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Neuro Conditions + Treatments Flashcards

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1
Q

What is the treatment of spinal bifida?

A

Folic acid supplements - mother
Myelomeningocele - primary surgical closure or intra-uterine repair

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2
Q

What is Spina Bifida?

A

Affects tissues overlapping the spinal cord - defective closure of caudal neural tube and non-fusion of vertebral arches

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3
Q

What is hydrocephalus?

A

Accumulation of CSF in ventricles - obstructive or communicating

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4
Q

What is the treatment for hydrocephalus?

A

Communicating - LP, lumbar drain, and external ventricular drain
Obstructive - endoscopic third ventriculostomy and external ventricular drain

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5
Q

What is Parkinson’s disease?

A

Degeneration of DA cells in substantia nigra - stiffness, slow movements, change in posture, and tremor.

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6
Q

What is the treatment of Parkinson’s disease?

A

Levodopa
Carbidopa or Benserazide - AAAD inhibitor
Entacapone or Opicapone - COMT inhibitor
Selegiline, reasagiline - MAOB inhibitor

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7
Q

What is multiple sclerosis?

A

CNS white matter disease - demyelination
Relapsing remitting course and develop progressive disability

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8
Q

What is the treatment of acute relapse in multiple sclerosis?

A

Oral prednisolone, rehabilitation and symptomatic treatment

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9
Q

What is 1st line treatment for multiple sclerosis?

A

Beta interferons and glatiramer acetate by SC or IM injections
Or teriflunomide and dimethyl fumarate by oral

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10
Q

What is myasthenia gravis?

A

Fatigable weakness - NMJ disorder
Gets worse with repetitive movements or at end of day

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11
Q

What is the treatment for myasthenia gravis?

A

Cholinesterase inhibitors - pyridostigmine
Immunoglobulins, steroids, steroid sparing immunosuppression and thymectomy

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12
Q

What is peripheral nerve disease?

A

Involves sensory, motor and autonomic involvement
LMN signs

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13
Q

What is the treatment of peripheral nerve disease?

A

Stop drug, surgery or immunoglobulin

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14
Q

What is motor neuron disease?

A

Amyotrophic lateral sclerosis - anterior horn cells disease
Pure rapidly progressive disease
Usually limb first then bulbar and resp. UMN and LMN signs

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15
Q

What is the treatment for motor neutron disease?

A

Riluzole - glutamate antagonist
Physio, OT, SALT, PEG and non-invasive ventilation

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16
Q

What is myelopathy?

A

Compression of spinal cord - pain, loss of feeling, and loss of bladder control
UMN signs

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17
Q

What is the treatment for myelopathy?

A

PT an corticosteroids
Spinal decompression surgery - ex. laminectomy

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18
Q

What is the treatment for spinal stroke/ infarction?

A

Reduce risk of recurrence - maintain BP, reverse arrhythmia, and aspirin/ clopidogrel
OT and physio.

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19
Q

What is the treatment for B12 deficiency myelopathy/

A

Intramuscular B12 injections

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20
Q

What is functional neurological disorders?

A

Change in function rather than structure - symptoms not explained by neurological disease
Tremor can stop with distraction of movement.

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21
Q

What is the treatment of function neurological disorders?

A

Antidepressants - anxiety and depression
Physical rehab and psychiatry

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22
Q

What is meningitis?

A

Inflammation/ infection of meninges
Classical triad - altered mental state, fever and neck stiffness.

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23
Q

What is the treatment for meningitis?

A

IV ceftriaxone for bacterial
Immunisation - meningococcal, pneumococcal and Hib vaccines

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24
Q

What is encephalitis?

A

Inflammation/ infection of brain substance
Viral has slower onset and more prominent cerebral dysfunction
Progressive headache and fever.

