Neuro Flashcards
(36 cards)
Cerebellar causes
VINDICATE:
Vascular: stroke
neoplastic: NB
degen: FA
Drug/siatrogenic: phenytoin
C..CP
AI: MS
Trauma
Endo: Wilsons, nutritional Vit E
signs of neuro chronicity
wasting
deformity
contractures
AFOs well worn
growth asymmetry
paresis vs plegia
paresis = weakness
plegia = can’t move
cognitive impairment phrase
= “behave younger than I expect”
pes cavus = what DDx
spinocerebellar lesion (friedrich’s)
peripheral nerve (CMT)
spinal lesion e.g. spina bifida
Exam signs of myotonic dystrophy
myotonic facies - droopy mouth, expressionless (squeeze eyes)
make fist and release
percussion myotonia
types of gait + where is the lesion?
- hemiplegic (swinging, one arm in) = unilateral spinal/brain
- diplegic (both legs swing, adducted) = spinal e.g. transverse myelitis / brain e.g. CP
- ataxic (broad based) = cerebellar (with bad turning) / vestibular / sensory
- myopathic i.e. high stepping gait = ankle DF weakness from L4, L5, S1 from common peroneal palsy / radiculopathy / polyneuropathy e.g. CMT
- myopathic i.e. Trendelenburg (waddling with circumduction) = DMD, BMD, myotonic dystrophy / systemic disease e.g. thyroid, dermatomyositis
- choreoform (writhing) = HD, CP, Wilsons
- antalgic
Diplegic gait
Brain - PVL causing CP!!
Spine - inflammatory e.g. transverse myelitis, congenital e.g. spina bifida, tumour, trauma
Hereditary spastic diplegia
Toe walking gait vs can’t toe walk suggests?
Toe walking = DISTAL strength
Can’t toe walk = PF (S1) weakness e.g. CMT
Toe walking = BMD/DMD, CP/spasticity
Can’t heel walk suggests?
DF weakness (L5) - CMT!!!, DMD, CP
horner’s sign and causes
= ptosis, miosis and anhidrosis
- post-cardiac surgery
- NB
- NF
- tumour
ptosis + large pupil vs small pupil
or just ptosis
ptosis + large pupil = CNIII palsy
ptosis + small pupil = Horner’s
ptosis e.g. MG, congenital ptosis, dystrophies
causes of unilat vs bilat SNHL
unilat e.g. acoustic neuroma, trauma
bilat
1. genetic e.g. connexin
2. syndromic e.g.
3. toxins/drugs e.g. gentamicin
4. infection e.g. rubella / CMV
5. meniere’s
DDx of nystagmus
- cerebellar
- vestibular
- congenital
- physiological
CNIII, IV, VI palsies
III = down and out with ptosis and large pupil
IV = up and in, head tilts away from side of lesion
VI = in
cortical blindness = ?
loss of vision but pupillary reflex (CNII) intact
cataracts DDx
Congenital:
CMV
Turner
T21
Acquired:
Steroid
Alport
DDx of ophthalmoplegia
UMN - demyelination, tumour, vascular
LMN - nerve e.g. GBS/Bell’s/ICP, NMJ, muscle
foot drop causes
- CMT
- common peroneal palsy
- L5/S1 nerve palsy
CMT vs FA
both ataxic, loss of proprioceoption and vibration, pes cavus
FA Romberg’s positive
hemiplegia DDx
VINDICATE
V: vascular
- vessels e.g. Moya Moya, Sturge Weber, NF
- cardiac
- haem e.g. sickle cell
I: infection - inflammatory e.g. encephalitis
N: neoplasm
C: congenital - will get facial sparing
A: autoimmune
T: trauma
E: endocrine/metabolic
what level of LL flexion corresponds with what nerve root? e.g. in spina bifida
hip flexion = L1/2
knee flexion = L3/4
ankle DF = L4/5
*saddle area = S3 and below i.e. incontinence
key areas to look for in spina bifida
HC
neck - VP shunt
back - scoliosis
nystagmus
incontinence (say to look for anal tone)
percuss for bladder
abdo reflex
pressure areas
hemiplegia - how to tell where the level of the lesion is?
facial weakness side:
cortical = same side as lesion
subcortical = same side
brain stem = opposite side
spine = no facial features
