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Flashcards in Neuro disorders Deck (59):
1

CN1

olfactory

2

CNII

vision

3

CNIII

oculomotor. Most EOMs, opening eyelids, pupillary constriction

4

CN IV

trochlear. Down and inward eye movement

5

CN V

trigeminal. muscles of mastication, sensation of face, scalp, cornea, mucus membranes and nose

6

CN VI

abducens, lateral eye movement

7

CN VII

Facial nerve. moves face, closes mouth and eyes, taste (anterior 2/3) saliva and tear secretion

8

CN VIII

acoustic. Hearing and equilibrium

9

CN IX

glossopharyngeal. Phonation (one third) gag reflex, carotid reflex, swallowing, taste (posterior)

10

What disorder the 7th cranial associated with?

bells palsy

11

pneumonic for CN

Some Say Marry Money But My Brother Says Big Butts Matter Most

12

s/sx of tension HA

vise-like or tight in quality
usually generalized
may be most intense about the neck or the back of the head
no associated focal neuro deficits
last several hours

13

Classic migraine

migraine with aura

14

common migraine

migraine without aura

15

What have migraines been related to?

dilation and excessive pulsation of branches of the external carotid arty; typically lasts 2-72 hours following the triennial nerve pathway

16

what kind of foods are triggers for migraines

nitrate containing foods (pickles, cured meats)

17

symptoms of migraine

UNILATERAL then LATERALIZED throbbing headache that occurs episodically
may be dull or throbbing builds gradually and lasts several hours or longer
FOCAL NEURO DISTURBANCES
n/v
photophobia and phonophobia

18

What focal neuro deficits may be seen with migraines

visual disturbances occur commonly; field deficits, luminous visual hallucinations
aphasia, numbs, tingling, clumsiness or weakness

19

When do you start prophylactic therapy for migraines

if attacks occur more than 2-3 times per month

20

What kind of prophylactic therapy are there?

amitriptyline (elavil) (TCA)
divalproex (anti-epileptic, mood d/o)
Propanolol (beta blocker)
imipramine (TCA)
clonidine (anti-hypertensive, central acting alpha 2 adrenergic agonist)
verapamil (CCB)
topiramate (anti-epileptic)
gabapentin (analgesic, anti-epileptic)
methysergide
magnesium

21

Management of an acute migraine

rest in dark room
ASA
sumatriptan 6mg SQ at onset, may repeat in 1 hour, can have 3 total per day
Sumatriptan 25mg PO at onset

22

What is the characteristic of a cluster headache

Severe, UNILATERAL, periorbital pain occurring daily for several weeks
ipsilateral nasal congestion, rhinorrhea and eye redness may occur

23

What may precipitate a cluster headache

alcohol

24

how long do cluster headaches last

less than 2 hours, pain free months or weeks between attacks

25

Management of cluster headache

sumatriptan 6mg SQ
inhalation of 02
ergotamine tartrate aerosal inhalation

26

What kind of altered vision will you see in TIA

Ipsilateral monocular blindness (amaurosis fugax)

27

How do vertebrobasilar and carotid strokes present differently?

vertebrobasilar with be more neuro looking and the carotid stokes are more classical stroke symptoms

28

What are the 2 partial seizures classes

simple partial and complex partial

29

define seizure

a variety of paroxysmal events occurring as a result of abnormal electrical activity

30

character of simple partial seizure

Common with cerebral lesions
no LOC****
rarely lasts over a minute
motor symptoms often start in a single muscle group and speed to the entire side of the body
paresthesias, flashing lights, vocalizations, hallucinations

31

Character of complex partial

any simple partial seizure followed by impaired LOC****
May have aura, staring, automatisms such as lip smacking or picking at clothing

32

What are the 2 kinds of generalized seizures

Absence (petite mal) and tonic clonic (grand mal)

33

What are the characteristics of absence (petite mal)

sudden arrest of motor activity with blank stare
commonly discovered in children/adolescence, begin and end suddenly

34

What are the characteristics of a tonic-clonic seizure?

grand mal
may have an aura
begins with contractions (repetitive contractions of the muscle) LOC, then clonic contractions (Maintained involuntary contractions of muscle)
lasts 2-5 minutes
incontinence
postictal period

35

Status epilepticus

series of grand map seizures of >10min duration
may occur while awake or asleep, but never gain consciousness between attacks

36

What are some anticonvulsants

carbamazepine
Phenytoin
phenobarbitol
valproic acid
primidone
clonazepam

37

What you need to know about anticonvulsants

dosages should be titrated
discontinuance should be tapered and never abruptly withdrawn

38

What is the hallmark of deficiency in parkinsons

deficiency of DOPAMINE

39

Trio of findings in parkinsons

Tremor: slow, most conspicuous at rest, may be enhanced at rest
rigidity
bradykinesia

40

What is the myersons sign

repetitive tapping over the bridge of the nose produces a sustained blink response

41

What are the meds used to increase available dopamine

carbidopa-levodopa (sinemet)
Ropinirole hydrochloride (requip)
amantadine (symmetrel)
Tolcapone (Tasmar)
Pramipexole (mirapex)

42

Anticholinergics used in parkinsons

Benztropine (congentin)
Trihexyphenidyl (Artane)

43

cause of myasthenia gravis

autoimmune disorder resulting in reduction of the number of acetylcholine receptor sites at the neuromuscular junction

44

when is weakness worse in MG

arose after exercise and better after rest

45

s/sx of MG

ptosis
diplopia
dysarthria (unclear articulation of speech)
dysphagia
extremity weakness
fatigue
respiratory difficulty
sensory and DTR normal

46

What is found in the serum of most MG patients

antibodies to acetylchoine receptors

47

What is included in the management of MG

neuro referral for anti cholinesterase drugs, immunosuppressives and plasmapahesis

48

What causes MS

The bodes immune system attacks myelin, a key substance that serves as a nerve insulator and helps in the transmission of nerve signals

49

What is bells palsy

facial paresis, frequently resolving completely without treatment, involves the facial nerve

50

S/sx of bells palsy

abrupt onset of facia paralysis
pain about the eye may accompany the weakness
face feels stiff and pulled to one side, UNABLE TO MOVE FOREHEAD
ipsilateral restriction of the eye closure
difficulty with eating and fine facial movements
may be a disturbance of taste

51

management of bells palsy

prednisone 60mg divided in 4-5 doses daily, tapered over 7-10 days
acyclovir (when suspected varicella zoster infection= Ramsey hunt syndrome)
lubricating eye drops
neuro referral as needed

52

What differentiates bella palsy from CVa

bells palsy cannot raise forehead, stroke can

53

causes of trigeminal neuralgia

MS
pressure on the trigeminal nerve from a swollen blood vessel or tumor

54

define trigeminal neuralgia

nerve disorder that causes a stabbing or electric shock like pain in parts of the face

55

s/sx trigeminal neuralgia

very painful sharp spasms that last a few seconds or minutes, can be constant
pain is localized to one side of the face

56

Management of trigeminal neuralgia

neuro exam, MRI, and trigeminal reflex testing
antis drugs, muscle relaxants, TCAs

57

What happens as we age to our fever response?

blunted or absent
compromised thermoregulation

58

What happens to touch and pain in gerontology?

decreased sense of touch
increased muscarinic parasympathetic responses

59

what are symptoms of cluster headaches?

severe, unilateral, periorbital pain lasting weeks. Ipsilateral nasal congestion can also occur