clinical 2 Flashcards
(52 cards)
what is chorea
involuntary, rapid, jerky movements
what causes chorea
damage to basal ganglia, especially caudate nucleus
what 4 features are associated with motor neurone disease
- fasciculation
- absence of sensory signs/symptoms
- lower motor neuron signs in arms and upper motor neuron signs in legs
- wasting of the small hand muscles/tibialis anterior is common
what will electromyography show in someone with motor neurone disease
a reduced number of action potentials with an increased amplitude
what will nerve conduction studies in motor neurone disease show?
will be normal - but can rule out neuropathy
raised intracranial pressure of uncertain cause is called
Idiopathic intracranial hypertension
Idiopathic intracranial hypertension can lead to what if untreated
papilloedema leading to blindness
who gets Idiopathic intracranial hypertension
overweight woman and on certain medications
what medications are associated with Idiopathic intracranial hypertension
tetracycline antibiotics isotretinoin contraceptives steroids levothyroxine lithium cimetidine
how do you treat idiopathic intracranial hypertension
repeated therapeutic lumbar punctures, where the pressure is lowered by draining off CSF until symptoms settle and with acetazolamide (diuretic)
ABCD2, A is
age >= 60 yrs (1 point)
ABCD2, B is
Blood pressure >= 140/90 mmHg (1 point)
ABCD2, C is
Clinical features:
- Unilateral weakness (2 points)
- Speech disturbance, no weakness (1 point)
ABCD2, D is
Duration of symptoms
- > 60 minutes (2 points)
- 10-59 minutes (1 point)
- diabetes (1 point)
ABCD2 score does what
asses risk of stroke in days following TIA
max possible ABCD2 score
7
for ABCD2, what score means you’re at risk
4+
if someone scores 4+ on ABCD2 what is treatment
- aspirin (300 mg daily) started immediately
- specialist assessment and investigation within 24 hours of onset of symptoms
- measures for secondary prevention introduced as soon as the diagnosis is confirmed
what is phonophobia
hypersensitivity to sound
in what condition is phonophobia very common
migrane
initial symptoms for lewy body dementia apposed to pakinsons
lewy body = dementia symptoms first, along with hallucinations
parkinsons = movement problems first
characteristic histological feature of lewy body dementia
alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic and neocortical areas
what drugs should be avoided in those with lewy body dementia and why
Neuroleptics - they develop irreversible parkinsonism
how do you diagnose lewy body dementia
single-photon emission computed tomography (SPECT)
