS

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5
Q

What causes parkinsonism?

A

Loss of dopamine mediated inhibition of effects of Acetylcholine on basal ganglia

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6
Q

What is the classic triad of Parkinson’s disease?

A

resting tremor, bradykinesia, cogwheel rigidity

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7
Q

How do you differentiate Idiopathic parkinsons from secondary?

A

Gradual onset of symptoms in Parkinson’s and responds well to levodopa, no midline features (ataxia, sphincter disturbance)

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8
Q

What is the classic histological feature of Idiopathic parkinsons?

A

Lewy bodies (eosinophilic intraneural hyaline inclusions)

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9
Q

Which neurones are affected in Parkinsons disease?

A

dopaminergic neurones of the pars compacta of the substantia nigra

This results in reduced dopamine in the neostriatum (caudate, putamen, Globus pallidus)

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10
Q

Symmetrical high signal abnormalities in globus pallidus with no findings on T2 or GRASS

A

Manganese poisoning

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11
Q

What does CO poisoning look like on CT

A

bilateral hypodensity in basal ganglia in globus pallidus

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12
Q

What is Shy-Drager syndrome?

A

Multi-system atrophy (MSA) or Parkinsonism PLUS idiopathic orthostatic hypotension PLUS autonomic dysfunction. Degeneration of preganglionic lateral horn neurones of thoracic spinal cord

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13
Q

What is Steele-Richardson-Olszewski syndrome?

A

Progressive supranuclear palsy

Triad of -
supranuclear palsy
Pseudobulbar palsy
axial dystonia

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14
Q

What percentage of MS patients have trigeminal neuralgia, what is different about their TN?

A

2%

Occurs at a younger age and is more often bilateral.

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15
Q

What is the likely cause for an internuclear ophthalmoplegia?

A

MS affecting the MLF

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