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Neuro Flashcards

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1
Q

Causes of seizures

A 
Epilepsy
Stroke
Infection
Head injury
Hypoglycaemia
Hyponatraemia
Eclampsia
...
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2
Q

Seizure types

A

Generalised tonic-clonic:
Absence: brief LOC, no loss of postural tone, quick recovery, no post-ictal confusion

Focal (+/- awareness):

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3
Q

Primary headaches

A

Tension type: band-like, dull pressure. Stress-related.
Migraine: unilateral/severe/throbbing, +/- aura

Cluster:

  • severe pain, supraorbital/orbital/temporal
  • ipsilateral autonomic symptoms (Ptosis/Miosis/Lacrimation/Eyelid oedema)
  • Restlessness
  • Pain occurs in clusters – usually daily for some weeks (usually 6-12), followed by a period of remission. During a cluster, patients may experience 1-8 attacks/day. During remission, patients are usually asymptomatic.
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4
Q

Red flags for headaches (SNOOP4)

A
  • System symptoms
  • Neuro signs (focal)
  • Onset
  • Old age >50
  • Pattern change, including: papilloedema/precipitating factors/positional aggravation
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5
Q

Deadly secondary headaches

A 
Meningitis
SAH/ICH, stroke
Tumour
Temporal arteritis
Carotid sinus thrombosis
Carotid/vertebrobasilar dissection
Acute angle closure glaucoma
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6
Q

Bell’s palsy

  • what
  • treatment
A

Facial nerve palsy, potentially due to compression of the geniculate ganglion, nerve oedema, or viral illness.

Self-limiting
Glucocorticoids (PO pred), eye care, psych support, +/- antivirals

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7
Q

Guillain-Barre Syndrome

A

Distal weakness +/- sensory loss ~3w following a viral illness.
~20% have facial/resp muscle weakness (with risk of paralysis and death)

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8
Q

Causes of neuropathy

A

Metabolic: diabetes, thyroid disease, liver disease, uraemia
Toxins: alcohol, heavy metals, arsenic, chemotherapy
Vitamin deficiencies: B1, B12
Genetic: Charcot-Marie-Tooth

Mononeuritis multiplex (>2 nerves, asymmetrical)

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9
Q

Horner’s syndrome

  • what
  • associated with…
A

Caused by a lesion anywhere along the sympathetic pathway that supplies the head, eye and neck.
e.g. internal carotid dissection, stroke, tumour/mass, trauma, apical lung lesion (Pancoast tumour)

Ptosis, miosis, anhydrosis

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10
Q

Investigations for Horner’s Syndrome

A

Apraclonidine eye drops: a-2 agonist. Dilation in affected eye, unchanged/constriction in normal eye

Neuroimaging: depends on suspected site of lesion. MRI/MRA or CT with contrast

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11
Q

Acetylcholine

A

Excitatory (inhib. in cardiac/smooth muscle)

Receptors: nicotinic or muscurinic

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12
Q

Glutamate

A

Excitatory

Multiple receptors, including NMDA

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13
Q

GABA

A

Inhibitory

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14
Q

Catecholamines

A

Adrenaline/noradrenaline/dopamine

Alpha-1/2, beta-1/2/3 adrenoreceptors; D1-5

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15
Q

Dopaminergic pathways/functions

A 
The main functions of dopamine can be divided into:
Motor control (nigrostriatal system)
Behavioural effects (mesolimbic and mesocortical system)
Endocrine control (tuberohypophyseal system)
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16
Q

Serotonin

Study These Flashcards
A

Inhibitory
Receptors 5-HT 1-7

Actions in GIT, blood vessels, platelets, and CNS

CNS: 
Hallucinations
Sleep/wakefulness
Mood
Feeding/appetite
Vomiting
Pain perception
17
Q

Parkinson’s Disease Drugs

Study These Flashcards
A

L-Dopa + carbidopa
DA agonists

MAO-B inhibitors - stops breakdown of L-DOPA
COMT inhibitors - stops breakdown of L-DOPA
Acetylcholine inhibitors

18
Q

Alzheimer’s Drugs

Study These Flashcards
A

Acetylcholinesterase inhibitors

NMDA receptor antagonist

19
Q

Red flags for back pain

20
Q

Contraindications to thrombolysid

Study These Flashcards
A 
Stroke/head trauma/major surg in last 3 months
Bleeding disthesis
Hx ICH
SAH suspected
Actively bleeding
Varices
Pregnant/<10/7 post-partum
Recent CPR
Recent LP
21
Q

Migraine treatment

22
Q

Head injury: poor prognostic factors

Study These Flashcards
A

Low GCS on presentation
Age >60
Severity of primary injury: ICP, pathology (tumour/bleed), duration of coma
Secondary cerebral insults (hypotension, hypoxia)
Significant medical comorbidities

23
Q

Parkinsonism syndromes differentiating features

Study These Flashcards
A

Progressive supranuclear palsy: vertical gaze palsy, expressionless face

MSA: autonomic dysfunction

Dementia with Lewy bodies: visual hallucinations

24
Q

Stroke Bamford classification

Study These Flashcards
A

TACS:

  • Unilateral weakness
  • Homonymous hemipnopia
  • Higher cerebral dysfunction (dysphasia, apraxia, right-left confusion, optic ataxia)

PACS: 2/3 of above

Lacunar:
Pure sensory
Pure motor
Sensorimotor
Ataxic hemiparesis
Clumsy hand - dysarthria

POCS: 1 of…

  • CN palsy + contra lateral sens/motor deficit
  • bilateral sens/motor deficit
  • cerebellar dysfunction (nystagmus/vertigo/ataxia)
  • conjugate eye movement disorder
  • isolated homonymous hemionopia or cortical blindness
25
Serotonin syndrome
Gut: nausea, vomiting NM: seizures, UMN signs AMS: agitation Autonomic: high BP/HR, sweating, palpitations

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