NEUROLOGY management Flashcards
Myoclonic seizures female ?
Levetriacetam - lamotrigine can make myoclonic seizures worse
Management of myasthenic crisis?
IV immunoglobulin and plasmapheresis
Cluster headache?
100% oxygen and SC sumatriptan
Trigeminal neuralgia management?
Carbamazepine
Cluster headache prophylaxis?
Verapamil
Management of raised ICP?
-IV mannitol
-CSF drainage
How does IV mannitol work in ICP secondary to brain injury?
osmotic shift of water out of brain parenchyma
Controlling spasticity in MS?
Baclofen and gabapentin
Guillan barre treatment?
IV immunoglobulins
TIA with carotid artery stenosis >50%?
Carotid endarterectomy
Stopping of antiepileptic drugs time period?
considered if seizure free for > 2 years - stop over 2-3 months
When is time cut off for thrombolysis in managameen of ischameic stroke?
-4.5 hours from symptoms onset
-Can be performed 4.5-9 hours if patient was well 4.5 hours previously
What is the reason for the 4.5 hour cut off?
risk of haemorrhagic transformation is too high
Neuroleptic malignant syndrome blood results?
-Raised CK (AKI)
-Leukocytosis (raised WCC)
Gold standard testing for venous sinus thrombosis?
MR venogram
What is alternative to MR venograpahy?
CT venogrpahy
what are the specific syndromes of sinus thormbosis?
- Saggital sinus thrombosis
- Cavernous sinus thrombosis
- Lateral sinus thormbosis
What are the common features of intracranial venous thrombosis?
Headache (sudden onset)
Nausea and vomiting
Reduced consciousnes
What kind of sinus thrombosis is most common?
50% patients have isolated sagittal sinus thrombosis (remainder have coexisting lateral sinus and cavernous sinus thrombosis)
Other investigation with intracranial venous thrombosis?
-Non contrast CT (normal 70%)
-D-dimer may be elvated
