NUMBNESS/WEAKNESS Flashcards
numbness/weakness key hx: onset
acute, chronic, relapsing
numbness/weakness key hx: location
distribution (UL/BL, proximal/distal)
numbness/weakness key hx: timing
duration/progression
numbness/weakness key hx: character
pain (headache, neck/back pain)
numbness/weakness key hx: assoc. sxs
constitutional sxs
other neuro sxs
numbness/weakness key hx: med hx
hx or diabetes, alcoholism, atherosclerotic vascular dz
numbness/weakness key PE
VS
neuro and MSK exams
relevant vascular exam
TIA ddx
stroke
migraine with sensory aura
hypoglycemia
seizure with Todd paresis
TIA w/u
ct head cbc elytes, glucose fasting lipid panel ecg mri brain doppler u/s carotid echocardiography eeg
stroke ddx
tia seizure with Todd paresis intracranial neoplasm subdural or epidural hematoma hypoglycemia
stroke w/u
ct head cbc elytes, glucose pt/ptt/inr fasting lipid panel mri brain mra doppler u/s carotid echocardiography ecg
guillain-barre syndrome ddx
MS
transverse myelitis
spinal cord compression
peripheral neuropathy
guillain-barre syndrome w/u
cbc elytes mri spine cpk electromyography nerve conduction studies lp -- csf analysis PFTs serum b12
MS ddx
stroke cns vasculitis conversion disorder malingering cns tumor vitamin b12 deficiency neurosyphilis
MS w/u
cbc esr ana, anca vdrl/rpr serum b12 mri brain, spine lp -- csf analysis visual evoked potentials
diabetic peripheral neuropathy ddx
alcoholic peripheral neuropathy b12 deficiency uremic nephropathy hypocalcemia hyperventilation paraproteinemia/myeloma
diabetic peripheral neuropathy w/u
HbA1c glucose esr calcium serum b12 ua TFTs urea, elytes serum and urine protein electrophoresis emg nerve conduction studies
myasthenia gravis ddx
MS
intracranial neoplasm compressing CN III, IV, or VI
Horner syndrome
botulism
MG w/u
ice pack test tensilon (edrophonium) test anti-AChR Abs emg nerve conduction studies cxr ct chest mri brain
Todd paralysis ddx
TIA stroke intracranial neoplasm hemiplegic migraine head injury hypoglycemia malingering
Todd paralysis w/u
cbc glucose, elytes toxin levels eeg ct brain mri brain doppler u/s carotid
carpal tunnel syndrome ddx
overuse injury of median nerve
cervical disc disease
medial epicondylitis
carpal tunnel syndrome w/u
TSH
CBC
EMG
nerve conduction study