Neurology Lists

Question 1

Causes of ACUTE polyneuropathy (4)

also for predominantly motor neuropathy

Answer 1

Guillain-Barre Syndrome
Lead Toxicity
Porphyria
Diptheria

Question 2

Causes of SUBACUTE polyneuropathy (3)

Answer 2

Drugs - “PAIN”
Toxins - EtOH
B12 deficiency
Hypothyroidism

Question 3

Causes of CHRONIC polyneuropathy (4)

Answer 3

Diabetes
Malignancy / paraneoplastic / paraproteinaemia
Hereditary conditions
Uraemia

Question 4

Drugs that cause peripheral neuropathy (4)

PAIN drugs!

Answer 4

Phenytoin
Amiodarone
Isoniazid
Nitrofurantoin

Question 5

Investigations for peripheral neuropathy?
Nerve related (2)
Underlying cause (7)

Answer 5

Nerve conduction studies
-> axonal vs demyelinating
EMG

Fasting glucose / HBa1C
UEC
TFT
ESR / Auto-antibodies
B12 levels
SPEP
\+/- LP 
-> raised proteins for GBS

Question 6

Initial investigations to guide acute management if GBS suspected?

Answer 6

Vital capacity
ABG
Bulbar function
ECG + BP - autonomic compromise / arrhythmia
Stool culture - campylobacter

Question 7

Palpable peripheral nerves (4)

Answer 7

Hereditary forms of neuropathy
Leprosy
Acromegaly
Amyloidosis

Question 8

Difference between demyelinating neuropathy and axonal neuropathy

Answer 8

Demyelinating = loss of velocity
Axonal = loss of amplitude
Can have secondary axonal loss in demyelinating neuropathy

Question 9

Small fibre neuropathy

Answer 9

Pain and temperature - small diameter axons
(vibration / proprioception relatively preserved)
Diabetes
Alcohol

Question 10

Features of autonomic neuropathy (6)

Answer 10

Postural hypotension
Arrhythmia 
Abnormal sweating
Ileus
Urinary retention
Impotence

Question 11

Management of peripheral neuropathy (4)

Answer 11

Reverse underlying cause if possible
Treat pain with neuropathic agents
Monitor for complications such as ulcers
Appropriate footwear / gait aid to improve function

Question 12

Mononeuropathy multiplex can mimick polyneuropathy - what are the causes (5)

Answer 12

Diabetes
Vasculitis
CT disease
Malignancy
Amyloidosis

Question 13

Miller-Fisher Syndrome (3)

Associated with anti-ganglioside antibodies in serum

Answer 13

Ataxia
Arreflexia
Opthalmoplegia

Question 14

MRC grading scale

Answer 14

0 = no contraction
1 = flicker
2 = active movement when gravity is eliminated
3 = active movement against gravity 
4 = active movement against gravity and resistance
5 = full power

Question 15

Cerebellar face signs (4)

Answer 15

Head tremor
Jerky eye movements
Nystagmus
Dysarthric speech

Question 16

Cerebellar arm signs (3)

Answer 16

Rebound phenomenon
Intention tremor and/or past pointing (dysmetria)
Dysdiadochokinesia

Question 17

Cerebellar leg signs (3)

Answer 17

Heel shin incoordination
Ataxic gait
Romberg’s NEGATIVE in pure cerebellar syndrome

Question 18

Common causes of cerebellar ataxia
“Drugs Make Vera Tumble”
3 D 2 M 2 V 1 T

Answer 18

Developmental - Arnold Chiari
Degenerative - Spinocerebellar ataxia
Drugs - phenytoin / EtOH
Metabolic - thiamine deficiency
Multiple sclerosis
Vascular - stroke
Viral / infective - viral cerebellitis (children)
Tumours - primary, secondary, paraneoplastic

Question 19

Causes of paraneoplastic cerebellar syndrome

Answer 19

Small cell lung cancer
Ovarian carcinoma
Lymphoma

Associated with anti-neuronal antibodies
Anti Yo + Anti Hu

Question 20

Friedreich’s ataxia - other features (5)

Answer 20

Kyphoscoliosis
Optic atrophy
Sensory neuropathy
Cardiomyopathy
Diabetes

Question 21

What are the causes of spastic paraparesis?

Intrinsic (4)
Extrinsic (3)
Congenital (3)
Degenerative (1)

Answer 21

Transverse myelitis
Connective tissue disorders
Demyelination
Spinal cord infarction

Spondylosis
Tumour
Haematoma

Spina bifida
Cerebral Palsy
Hereditary spastic paraparesis

Primary lateral sclerosis