Neurology Intro Flashcards
1
Q
What is included in a neurological systems review?
A
- Fits, faints and funny turns
- Headaches
- Memory problems
- Altered vision
- Hearing difficulties
- Speech and swallowing difficulties
- Weakness
- Numbness, tingling
- Balance or co-ordination difficulties (vertigo/dizziness)
- Incontinence or erectile dysfunction
2
Q
What are the features of a cluster headache?
A
- Occur lots in the space of a few weeks before having months symptom free
- Usually occur at night
- Unilateral retro-orbital pain with red eye and watering
- Tend to last between 15-180 mins, with most episodes lasting less than an hour
- Sufferer will be unable to stay still
- Associated with unilateral autonomic dysfunction, including eye watering, eye injection and nasal congestion
3
Q
What are the features of a migraine?
A
- Evenly spread episodes throughout the year
- Can last from a few hours to 72hrs
- Tend to relieve symptoms by lying down in a dark room
- Unilateral, pounding
- Aura symptoms
- N+v
- Photophobia
- Phonophobia
4
Q
What is a tension headache?
A
Tight, band-like sensation, precipitated by stress.
5
Q
What is trigeminal neuralgia?
A
Brief, stabbing pain when brushing teeth or chewing
Do not give opioids
6
Q
What are the characteristic features of meningitis?
A
- Photophobia
- Neck stiffness
- Fever
7
Q
How does raised ICP and SAH present?
A
- Raised ICP is headache triggered by changes in position or exertion, changes in vision with leaning forward.
- SAH: sudden onset, excruciating headache
8
Q
What is acute glaucoma and sinusitis?
A
- Acute glaucoma: pain around eye, blurred vision with halo around lights
- Sinusitis: facial tenderness, rhinorrhoea
9
Q
What are the NICE headache red flags?
A
- Sudden onset with high severity headache
- Headache with fever
- New onset neurological deficit
- New onset cognitive dysfunction
- Change in personality
- Impaired level of consciousness
- Recent head trauma (within 3 months)
- Headache triggered by cough, sneeze, exercise or changes in posture (valsalva manoeuvres)
- Headache associated with halos around lights or headaches get worse in the dark
- Headache associated with jaw claudication and scalp tenderness
10
Q
What are the different types of TLoC?
A
- Syncope: vasovagal or cardiogenic
- Seizure: provoked or unprovoked
- Psychogenic non-epileptic attacks (Non-Epileptic Attack Disorder - NEAD)
- Rarer causes: migranous events, vestibular disorders, cerebrovascular events, sleep disorders
11
Q
How do you diagnose TLoC?
A
HISTORY
- Pre-syncopal symptoms - cold, lightheaded
- Seizure, jerking/twitching
- Abnormal taste/smell
- After were they confused
- Were they unconscious
12
Q
What are the features of syncope?
A
- Syncope: loss of consciousness caused by lack of cerebral blood supply
- Motor activity is common - esp. if prolonged or upright (symptoms don’t last long): twitching of limbs, stiffening + jerking, tongue biting and incontinence can occur
- Clear presyncopal symptoms (PPP): position, provocation, prodromal (visual blurring etc)
13
Q
What is non-epileptic attack disorder?
A
- Causes episodes of LOC with no electrical abnormality
- Usually pelvic thrusting and back arching whilst conscious - bilateral limb movement
- Presents also as slumping suddenly - HR and BP remain normal
- Psychogenic condition - treatment is psychotherapy
14
Q
What conditions cause TLoC?
A
- Postural hypotension: triggered by suddenly standing
- Vasovagal syncope: triggered by fear, pain, micturition or prolonged standing. Preceded by pallor, nausea or sweating. No confusion after.
- Aortic stenosis: chest pain, SOB and collapse on exertion
- HCOM/cardiogenic syncope: triggered by vigorous exercise in young person
- Arrhythmia/cardiogenic syncope: palpitations or chest pain beforehand, FH of sudden unexplained death
- Carotid sinus hypersensitivity: collapse on shaving or turning head
15
Q
How would absence seizures present?
A
Being told off by teachers for seemingly daydreaming.
