Pattern Recognition in Neurology Flashcards
How do vascular or traumatic neurological problems present?
Most severe at the start (i.e. thunderclap headache, stroke etc)
What percentage of right handed people have a dominant left hemisphere?
> 99%
What hemisphere is dominant in left handed people?
50% chance of right hemisphere dominance
Possibly, 80% of people have bilateral representation
How does Broca’s aphasia present?
Non-fluent aphasia
Good comprehension
Assoc. contralateral hemiparesis if nearby motor strip is involved
Where is Broca’s area?
In the dominant inferior frontal gyrus
How does Wernicke’s aphasia present?
Fluent speech but nonsensical
Poor auditory comprehension
Poor awareness of their condition
Where is Wernicke’s area?
In the dominant superior temporal gyrus
What is a textbook sign that differentiates a CNS disorder from a PNS disorder?
Spasticity of upper limb flexors and leg extensors
- Arm stays flexed and leg stays straight and swings when walking
What pattern of sensory loss & weakness is textbook for brainstem lesions?
Facial weakness on one side and body weakness on the contralateral side
Arm weakness but normal legs
What is the pattern of weakness and sensory loss in brown-sequard syndrome?
Weakness in one leg but sensory loss in the other
What is the most common patterns of weakness/sensory loss in a CNS issue?
Paraplegia
Hemiplegia
What is the pattern of weakness in PNS lesions?
Peripheral or localized area (i.e. footdrop)
Can be a whole limb in a plexus issue
Is pain most common in PNS or CNS issues?
PNS
What areas are effected in NMJ issues?
Ocular & bulbar issues
Large proximal muscles
Are sensory symptoms possible in a NMJ issue?
No
What is a textbook characteristic of NMJ issues?
Fatiguability - Worse after muscle use
What areas are effected by muscle issues?
Proximal & symmetrical muscles
Are sensory symptoms possible in muscular issues?
No
How are reflexes effected in CNS issues?
Brisk reflexes
How are reflexes effected in PNS issues?
Decreased reflexes
How can upper motor neuron problems be differentiated from lower motor neuron?
- Increased tone spasticity
- Hyperreflexia
- Extensor plantar response
How can lower motor neuron problems be differentiated from upper motor neuron?
- Decreased tone
- Hyporeflexia
- Flexor plantar response
- Muscle atrophy, fasciculations
What is a telltale signs that differentiate spinal cord problems from brain problems?
A clear level in the spinal cord at which symptoms stop
What is a classic presentation & history of Guillain-barre syndrome?
Stomach bug with a history of travel followed by PNS issues
