Neuro Misc Flashcards
Transient Global Amnesia
Acute and isolated ANTEROgrade amnesia in otherwise alert and well person.
Sometimes triggered by exertion or stress.
- NO other deficits
- Key: repetitive questioning
- Diagnosis of exclusion
- Lasts up to 24/24
- No long-term issues
Acute Dystonic Reactions
Akisthesia
Oculogyric crisis
Spasmodic torticollis
Tongue/ facial
LARYNGOSPASM (rare)
Idiosyncratic (not dose-related)
Causes:
- Antipsychotics
- Antiemetics
- Antihistamines
- Carbon monoxide
Benztropine 1-2mg IM/IV then PO TDS
What do the following gaits signify?
Broad based
Shuffling
Foot slap
Steppage
Duck-waddle
Scissor
Broad-based: cerebellar (will be ataxic too)
Shuffling: Parkinsons
Foot slap: foot drop OR sensory loss
Steppage: foot drop
Duck-waddle: (swinging/weak hips) myopathy
Scissor gait: spastic paresis (UMN)
Causes of foot drop:
L4/5 radiculopathy
- Disc hernation
- Foraminal stenosis
Sciatic nerve
- Piriformis Sx
- Pelvic injury
Peroneal nerve
- Injury/ compression about knee/fibular head
- Compartment Sx
Anterior tibialis
- Myopathy
Causes of hydrocephalus:
Increased production or decreased resorption (COMMUNICATING)
–> Normal-pressure hydrocephalus
–> Meningitis
–> Post-haemorrhage
–> TBI
Obstructive (NON-COMMUNICATING)
–> Shunt malfunction
–> Tumour
–> Post-haemorrhage
–> Venous sinus thrombosis
–> Ventriculitis
–> Congenital (AVM, spina bifida, aqueduct stenosis etc.)
Normal Pressure Hydrocephalus:
Idiopathic.
Gait disturbance (‘glue footed)*
Urinary incontinence
Cognitive impairment (pseudodementia)
No ICP signs, normal pressure on LP
DDX: Dementia, Parkinson’s, posterior stroke
‘Sunsetting’ eyes = hydrocephalus
What does Romberg test?
Proprioception
—> dorsal columns of spinal cord.
Isolates by elimination of vision
Ataxia is cerebellar or sensory (proprio/ dorsal columns)
Swaying is not positive (this is appropriate correction).
Positive = sensory/ proprio/ cord/ intoxication etc.
Negative = cerebellar
