Neuro differentials Flashcards
(17 cards)
name some headache differentials
tension headache, cluster headache, increased ICP, migraine, glaucoma, temporal arteritis, meningitis, trigeminal neuralgia, sinusitis and subarachnoid haemorrhage
how may a tension headache present?
bilateral tight band sensation
recurrent and occurs late in day
associated with stress
how may a cluster headache present?
short painful attacks around one eye
30mins-3hrs
once/twice a day for 1-3 months
may be lacrimation and flushing
how may a migraine present?
unitemporal pulsating headache
hrs-days
may be aura
need to lie down in dark room photophobia
how may meningitis present?
photophobia neck stiffness
systemic effects: fever and non blanching rash
how may a trigeminal neuralgia present?
2 sec paroxysms of stabbing pain in unilateral trigeminal nerve distribution
how may temporal arteritis present?
unilateral throbbing pain
scalp tenderness and jaw claudication
>55yrs
may be visual problems
how may a subarachnoid haemorrhage present?
v.sudden onset of severe headache (like someone has hit them over the head with a brick)
how may increased ICP present?
worse in the morning and with coughing and bending
vomiting and decreased GCS
may have neurological symptoms and seizures if tumour
how may glaucoma present?
pain around eye
swollen red eye
visual blurring and halos
how may sinusitis present?
facial pain exacerbated by leaning forward
rhinorrhoea
Name some vertigo differentials
Benign positional vertigo Vestibular neuritis Viral labyrinthitis Meniere's disease acoustic neuroma chronic otitis media eustachian tube dysfunction strokes head injury drugs
How may benign positional vertigo present?
attacks of sudden rotational vertigo
evoked by head turning
last 30s
How may vestibular neuritis present?
often preceded by an URTI
sudden rotational vertigo and vomiting
lasts days but imbalance may persist
may reoccur several times a year
How may viral labyrinthitis present?
often preceded by an URTI
severe vertigo and hearing disturbance
may be tinnitus, otalgia, NV and fever
How may Menieres disease present?
TRIAD- vertigo, tinnitus, hearing loss
minutes-hrs
What are some differentials for a fall/fit/syncope?
epilepsy- partial or generalised postural hypotension arrhythmia aortic stenosis Parkinsons TIA/stroke Vasovagal others
