Neuroscience Flashcards
What two things are easy to forget to ask for in a headache history?
- Any particular stress at the moment
- Any use of over the counter medication
In headaches what eye symptoms need to be asked about?
Need to ask whether the patient has migraines with or without aura.
Aura includes blurring of vision, black outs or black dots/zig zagged lines.
If someone presents with a collapse what do you ask?
When did it start? Sudden or Gradual? What were you doing at the time? Did you fall to the floor? Did you loose consciousness ? Did anyone witness the attack? Did they say you were seizing? History of epilepsy? Did you loose contience? Did you injure yourself? How did you feel before the collapse? Any change in vision? How did you feel after collapsing? Did you have a headache? Did you notice any weakness or numbness to limbs Did you notice any changes to speech or vision? Any episodes like this in the past? Past head injury? When was the last time they ate? Any recent injury?
When asked about sudden onset weakness- what do you ask?
- when
- what were you doing
- which limbs are affected
- is one side or both sides affected
- does the patient have numbness or lack of power anywhere
- is the patient in any pain.
- does the patient have any similar episodes like this in the past
- any changes in visual or speech
- suffered from any headaches
- suffered from any loss of consciousness did they fall to the floor?
- any cardiovascular changed
If someone has collapsed think of 3 possible causes?
Abdominal pain or headache —> subarachnoid haemorrhage or AAA
Abdominal pain: ectopic pregnancy
Diabetic patients: ask when they last ate
Compare and contrast extra dural and sub dural haematomas
Subdural: rupture of bridging veins. There will be a fluctuating level of consciousness over a couple of weeks
Extradural: fracture of the temporal bone leading to tear of the middle meningeal artery. This will lead to brief unconsciousness. Then a lucid interval and then rapidly deteriorating condition as the ICP increases
What are 4 signs of an increase in ICP
Headaches
Confusion
Seizures
Vomiting
3 features of Parkinson’s:
Rigidity
Bradykinesia
Resting Tremor
+ stoop, decreased smell and stooped posture
HEADACHES: WHAT SHOULD YOU ALWAYS ASK??
Pain in scalp
Watering Eye
Rhinorrea
Miosis or ptosis
** All above are symptoms of a cluster headache**
What is the treatment of MS:
Acute: steroids (IV methylprednisolone)
Chronic: Interferon IB or IA
+ dimethyl fumarate
Symptomatic treatment give Baclofen and Botox injections
Treatment of Myasthenia Gravis
Diagnosed with anti-AChR antibodies
Pyridostigmine (anti-cholesterase)
MND treatment
Anti-glutamergic drug Riluzole
Spasm: baclofen
Analgesia: NSAIDs
What is MS?
It is a chronic autoimmune T cell mediated inflammatory response of the CNS. It involves multiple plaques of demyelination in the brain and spinal cord. Affects oligodendrocytes and only brain white matter!
Name the 3 types of MS
Relapsing Remitting
Secondary Progressive
Primary progressive MS: worse from the start no release or remitting sections
MS: what do people initially present with? And name a few other symptoms:
Unilateral optic neuritis (pain in one eye) and reduced central vision Numbness and tingling in the limbs Leg weakness Cerebellar symptoms Trigeminal neuralgia Bladder and sexual problems
