Neurology Flashcards
(55 cards)
A Jacksonian seizure is also known as a temporal lobe seizure T/F
F - AKA focal (partial) motor seizure
Note: consciousness preserved; often Todds paralysis afterwards
Carbamazepine is the first line tx for juvenile myoclonic epilepsy T/F
F - it can actually WORSEN seizures.
Note: usually use valproate or topiramate
Patients have excellent prognosis but often require lifelong AED to avoid relapses
Pt with preE coming in post seizure what is the initial mgmt of choice
Mg bolus
Pt with an intracranial bleed at what BP are anti HTNs indicated
> 170 systolic
When is NSGY opinion indicated in intracranial haemorrhage?
If intermediate or reducing GCS
OR cerebellar haemorrhage
Non neurological feature of Friedrich’s ataxia
It is associated with cardiomyopathy, scoliosis, pes cavus and diabetes
1st line treatment of Parkinson’s disease
Levodopa, dopamine agonists, or MAO-B inhibitors (eg selegiline) are the first choice options as there is evidence behind their use in providing symptoms control
Mnemonic for cavernous sinus thrombosis structures involved?
O TOM CAT
O: Oculomotor nerve
T: Trochlear nerve
O: Ophthalmic branch of trigeminal nerve
M: Maxillary branch of trigeminal nerve
C: Internal carotid artery
A: Abducens nerve
T: Trochlear nerve
Typical presentation of neurological AV malformations
seizures and a background of headaches.
Intermittent headaches with neurology affecting multiple cranial nerves is suggestive of ___
Cavernous Sinus Thrombosis
Frontotemporal dementia most commonly presents with memory problems T/F
F - more commonly presents with loss of insight and behavioural changes than memory problems
Presentation of neuralgic amyotrophy
Sudden onset of extreme pain in the upper extremity
followed by rapid multifocal motor weakness and atrophy and a slow recovery in months to years.
Usually proceeded by an upper respiratory tract infection.
Note: NA includes both an idiopathic (also known as Parsonage-Turner syndrome) and hereditary form.
Sporadic vs variant CJD
Sporadic: onset 45 -75 yrs old
- myoclonus
- dementia
-ataxia
-psychiatric/behavioural changes
Variant: average onset 26 yrs old
-Psychiatric prodrome
-Painful sensory symptoms
Investigations for CJD
Sporadic: EEG, LP (abnormal high levels of proteins 14-3-3 and S100B) and MRI brain
Variant : MRI is investigation of choice as EEG and LP are less sensitive
Use of memantine vs donepezil in Alzheimers dementia
Donepezil (or galantamine, or rivastigmine) usually first line
Memantine is for severe dementia or if unable to tolerate anti cholinesterase inhibitors
In the setting of trauma amnesia for greater than 30 minutes of events before impact is an indication for CT brain T/F
T
Acute total (painful) third nerve palsy with a dilated unreactive pupil is caused by_____
Compression of CN III, for example by tumour, posterior communicating or posterior cerebral artery aneurysms.
Features of multi system atrophy
-parkinsonian features
-autonomic insufficiency (leading to postural hypotension, anhidrosis, disturbance of sphincter control, impotence)
-signs of a cerebellar deficit.
Chronic inflammatory demyelinating polyneuropathy is clinically similar to which disease
GBS except follows a more chronic progressive course
18 yr old male presents with painless loss of vision in one eye a few weeks after losing vision in other eye. Most likely dx
Leber’s optic atrophy
Note: typical patient is a young male, LOV is painless but severe.
On MRI brain lesions enhance with gadolinium contrast - which is more likely MS or ADEM
ADEM
Note: MS lesions can sometimes enhance though less likely.
Think ADEM if encephalopathy, fever and focal neurology. May have had a preceding flu like illness or recent vaccinations
Optic neuropathy, proptosis, chemosis, Horner’s syndrome, ophthalmoplegia (sixth nerve palsy) and decreased corneal reflex is typical of ___
Orbital apex syndrome
Note: decreased corneal reflex is due to involvement of V1
What is the most common cause of limbic encephalitis
In 60% of cases it is paraneoplastic. Most commonly malignancy is small cell lung Ca
Benign paroxysmal positional vertigo (BPPV) is associated with hearing loss T/F
F - it is not associated with hearing loss
Note:characterised by brief episodes of severe vertigo accompanied by nausea and vomiting. Vertigo can last for weeks and then self resolves.
Meniere’s disease is associated with hearing loss