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25
What is the treatment for encephalitis?
Viral - acyclovir Bacterial - targeted antibiotics
26
Describe a brain abscess and empyema
Abscess - localised area of pus Empyema - thin layer of pus between dura and arachnoid membranes Signs of raised ICP
27
What is the treatment for brain abscess and empyema?
Surgical drainage Penicillin or ceftriaxone Metronidazole for anaerobes High dose needed
28
What is Creutzfeldt-Jacob Disease?
Transmissible proteinaceous prion Rapid progression and often death in 6 months Early abnormal behavioural changes
29
What is the treatment for CJD?
Sedatives/ antidepressants and antipsychotics Benzodiazepines/ antiepileptics
30
What is pyogenic vertebral osteomyelitis and discitis?
Spinal infection Mainly lumbar then thoracic and cervical Axial pain and sign is fever.
31
What is the treatment for pyogenic vertebral osteomyelitis and discitis?
Broad spectrum IV antibiotics for 6-8 weeks Immobilisation if pain and stabilises spine Then possible surgery
32
What are spinal haematomas?
Subdural, subarachnoid, and intramedullary haemorrhage Intense knife like pain in location MRI is gold standard
33
What is the treatment of spinal haematoma?
Coagulopathy Emergency surgical decompression - laminectomy
34
What is cauda equina syndrome?
Surgical emergency - compressive, ischaemic and/or inflammatory causes. LMN sings bilaterally, saddle anaesthesia and bladder/bowel involvement
35
What is the treatment of cauda equina syndrome?
Surgical decompression - emergency
36
What is the difference between myelopathy and cauda equina syndrome?
Myelopathy - UMN and bladder/ bowel involvement Cauda equina - LMN and bladder/ bowel involvement
37
What is glioblastoma multiforme (GBM)?
Type of glioma Spread through white matter in CSF pathway Raised ICP, epileptic fits, 3 and 6th palsy, and altered consciousness
38
What is the treatment of GBM?
Steroids and anticonvulsants RT of whole brain or stereotactic Surgery
39
What is a stroke?
Sudden onset of focal or global neurological symptoms - ischaemia or haemorrhage Symptoms last more than 24hrs
40
What is the treatment of a stroke?
Ischaemic - CT scan and tPA/ thromboectomy Aspirin if after 3 hrs
41
What is the treatment of a tension type headache?
Paracetamol and NSAIDs Tricyclic antidepressants - amitriptyline
42
What is a migraine?
Unilateral, aura, photophobia, phonophobia, episodic and is disabling.
43
What is the treatment for migraines?
Modifiable lifestyle factors Aspirin, triptans and NSAIDs Prophylactic - propranolol, candesartan, antiepileptics, amitriptyline
44
What is trigeminal neuralgia?
Primary headache - intense pain along nerve. Brief and severe. Unilateral - maxillary or mandibular Triggers
45
What is the treatment of trigeminal neuralgia?
Carbamazepine Surgical - glycerol ganglion injection, stereotactic radiosurgery, and microvascular decompression
46
What is a cluster headache?
Trigeminal autonomic cephalalgias - unilateral head pain in mainly V1 Bouts lasting 1-3 months and circadian rhythm
47
What is the abortive treatment for cluster headache?
Triptans - sumatriptan Oxygen 10-15 ltrs
48
What is transitional or preventative treatment for cluster headaches?
Oral prednisolone and greater occipital nerve block Preventative - verapamil and 2nd line is topiramate
49
What is paroxysmal hemicrania?
Trigeminal autonomic cephalalgias - 2-40 attacks a day Absolute response to indomethacin
50
What is SUNCT/SUNA?
Short lasting unilateral neuralgiform with or without autonomic symptoms Stabbing/ pulsating pain, 10-240 secs, had triggers, have 2-300 a day/
51
What is the treatment for SUNCT/SUNA?
Lamotrigine, topiramate and oxcarbazepine Transitional - GON block Surgical - occipital nerve and deep brain stimulation.
52
What is intracranial hypotension?
Can be spontaneous or after LP Headache worse upright and lessens when lying back as brain sink
53
What is the treatment of intracranial hypotension?
Epidural blood patch Best rest, fluids, analgesia, caffeine
54
What is a subarachnoid haemorrhage?
Aneurysmal rupture and bleeding into subarachnoid space Thunderclap headache - whole head and instantaneous
55
What is the treatment of subarachnoid haemorrhage?
Coiling and clipping Nimodipine for vasospasm
56
What is the treatment of absence seizures?
Ethosuximide
57
What is first line for partial and secondary generalised seizures?
Lamotrigine, carbamazepine, and levetiracetam
58
What is the treatment for focal seizures?
Carbamazepine
59
What is first line for primary generalised seizures?
Sodium valproate, lamotrigine, and levetiracetam
60
What is the treatment for status epilepticus?
Midazolam and Lorazepam

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