Nervous System Flashcards
(13 cards)
What is benignparoxysmal positional vertigo?
abnormal feeling of motion triggered by certain provocative positions. The condition is most often attributed to the presence of calcium debris within the posterior semicircular canal. Nystagmus is commonly seen.
What is Vertebrobasilar insufficiency?
reduced blood flow in the base of the brain, typically secondary to emboli, thrombi, or arterial dissection. The labyrinth and brainstem are commonly affected, and symptoms may include vertigo, dizziness, dysarthria, diplopia, and numbness. The vertigo often resolves on its own, but the condition should not be taken lightly. Risk factors for vertebrobasilar insufficiency include diabetes mellitus, hypertension, hypercholesterolemia, arrhythmia, coronary artery disease, circulatory problems, and a history of smoking cigarettes.
Pseudotumor cerebri, also known as idiopathic intracranial hypertension, arises from…
chronically elevated intracranial pressure.
Pseudotumor cerebri most commonly occurs in obese women of childbearing age. It is also thought to occur secondary to endocrine disorders and the usage of some medications, including the acne treatments isotretinoin and minocycline
Acoustic neuromas result from the proliferation of
Schwann cells
MRI revealing hyperintense lesions in the brain and/or spinal cord on T2-weighted images. Ovoid-shaped periventricular white matter lesions can be seen in 23%-75% of patients.
neurologic deficits are disseminated in time and space.
Diagnosis?
MS
What is the best long term pharmoacotherapy for MS? Short term therapy for new symptoms?
Short term therapy for uveitis?
Beta interferon
Oral steroid
IV steroid
MS presentation and workup
Most common sx: uveitis, motor and sensory problems, defects of bladder
Diagnosis: MRI
CSF (if MRI nondiagnostic): oligoclonal bands
Initial therapy: steroids
Disease modifying therapy: beta interferon, glatiramer
For treatment of fatigue and spasticity in MS use these drugs…
Fatigue: Amantadine
Spasticity: Baclofen or tizanidine
First line treatment for absence seizures?
Ethosuxomide
Main side effects of Valproic acid?
Thrombocytopenia
Also, VPA can cause life-threatening hepatotoxicity and pancreatitis; liver enzymes should be measured intermittently, and lipase should be obtained in any patient with acute abdominal pain. VPA is also a known teratogen that has been linked to neural tube defects; it should be used with caution in women of child-bearing age
Treatment of status epilepticusb
Benzodiazepines (Ativan/Lorazepam)
If seizure persists after 10 min then Fosphenytoin
If seizure persists after another 10 min then Phenobarbital.
IF seizure persists another 10 min. then general anesthesia (phenobarbital, thiopental, midazolam, propfol)
Treatment of Prolactinoma?
Dopaminergic receptor agonists (bromocriptine and cabergoline) are the first-line treatment for prolactinomas
Parkinsonian features, progressive cognitive decline/dementia with fluctuations in cognition, visual hallucinations and rapid eye movement sleep behavior disorder (ie, loss of normal rapid eye movement sleep atonia).
Diagnosis?
Lewy body dementia
Frontotemoporal dementa: personality changes
Normal pressure hydrocephalus: triad is cognitive impairment and urinary incontinence, abnormal gait
Vascular dementia: early executive dysfxn with focal neurologic deficits
