OSCESTOP Flashcards by Sophie Shorten

Differentials for proximal weakness

CMIND **normal sensation
Congenital - mitochonrial 
Metabolic - Cushings, hypothyroidism
Inflammatory - dermato/polymyositis, IBM
Neuromuscular - MG, LAMS
Dystrophies - Becker's, FSHD, limb girdle

How well did you know this?

Not at all

Perfectly

Bilateral UMN / pyramidal weakness

3Ms

MS
MND (normal sensation)
Myelopathy (sensory level)

Others - brainstem stroke, hereditary spastic paraplegia

How well did you know this?

Not at all

Perfectly

Unilateral UMN / pyramidal weakness

Intracranial - CVA, SOL, MS (hemisensory loss)
Brainstem - MS
Spinal cord - MS, trauma, SOL, abscess/haemhorage/AVM (sensory level)

How well did you know this?

Not at all

Perfectly

Bilateral LMN distal weakness + loss of sensation

sensory motor polyneuropathy
DIM VIT

DM
Inherited - CMT
Metabolic - B1, B12 def.
Vasculitis - SLE, PAN, RA
Infection - herpes zoster, HIV, leprosy, syphilis
Toxins - EtOH, TB drugs, nitrofurantoin, vincritine, cisplatin, amiodarone

How well did you know this?

Not at all

Perfectly

Bilateral LMN distal weakness with NORMAL sensation

distal motor neuropathy

GBS
CIDP
Myotonic dystrophy
Lead poisoning
Porphyria
IBM (distal arms, prox legs) 
Progressive muscular atrophy

How well did you know this?

Not at all

Perfectly

Unilateral LMN - radiculopathy

Radiculopathy * dermatomal sensory loss

disc herniation
cervical spondyosis with osteophytes
spinal canal stenosis
nerve sheath tumours

How well did you know this?

Not at all

Perfectly

Mononeuritis multiplex

Vasculitis - GPA, EGPA, PAN, microscopic polyangiitis

Autoimmune - SLE, Sjogrens, RA, Sarcoid,

How well did you know this?

Not at all

Perfectly

UMN + LMN

MND
Dual pathology: eg. cervical myelopathy + peripheral neuropathy
Cervical radiculomyelopathy

How well did you know this?

Not at all

Perfectly

Absent ankle jerks +/- KJs and up going plantars

Subacute combined degeneration of the cord
Syphilic tabo-paresis
Frederich’s ataxia
MND

How well did you know this?

Not at all

Perfectly

Cerebellar disease

MAVIS P

MS
Alcohol
Vascular - thromboembolic, haemorrhage
Inherited - Freiderich's ataxia, SCA, ataxia telangectasia
SOL
Paraneoplastic

How well did you know this?

Not at all

Perfectly

Complex ophthalmoplegia

Graves
Mitochondrial myopathy 
Myesthenia gravis
Multiple CNs - cavernous sinus pathology, mononeuritis multiplex
Brainstem - Stroke, SOL, tumour

How well did you know this?

Not at all

Perfectly

Optic atrophy

MS
Ischaemia
Temporal arteritis
compression (SOL, raised ICP)
Glaucoma
DM
methanol

How well did you know this?

Not at all

Perfectly

3rd nerve palsy

PCOM aneurysm
Cavernous sinus thrombosis
DM, mononeuritis multiplex, MS, SOL

How well did you know this?

Not at all

Perfectly

6th nerve palsy

Raised intracranial pressure

DM, mononeuritis multiplex, MS, SOL

How well did you know this?

Not at all

Perfectly

Unilateral facial nerve

Bells palsy 
Ramsay Hunt 
Brainstem lesion (SOL, demyelination, stroke) 
TB
Nerve infiltration (lymphoma/sarcoid)
Parotid tumour/surgery

How well did you know this?

Not at all

Perfectly

Bilateral facial nerve

Bilateral Bells palsy 
Sarcoid
Autoimmune - MG, vasculitis
Inflammatory - GBS
Dystrophies
Amyloidosis

Bulbar palsy

MND
Brainstem infarct/SOL
MG
GBS
Polio
Syphilis 
Syringiobulbia

Pseudobulbar palsy

MND
Brainstem infarct/SOL
MS
internal capsule infarct/small vessel disease
neurodegenerative
brain tumour
high brainstem tumours
PSP

CN 3-6

cavernous sinus thrombosis

CN 5-8 + cerebellar

cerebellar pontine angle tumour

CN 9-10

+11 = julgular foramen syndrome

+12 = pseudobulbar/bulbar palsy

CN 9-10 + ipsilateral horners + cerebellar + sensory loss (ipsi face, contra body)

= lateral medullary syndrome

Homonymous hemianopia

Stroke, cerebral SOL

Bitemporal hemianopia

pituitary tumour
craniopharngioma
suprasellar meningioma
aneurysym

Tunnel vision

Glaucoma | Retinitis pigmentosa

Central scotoma

MS, ischaemic, temporal arteritis, compression, glaucoma, methanol

Homonymous quadrantanopia

Parietal Inferior | Temporal Superior

Monocular visual loss

``` Central retinal artery occlusion Vitreous haemorrhage Large retinal detachment Trauma Papillodema ```

Ptosis - unilateral or bilateral

MG | Muscular dystrophy

Ptosis - unilateral

Horners 3rd nerve idiopathic

Ptosis - bilateral

Congenital | Tabes dorsalis with Argyle Robertson pupils

Differentials for Horners

1st - MS, spondylosis, SOL, syringiomyelia, stroke/lateral medullary syndrome 2nd - Pancoast tumour, cervical rib 3rd - Carotid artery dissection, malignant infiltration (thyroid, lymphoma or mets)

Chorea

``` Huntingtons Sydenhams chorea Drugs Stroke HIV ```

Hemibalism

Stroke SOL HIV trauma

Athetosis

asphyxia neonatal jaundice thalamic stroke

Dystonia

``` trauma drugs Wilson's disease PD Huntington's Stroke SOL encephalitis asphyxia ```

Myoclonus

``` epilepsy metabolic physiological toxins/drugs SOL MS PD CJD ```

Unilateral LMN - plexopathy

Plexopathy *vast dermatomal sensory loss | - brachial neuronitis, trauma, congenital, thoracic outlet syndrome, neoplastic infiltration

Unilateral LMN - peripheral nerve

- Median / Carpal tunnel syndrome - - pregnancy, obesity, local pressure, endo: hypothyroid, acromeg, diabetes - Ulnar - -Compression at elbow; bony, crutches, periop; fracture; idiopathic; DM - Radial - - at elbow; fracture, compression, ganglion - - humeral shaft fracture - - axilla; crutches/ saturday night palsy - common peroneal - - plaster cast compression, trauma, diabetes, leprosy