neurology session Flashcards
1
Q
what are some common presentations of neurological problems
A
- confusion
- coma
- memory loss
- attacks or altered consciousness
- gait disturbances or imbalance
- movement problems
- headache
- pain or parathesiae
- visual loss or change
- sensory disturbance
- weakness
- dizziness
- problems swallowing or speaking
2
Q
what are some common conditions
A
- dementia
- mutliple sclerosis
- head injury
- parkinson’s
- neurodegenerative conditions
- peripheral neuropathies
- muscle diseases
- stroke
- epilepsy
- migraine
- meningitis and encephalitis
- spinal cord disease
- neuromuscular diseases
- CNS tumours
- sleep disorders
3
Q
what are some symptoms of myasthenia gravis
A
- intermittent double vision
- slurred speech
- difficulty swallowing
- symptoms are worse at the end of the day
4
Q
what are some signs of myasthenia gravis
A
- ocular, facial and bulbar weakness
- fatiguable symptoms
- bilateral fatiguable ptosis
- bilateral facial weakness
- fatiguable dysarthria
- poor cough and neck flexion weakness
- mild fatiguable Proxima limb weakness
5
Q
what is ptosis
A
- drooping of upper eyelid
6
Q
what is the pathogenesis of myasthenia gravis
A
- autoimmune disorder = AB’s to EACh receptor at post-synaptic NMJ
- association with other autoimmune disorders
- may be associated with thyme hyperplasia or thymoma
- affects young women in 20’s and older men in 70’s
- fatiguable weakness of ocular, bulbar, neck, respiratory and/or limb muscles
- AB’s to ACh receptor present in 85% of cases
- single fibre EMG and repetitive nerve stimulation also present
7
Q
what is the management of myasthenia gravis
A
- managed with pyridostigmine (anti-acetylcholine esterase) and immunosuppressive therapies (steroids and IV immunoglobulin)
8
Q
if tongue is deviating towards the left what does that mean
A
- left hypoglossal nerve isn’t working
9
Q
what can hypoglossal nerve damage be a complication of
A
- prolonged intubation
10
Q
what is anarthria
A
- unable to form speech
11
Q
what are some signs and symptoms of motor neurone disease
A
- progressive dysarthria/anarthia over months
- progressive dysphagia over months
- emotional lability and change in personality
- struggles to move tongue and palate
- affects speech and swallowing
- limb weakness often presented with, but a 1/4 of patients present with progressive speech and swallowing difficulties
12
Q
what can be used for patients who can’t speak
A
- light writer
- types into machine which then speaks
13
Q
what are the signs and symptoms of Tourettes
A
- presents under the age of 18
- involved motor and speech tics
- involuntary vocalisations
- co-morbid and anxiety and obsessive symptoms
14
Q
what can speech and motor difficulties be brought on by
A
- bacterial meningitis
15
Q
what is a hemifacial spasms
A
- blood vessel that supplied posterior brain that crosses brainstem and touches nerve root for facial nerve on one side and irritates it and causes that continuous firing
- twitching of muscles of face
- gradually worsening
