Neuro Flashcards
Causes of mononeuritis multiplex?
DM, sarcoidosis, neoplasticism, amyloid, vasculitos, Leporosy (ie infiltration or infarction based causes)
How can you classify peripheral neuropathies?
Demyelination - GBS, hereditary, CDIP
Axonal degeneration - damage, toxins, metabolic disorders
Compression - focal demyelination (ie carpal tunnel)
Infarction (diabetes, vasculitis)
Infiltration - by inflammatory cells in leprosy, granulomas, neoplastic
What does the carpal tunnel contain?
Median nerve, one tendon of FPL, 4 tendons of FDP, 4 tendons of FDS
What two tests are positive in carpal tunnel?
Tinels and Phalons- they both should elicit patients symptoms. Tinels by tapping on median nerve at wrist, Phalens by keeping hands in inverse prayer position for 30-60 seconds.
What is the management of carpal tunnel syndrome?
Conservative - treat underlying cause, reassurance, splint in extension, avoid triggers
Medical - steroid injection
Surgical - division of flexor retinaculum to decompress.
What does the seventh nerve do?
Face, ear, taste, tear
Treatment for Bell’s palsy?
Conservative - reassure, lubricate affected eye, patch eye at night, refer is uncertain diagnosis or bilateral
Medical - steroids
Surgical - refer to plastic surgeons if no recovery in 6-9 months
Infections associated with GBS?
GI (C jejuni) Resp (H influenza, M pneumoniae) viral (EBV, HIV, CMV)
What are the symptoms and signs of GBS?
Acute flaccid paralysis starting distally, mainly affecting legs, following 1-3 weeks after infection. Absent tendon reflexes. 25% have respiratory muscle paralysis.
What is miller fischer syndrome?
A post-infectious neurological syndrome characterised by opthalmoplegia, ataxia and areflexia.
Triad of horners?
Partial ptosis, anhydrosis and meiosis (constructed pupil)
A hemifacial loss of sweating in Horners syndrome implies the lesion is where?
Preganglionic (ie pancoasts tumour, cervical rib, trauma, thyroid mass, mediastinal mass)
Which ganglion is affected by HSV in Ramsay Hunt syndrome?
Geniculate ganglion
How do cerebellar syndromes present?
Dysdiadokinesia, ataxia, nystagmus, intention tremor, slurred speech, hypotonia. It presents with ipsilateral signs.
What things can cause a cerebellar syndrome?
Intracranial (MS, SOL, stroke)
Systemic (Alcohol, phenytoin, paraneoplastic)
Inherited (Friedrich’s ataxia, Wilson’s disease)
