Neurology

Question 1

What is the treatment of acute hemiplegic migraine and for prophylaxis?

Answer 1

Acute: NSAIDs
Prophylaxis: Verapamil

Question 2

What is the treatment for acute migraine and prophylaxis?

Answer 2

Acute: NSDAID or aspirin or paracetamol, plus triptan
Prophylaxis:propanolol or topiramate or amitriptyline, 2nd line - candesartan

Question 3

What is the treatment for acute and prophylaxis of cluster headache?

Answer 3

Acute: high flow oxygen, sumatriptan
Prophylaxis: verapamil, topiramate, sodium valproate

Question 4

What is the best antipsychotic to use in the context of Parkinson’s?

Answer 4

Quetiapine (lowest incidence of extra-pyramidal side effects

Question 5

Features of temporal lobe seizure
Aura
Awareness
Rx

Answer 5

Épigastrique aura/lip smacking
Awareness preserved or impaired
Rx: levetiracetam, lamotrigine, carbamazabine

Question 6

Features of parietal lobe seizures

Answer 6

Contralateral sensory disturbance

Question 7

Features of frontal lobe seizure

Answer 7

Scream
Facial expressions
Fencing posture

Question 8

Features of gelastic seizures

Answer 8

Sudden bursts of energy or laughing

Question 9

Dorsal column clinical examination

Answer 9

Fine touch
Proprioception
Vibration

Question 10

Anterior spinal artery syndrome

Answer 10

Loss of pin prick and temp
Diminished relflexes
Flaccid bilateral weakness
MRI: owl sign

Question 11

Lateral medullary syndrome (vertebral artery dissection)

Answer 11

Ipsilateral horners, ipsilateral laryngeal, pharyngeal and palatal hemiparalysis
Cerebella involvement