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Neuro 7 Flashcards

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1
Q

What is an “aura” when it comes to seizures

A

Aura = simple partial seizure that precedes progression to bigger seizure

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2
Q

What is Lennox-Gastaut syndrome

A

Pediatric seizure syndrome associated with intellectual disability

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3
Q

Major trigger for seizures in Juvenile myoclonic epilepsy (JME)

A

Sleep deprivation

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4
Q

During a seizure, do eyes usually turn toward towards or away from the affected side?

A

Away (“wrong way eyes”)

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5
Q

What is Todds paralysis and what is it often confused with

A

Postictal partial or complete hemiplegia

Can mimic stroke

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6
Q

Where in the brain is seizure: “deja-vu” sx, epigastric rising, nausea, vertigo, lip smacking

A

Temporal lobe

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7
Q

Where in the brain is seizure: neglect, aphasia

A

Parietal lobe

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8
Q

Where in the brain is seizure: nocturnal (looks like patient wakes up and acts weird), often without postictal state, fencing posture

A

Frontal lobe

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9
Q

Describe presentation of progressive supranuclear palsy

A

♣ Supranuclear ophthalmoplegia, with limitation of vertical more than horizontal gaze
♣ Axial rigidity and neck extension
♣ Early falls as a consequence of impaired postural reflexes, neck extension, and inability to look down

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10
Q

What are peripheral side effects of Levodopa

A

Nausea and vomiting, cardiac arrhythmias, orthostatic hypotension

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11
Q

What are the central side effects of Levodopa

A

Neuropsychiatric sx (anxiety, agitation, hallucinations, confusion)

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12
Q

MOA of Carbidopa

A

DOPA decarboxylase inhibitor (prevents peripheral conversion of L-Dopa to Dopamine)

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13
Q

Drug category and MOA of Entacapone

A

COMT inhibitor

Prevents conversion of L-Dopa to inactive metabolite in the periphery

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14
Q

MOA of Tolcapone

A

COMT inhibitor both peripherally and centrally

Prevents conversion of L-Dopa to inactive metabolite

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15
Q

MOA of Selegiline as Parkinson tx

A

Monoamine oxidase inhibitor (MAO-B), preventing metabolism of DA

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16
Q

MOA of Ropinirole

A

D2 receptor agonist

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17
Q

MOA of Pramipexole

A

D3 receptor agonist

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18
Q

MOA of Amantadine

A

NMDA antagonist - enhances effects of endogenous DA

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19
Q

What antimucarinics are used in the tx of Parkinsons

A

Benztropine

Trihexyphenidyl

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20
Q

What type of tremor is present in Essential tremor

A

Postural tremor (emerges during sustained maintenance of a posture)

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21
Q

What limbs are preferentially effected in Essential tremor

A

hands > arms > head&raquo_space; legs

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22
Q

What can decrease sx of Essential tremor

23
Q

Tx of essential tremor

Study These Flashcards
A

Beta-blockers (Propranolol)

Primidone (barbiturate)

24
Q

Action tremor is caused by dysfunction of what?

Study These Flashcards
A

Cerebellum and cerebellar outflow tract

25
What is chorea and what is the signature associated disease
Chorea = involuntary, abrupt, and irregular movements that flow randomly from one body part to another Huntingtions
26
What causes hemiballismus
Usually from contralateral lesion in the subthalamic nucleus, caudate, or putamen
27
What is dystonia
Sustained muscle contraction leading to repetitive twisting movements or abnormal postures
28
Example of and treatment of dystonia
Ex = torticollis Tx = Botox
29
Hiccup is what type of movement
Myoclonus
30
Tx of myoclonus
Clonazepam
31
Tx of tics
Dopamine antagonists (Haloperidol or SGA)
32
Presentation of Wilson disease
Liver dysfunction and neuropsychiatric sx Kayser-Fleishcer rings, renal disease
33
Describe possible neuro sx seen in Wilson disease
Tremor, ataxia, dysarthria, dyskinesia, parkinsonism, cognitive dysfunction, disturbances of mood and personality
34
Lab values seen in Wilson disease
- Increased serum copper - Decreased serum ceruloplasmin - Increased urine copper excretion
35
Tx of Wilson disease
Copper chelation with D-penicillamine
36
4 components of presentation is Sturge-Weber syndrome
1. Seizures 2. Port-wine stain of CN V1/V2 distribution 3. Intellectual disability 4. Glaucoma Think: guy has seizure and spills wine on face. Wine gets in eye (glaucoma) and he goes whoops
37
Triad of sx in Tuberous sclerosis
1. Intellectual disability 2. Seizure 3. Angiofibroma
38
Can hyperventilation precipitate focal seizures
No Only absence seizures, which are generalized seizures
39
Describe pathophys of Guillain-Barre syndrome
o Demyelinating polyradiculoneuropathy (of peripheral nerves)
40
Describe presentation of Guillain Barre
o Ascending symmetrical paralysis over days to weeks | o Autonomic dysfuction (e..g tachycardia, urinary retention, and arrhythmias) occur in 70% of patients
41
CSF findings of Guillain Barre
o CSF is usually abnormal and may show high protein with few cells
42
Tx of Guillain Barre
o Treatrement = IV immunoglobulin or plasmapheresis
43
Sx present in Meniere disease - other than vertigo, what are the ear sx?
Due to increased pressure and volume of endolymph * Episodic vertigo with nausea and vomiting * Ear fullness/pain * Unilateral sensorineural hearing loss * Tinnitus
44
Describe post-concussion syndrome
HA, dizziness, sleep disturbance, cognitive impairment, behavioral abnormalities (e.g. irritability)
45
What is the value of normal ICP
<15
46
What percentage of severe post-head trauma patients experience seizure
25%
47
Presentation and tx of neurosarcoidosis
♣ Presentation • Cranial neuropathy due to basal meningitis • Facial and optic nerves most frequently affected ♣ Treatment: • Steroids
48
Cause of Wernicke encephalopathy
Thiamine (B1) deficiency
49
Triad of Wernicke's
Ophthalmoplegia, (truncal) ataxia, confusion
50
Tx of Wernicke's
Administer thiamine BEFORE glucose
51
What is Korsakoff syndrome
Isolated memory disturbance and confabulation, personality change
52
Will Methylmalonic acid be increased or decreased in B12 deficiency
Increased B12 is needed to convert MMA to Succinyl CoA
53
Presentation of B12 deficiency
Damage to posterior and lateral columns of the spinal cord Paresthesias, weakness, gait problems

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