Niwroloji Flashcards
What are the causes of thiamine (vitamin B1 ) deficiency?
Alcohol excess
Malnutrition
What does wernicke’s encephalopathy cause?
Nystagmus, ophthalmoplegia and ataxia. (b1 deficiency)
Whst is an epileptic-like seizure but with no characteristic electrical discharges called?
Psychogenic non-epileptic seizures
What are lacunar infarcts?
Small infarcts around the basal ganglia, thalamus, internal capsule and pons
What are the symptoms of lacunar infarct?
Unilateral weakness of (+- sensory deficit) of any combination of face arm and leg
Pure sensory stroke
Ataxic hemiparesis
Define ataxia
Term for group of disorders that affect co-ordination, balance and speech
In what part of the brain are early alzheimers changes likely to be seen?
Temporal lobe
What is Bell’s palsy?
An idiopathic facial nerve palsy typically giving unilateral faciak nerve weakness with involvement of the forehead as it affects the lower motor neurones
Dementia-y symptoms and Cardiovascular risk factors means what?
Vascular dementia
Dementia-y symptoms in a 20-40yr old and strong family history means what?
Huntington’s disease
Dementia-y symptoms and myoclonic jerks?
CJD (creutzfeldt-jakob disease)
Dementia-y symptoms and visual hallucinations?
Lewy body dementia
Dementia-y symptoms, dysphagia, dyspraxia and problems with spacial navigations and visual awareness and persucatory beliefs
Alzheimer’s disease
Dementia-y symptoms with executive function impairment and personality change
Picks disease/ fronto-temporal dementia
Dementia-y symptoms with urinary incontinence and abnormal gait
Normal pressure hydrocephalus
What pathological features are associated with Levy body dementia ?
Alpha synuclien
Donepezil and galantamine are examples of what?
Cholinesterase inhibitors
Rivastigmine is an example of what?
Butyl and acetylcholinesterase inhibitors
What type of medication is an NMDA receptor blocker?
Memantine
What is the treatment for Alzheimer’s dementia?
Donepezil, rivastigmine and galantamine are licensed for mild to moderate
Memantine for moderate to severe Alzheimer’s
What are the components of a neurological ROS?
Headache Fits, faints or funny turns Vision Hearing Speech and swallow Sensation Balance or coordination Memory
What are headache red flags
Sudden onset high severity headache
Headache with fever
New onset neurological deficit
New onset cognitive dysfunction
Change in personality
Impaired level of consciousness
Recent head trauma (within past three months)
Headache triggered by cough, sneeze, exercise, or changes in posture.
Headache associated with halos around lights or headaches that get worse in the dark.
Headache associated with jaw claudication and scalp tenderness.
20 minutes episodes of unilateral, debilitating episodes of retro-orbital pain with eye redness and watering means what?
Cluster Headache
Headache triggered by changes in position or exertion. Vision changes on leaning forward means what?
Increased inter cranial pressure
Describe common presentation of sinusitis?
Facial tenderness and rhinorrhea
Tight band like painful sensation precipitated by stress means what?
Tension headache
Describe common presentation of trigeminal neuralgia
Brief, stabbing pain when brushing teeth or chewing
Describe common presentation for migraine
Unilateral, pounding, multiple triggers, lasts for hours, aversion to bright lights and loud noises, may be precipitated by aura
Describe common presentation for acute glaucoma
Pain around eye, blurred vision with halos around lights
Photophobia, neck stiffness and fever means what?
Meningitis
Sudden onset excruciating headache likely means what?
Sub-arachnoid hemorrhage
Scalp tenderness and unilateral jaw claudication means what ?
Temporal Arteritis
What is TLC?
Transient Loss of Consciousness
What TLC is triggered by suddenly standing up?
Postural hypotension
What is cause of TLC triggered by vigorous exercise in you person?
Hypertrophic cardiomyopathy/ cardiogenic syncope
Collapse on shaving / whilst turning head likely to be due to?
Carotid sinus hypersensitivity
What does TLC due to aortic stenosis look like?
Chest pain, breathlessness and collapse on exertion
TLC with palpitations and chest pain beforehand. Family history of early death. Indicative of what?
Arrhythmia/ cardiogenic syncope
Vasovagal syncope is caused by what? And preceded by what?
Pain, micturition, fear and prolonged standing. Preceded by sweating, nausea and pallor. No confusion
Twitching and jerking in the morning means what?
Early morning myoclonus
Violent shaking, head moving from side to side, arching back, episodes of stillness before starting again and forced eye closure means what?
Psychogenic non-epileptic attack
Crying out, falling to the floor, period of stiffness followed by rhythmic jerking that gradually decreases in amplitude and frequency, confused for 30mins afterwards means what?
Generalized tonic-clinic seizure
What are the signs of upper motor neuron lesion ?
Increased reflexes and increased tone
What are the signs of lower motor neurons lesion?
Decreased reflexes, normal/decreased tone, fasciculations.
Tonic-clinic seizure, what immediate assessments do you want?
Vvitals and O2 sats, BM, ECG, neuronexam and bloods to check for acute metabolic disturbances e.g. hyponatraemia, hypocalcaemia
What is a stereotypical pattern for seizures? (They’re almost always the stereotype)
They take the same for with similar sequences of events, can arise from sleep, they tend to cluster, not especially effected by stress, and emotional shocks,
What % of epilepsy cases are medically refractory
20-30%
What are the signs of cerebellar lesions?
D -Dysmetria (past-pointing) A - Ataxia N- Nystagmus I- Intension tremor S-Slurred staccato speech H-Hypotonia
What are the causes of cerebellar disorders
P-paraneoplastic A-alcohol S-stroke/sclerosis T-trauma R-rare fredricks I-iatrogenic E-endocrine (hypothyroid) S-space occupying lesions
