Neurology: UWorld Flashcards by Caitlin Heim

Tx for MG

pyridostigmine

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Gait apraxia: description, assoc. signs, cuases

“freezing”: starting to turn and hesitating
assoc signs: dementia, incontience, frontal lobe signs
causes: frontal lobe degeneration

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Unilateral motor impairment + no sensory or cortical deficits + no visual field abnormalities ==> Lesion?

posterior limb of internal capsule (lacunar infarct)

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posterior limb of internal capsule occlusion ==> deficits?

Unilateral motor impairment + no sensory or cortical deficits + no visual field abnormalities

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Contralateral somatosensory &amp; motor deficit
\+ eye deviation 
\+ homonymous hemianopsia
\+ aphasia
\+ hemineglect

= lesion?

middle cerebral artery

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middle cerebral artery occlusion ==> deficits?

Contralateral somatosensory & motor deficit
+ conjugate eye deviation towards side of infarct
+ homonymous hemianopsia
+ aphasia
+ hemineglect (nondominant hemisphere)

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contralateral somatosensory & motor deficit @ lower extremity
+ abulia
+ dyspraxia, emotional disturbances, urinary incontinence

= lesion?

anterior cerebral a. occlusion

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anterior cerebral a. occlusion ==> deficits?

contralateral somatosensory & motor deficit @ lower extremity
+ abulia
+ dyspraxia, emotional disturbances, urinary incontinence

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contralateral hemiplegia + ipsilateral CN
+/- ataxia

==> lesion?

vertebrobasilar system lesion

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vertebrobasilar system lesion ==> deficits

contralateral hemiplegia + ipsilateral CN

+/- ataxia

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DM CNIII damage ==> ?

ptosis + down adn out gaze

- (sparing of parasymp) ==> normal light and accomodation

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Dementia w/Lewy bodies ==> sx?

alteration in alertness
visual hallucinations
extrapyramidal sx

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New dx of MG ==> testing?

CT to look for thymoma

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Characteristics of central cord syndrome

often 2/2 hyperextension injuries

- weakness UE > LE + localized pain/temp sensation deficit

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Anterior cord syndrome ==> ?

bilateral spastic motor paresis distal to lesion

- usually 2/2 occlusion of ant. spinal arter

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Brown-Sequard syndrome ==> ?

BS = hemisection of cord; usually w/penetrating injury
ipsilateral: weakness, spasticity, loss of vibation/proprioception
contralateral: loss of pain/temp

Most important risk factor for stroke

HTN

Cause of lacunar stroke

microatheroma/lipohyalinosis of small penetrating aa.

- ==> internal capsule ==> pure motor

Neuro fxn preserved in brain death

deep tendon reflexes

N. that provides corneal sensation

V1 (opthalmic br.)

Cause of hemi-neglect

hemi-neglect = ignoring left side of space

- 2/2 to injury @ right (non-dominant) parietal lobe

Peripheral vs. central facial palsy

peripheral = loss of forehead/brow movements

- central = sparing of forehead/preservation of forehead/brow movements

Cauda equina vs. Conus medullaris

Cauda = n. root compression
bilateral radicular pain
saddle anesthesia
asymmetric motor weakness
hyporeflexia/areflexia
late bowel/bladder dysfxn

Conus =
sudden back pain
perianal anesthesia
symmetric motor weakness
hyperreflexia
early bowel/bladder dysfxn

Features of myesthenia gravis

sx: intermittent eyelid drooping, double vision
ptosis bilateral
impairment of EOM

Cause of benign positional vertigo

-dislodgement of otoliths ("otoconia") fromm their usual position within the utricle ==> the semicircular canal

Cause of impotence with use of SSRIs

abnormal serotonin levels/regulation ==> impairment of arousal and excitement

C6 radiculopathy ==> ?

- loss of sensation @ lateral arm/thumb - mild weakness of wrist extension - decreased biceps reflex

Acoustic shwannoma ==> sx?

- hearing loss - tinnitus - vestibular problems - facial numbness/tingling - rarely facial paralysis

Lead poisoning ==> ?

- limb ataxia - wrist or foot drop - GI problems - microcytic anemia

Syringomyelia ==> ?

- Syringomyelic syndrome = lesion of central gray matter - Pain and temperature fiber ==> bilateral loss of these sensations over several dermatomes - tactile sensation is spared - m. wasting @ upper extremities

ALS ==> sx?

- loss of anterior horn cells (lower motor neurons) in the spinal cord and motor nuclei of the brainstem - loss of large motor neurons or Betz cells (upper motor neurons) in the frontal cortex - degeneration of the corticospinal tract = axial/limb motor