TIA

Question 1

How does TIA present?

Answer 1

• sudden onset focal neurological deficit
  
  • hemiparesis
  • dysphagia, dyslexia or dysarthria
  • visual or somatic sensory sx
• Non focal sx
  
  • light headedness
  • faint
  • blackouts
  • confusion
• recovery within 24 hrs

Question 2

What are the RF of stroke?

*remember ABCD

Answer 2

• Age: 60y and above
• BP: >140/ equal or >90
• Clinical features: Unilateral weakness, speech disturbance
• Duration of sx: 10 mins and above

Question 3

What Ix woudl you perform in primary care fro TIA?

Answer 3

• ECG
• Bloods - FBC, ESR, U&E, Cr, Lipids, Glucose
• Clotting screen

Question 4

How would you mx TIA?

Answer 4

• Start aspirin 300mg od
• Arrange urgent assessment by specialist stroke assessment
• Start tx for risk factors

Question 5

What is Amaurosis fugax?

Answer 5

• Form of TIA due to emboli passing through retina
• Causes brief loss of vision like curtain
• Same Mx as TIA

Question 6

What is Bell’s Palsy?

Answer 6

• facial palsy when no other medical condition is found to be causing facial weakness or paralysis

Question 7

What is the presentation of Bell’s palsy?

Answer 7

• Rapid onset (less than 72 hours).
• Facial muscle weakness (almost always unilateral)
• Ear and postauricular region pain on the affected side
• Difficulty chewing, dry mouth (in 20%), and changes in taste (in around 35%).
• Incomplete eye closure, dry eye (in 30%), eye pain, or excessive tearing.
• Numbness or tingling of the cheek and/or mouth.
• Speech articulation problems, drooling.
• Hyperacusis (in less than 5%).

Question 8

How would you mx Bell’s palsy?

Answer 8

• Reassure prognosis is good
• full recovery within 3–4 months.
• keep the affected eye lubricated.
• tape eyeusing microporous tape.
• Prednisolone
  
  • 50 mg daily for 10 days or