neurology session Flashcards
what are some common presentations of neurological problems
- 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
what are some common conditions
- 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
what are some symptoms of myasthenia gravis
- intermittent double vision
- slurred speech
- difficulty swallowing
- symptoms are worse at the end of the day
what are some signs of myasthenia gravis
- 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
what is ptosis
- drooping of upper eyelid
what is the pathogenesis of myasthenia gravis
- 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
what is the management of myasthenia gravis
- managed with pyridostigmine (anti-acetylcholine esterase) and immunosuppressive therapies (steroids and IV immunoglobulin)
if tongue is deviating towards the left what does that mean
- left hypoglossal nerve isn’t working
what can hypoglossal nerve damage be a complication of
- prolonged intubation
what is anarthria
- unable to form speech
what are some signs and symptoms of motor neurone disease
- 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
what can be used for patients who can’t speak
- light writer
- types into machine which then speaks
what are the signs and symptoms of Tourettes
- presents under the age of 18
- involved motor and speech tics
- involuntary vocalisations
- co-morbid and anxiety and obsessive symptoms
what can speech and motor difficulties be brought on by
- bacterial meningitis
what is a hemifacial spasms
- 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
how can hemifacial spasms be treated
- with injections to the right side of th face or alternatively, surgical protection from the nerve root by putting a sheath over it
what is an example of a functional neurological disorder
- onset is abrupt
- variety of presentations
- not caused by a muscle weakness
- can be improved by distraction
- sometimes have psychological origin but not always
what is dystonia
- involuntary muscle activation
- can be related to medications
- affects speech and impacts on her breathing and swallowing
what are some symptoms fo Parkinson’s disease
- affects walking, talking, motor function
- tremors
how can Parkinson’s be treated
- surgical procedure
- deep brain stimulation
- implant electrodes deep in the brain in the sub thalamic nucleus and attach electrodes to simulator in the anterior chest wall and programme simulation by impulse generator to try and improve symptoms
- only 10-15% of patients will benefit from this
- tremor can be stopped/greatly improved from it
