Neuro

Question 1

Ending Ix for CN exam

Answer 1

Finish my examination
- Smelling salts
- Blind spot
- colour vision utilising Ishihara plates
- Fundoscopy
- Corneal, jaw jerk and gag reflex
- Otoscopy

Question 2

Causes of Parkinsonism

Answer 2

Idiopathic Parkinson’s disease

Parkinson’s + syndromes:
* Progressive supranuclear palsy
* Multisystem atrophy
* Corticobasillar degeneration?

Drug-induced: metoclopramide, prochlorperazine

Question 3

Parkinson’s disease

Management

Answer 3

Conservative
* …

Medical
* L-DOPA
* Dopamine receptor antagonists
* …

Surgical
* deep brain stimulation - medical Tx not effective for motor Sx

Question 4

Pseudobulbar vs Bulbar palsy

Answer 4

Bulbar
* dysphagia
* nasal, slurred speech
* wasted, fasciculating tongue
* absent gag
* absent/normall jaw jerk
* ?LMN signs in limbs

Pseudobulbar
* Donald Duck dysarthria
* dysphagia
* small, spastic tongue
* normal/increased gag
* brisk jaw jerk
* ?UMN signs in limbs

Question 5

Causes of pseudobulbar palsy

Answer 5

Bilateral cerebrovascular accident (affecting internal capsule)

MS
Motor neurone disease
High brainstem tumour
Head injury

Question 6

Causes of bulbar palsy

Answer 6

MND
Syringobulbia
Guillain-Barre

Infective
* Poliomyelitis
* Subacute meningitis
* Neurosyphillis