Neurology Flashcards
(23 cards)
How do we treat fatigue in multiple sclerosis?
Amantadine, modafinil or SSRIs
How do we treat neuropathic pain in multiple sclerosis?
Amitryline or gabapentin
How do we treat depression in multiple sclerosis?
Antidepressants like SSRIs
How do we treat urge incontinence in multiple sclerosis?
Anti muscarinic medications like solifenacin
How do we treat spasticity in multiple sclerosis?
Baclofen or gabapentin
How do we treat oscillopsia in multiple sclerosis?
Gabapentin or memantine
What is the treatment for MS relapses?
Steroids either 500mg for 5 days or IV 1g if oral treatment has failed or relapses are severe
What management will a patient presenting with TIA and symptomatic carotid stenosis have, ideally within two weeks?
Carotid endarterectomy
How does progress after stroke in the first two weeks affect prognosis?
If you are going to make a good recovery, you do so in the first two weeks.
Improvement may continue til 6 months
How can determine is a foot drop is due to a common peroneal nerve palsy or a L5 root lesion?
Common peroneal nerve palsy is painless
L5 root lesion is painful
if a patient when looking to the right on H test is unable to adduct the left eye and gets nystagmus in the right eye abducting, what is the likely diagnosis?
left internuclear opthalmoplegia
what is the parkinson plus syndrome presenting with parkinsonism and vertical gaze palsy?
progressive supranuclear palsy
what parkinson’s plus syndrome presents with parkinsonism, no tremor and early autonomic clinical features such as: postural hypotension, incontinence, and impotence?
Multiple systems atrophy
what postural changes can be seen with MSA?
anterior flexion of neck (antecollis) and spine (camptocormia)
what are common syncopal causes of transient LOC?
Reflex causes: vasovagal, situational, carotid sinus hypersensitivity
Cardiac causes: arrhythmia, outflow obstruction e.g aortic stenosis
Orthostatic: drugs, dehydration
Cerebrovascular: subclavian steal, aortic dissection, vertebrobasilar insufficiency
what is the most cause of transient LOC in young, middle aged and elderly patients?
young- vasovagal
middle aged- cardiac arrhythmia
elderly- medications causing orthostatic hypotension
what are non-syncopal causes of transient LOC?
intoxication, head trauma, hypoglycaemia, seizures, narcolepsy
what questions would you ask regarding what happened before a syncopal episode?
Any warning?
Any precipitating factors? (exercise, pain)
Any recent head trauma?
what questions would you ask regarding what happened during a syncopal episode?
how long were they unconscious?
did they bite their tongue or become incontinent?
what questions would you ask regarding what happened after a syncopal episode?
how long did it take them to recover?
were they confused after recovery?
what can you look for on examination of patient who has a syncopal episode?
tongue- bitten?
signs of dehydration
head trauma
pulse and heart sounds
calves- ?pe
carotid bruits
BP- lying and standing
focal neuro signs
what is the most common cause of viral meningitis?
enteroviruses like coxsackie and echovirus
