common neurological conditions lecture Flashcards by HARRY RICHARDSON

4 most common

migraine
parkinsons
epilepsy
MS

How well did you know this?

Not at all

Perfectly

common migraine

no aura

How well did you know this?

Not at all

Perfectly

fx of migraine

aura
sx of 20m to 60m - nil else gives a set of symtoms for this duration
movement exacerbates
photophobia
phonophobia
hyperosmia
nausea - relief versus anti-emetics
allodynia - pain due to stimulus that does not normally provoke pain

How well did you know this?

Not at all

Perfectly

types of aura

zigzag strcutre
negative scotoma
positive scotoma
loss vision one sided

How well did you know this?

Not at all

Perfectly

hemiplegic migraine

aura - hem sensory loss or weakness - start in face
headache often mild and ipsilateral to sx
may be familial

How well did you know this?

Not at all

Perfectly

tx of acute migraine attack

aspirin 600-900mg
anti emetic
NSAID - ibruprofne and nurofen
triptans

How well did you know this?

Not at all

Perfectly

triptans

agonist 5

How well did you know this?

Not at all

Perfectly

prophylactic

proranolol - non slective if cardioselective horrifc
tricyclics
valporate
verapamil
candesartan
pizotifen
GONI - greater occipital nerve injections
topomax - topiramate - 2nd line in formula - can cause anorexia and contraindicated in glaucoma - not in child bearing age women
Bonta - botoz
anti- CGRP antagonists - end pathway of migraine blockade - can get constipated

How well did you know this?

Not at all

Perfectly

botox in what nerve as tx for migraine

greater and lesser occipital nerve

How well did you know this?

Not at all

Perfectly

parkinson disease

substantia nigral dopaminergic neuronal loss

How well did you know this?

Not at all

Perfectly

non motor sx of parkinsons

depressions , constipation, sleep disturbances and olfactory dysfunction

How well did you know this?

Not at all

Perfectly

bradykinesia

lose the amplitude of the action - movement becomes slower and and smaller.

How well did you know this?

Not at all

Perfectly

expyramidial rigidity

cogwheel rigidity

How well did you know this?

Not at all

Perfectly

tx parkinsons

physcial activity

How well did you know this?

Not at all

Perfectly

l dopa side effects

psychiatric sx linked to depression
N&V
prolonged use can cause wearing off effect

How well did you know this?

Not at all

Perfectly

2nd most common cause parkinsons

vascular induced
lower limb predominant
bilateral

epilepsy

at least 2 unprovoked seizures cocuring more than 24hr apart

seizures

little spike in neutrophils but no sign of fever or CRP - stress response

other one is subarachnoid haemorrhage

drug causes of seziure

tramadol
ciprofloxacin
neurleptics

ix epilepsy

haemo
biochem
uande ca
CXR
eeg
neuroimaging
ECG

only drug that treats epilspsy

tacrolimus

all other drugs are anti-seizure meds - ASMs such as

lamotrigine
levetriacetem
topiraamte
perampanel

side effect of kepra

mood changes such as bad tempered and then old increased OCD features

rescue therpay

buccal midazzolam

MS relapse remiting

younger people primary progressive - older pts - bladder and bowel disturbance - all below the waste not normally involving optic nerve

what condition needs to be ruled out with a headache that elicits meningism signs

posterior communicting artery aneruysm

used to treat cerebral oedema in patients with brain tumours

dexamethasone

CT head showing temporal lobe changes - think

herpes simplex encephalitis

This patient's decreased GCS and abnormal posturing (with fixed flexion of both arms, called the 'mummy baby' pose), on the background of a subdural haemorrhage, is highly concerning for brain herniation. what would you see in eyes

Downward and temporally-displaced gaze

CJD charcterised by

rapid onset dementia and myoclonus(jerks)

if a patient with Parkinson's disease cannot take levodopa orally, they can be given a

dopamine agonist patch as rescue medication to prevent acute dystonia

Stokes-Adams attack

A Stokes-Adams attack is a fainting spell that occurs when the heart has an abnormal rhythm, resulting in a loss of blood flow to the brain.

Laughter → fall/collapse ?

Cataplexy describes the sudden and transient loss of muscular tone caused by strong emotion (e.g. laughter, being frightened). Around two-thirds of patients with narcolepsy have cataplexy. Features range from buckling knees to collapse.

status elipitucs managment

First-line drugs are benzodiazepines in the prehospital setting PR diazepam or buccal midazolam may be given in hospital IV lorazepam is generally used. This may be repeated once after 5-10minutes If ongoing (or 'established') status it is appropriate to start a second-line agent such as levetiracetam, phenytoin or sodium valproate NICE state 'Take into account that levetiracetam may be quicker to administer and have fewer adverse effects than the alternative options.' If no response ('refractory status') within 45 minutes from onset, then the best way to achieve rapid control of seizure activity is induction of general anaesthesia or phenobarbital

difference between incidence and prevelance

Incidence is a measure of the number of new cases - prevalence is a snapshot of existing cases