Flashcards in Neurology 2 Deck (41):
what is focal neurology?
the effect of the brain injury
what is hemiplaegia?
a complication with the motor cortex
weakness in limbs and face
increased tone and increased reflexes
motor cortex problems may affect what else?
swallowing - dysphagia
speech - dysarthria
what is hyperparasthesia?
excessive physical sensitivity
caused by a problem with the sensory cortex
what hemisphere of the brain dominates speech?
dyspraxia - problems with sequencing may arise from what area of the brain?
what is hemianopia?
loss of vision
what is ataxia?
where does it come from?
what can it cause?
loss of co ordination
stems from cerebellum
intention tremor/cerebellar gait
what is the function of the basal ganglia?
what can go wrong with them?
slowness of action - bradkykineasia, tremor
what is a stroke?
disorder of vascular supply to the brain
what are strokes commonly caused by?
infarction - artherosclerosis/cardiac emboli
10 % haemorrhage
types of infarction?
completed stroke - persisting neurological defecit
what is the main factor for a stroke caused by a bleed?
usually more severe
what do clinical features of a stroke depend on?
site of infarction
what are some clinical signs of a stroke?
what do you use to diagnose a stroke?
what are the outcomes of a stroke?
33% significant disability
what kind of surgery can be done on a stroke patient?
what is the long term treatment for a stokes patient?
antiplatelets/ warfarin if AF/ NOAC
address high bp/cholesterol/smoking/diabetes
types of rehab treatment on offer to strokes patients?
what type of nutritional support can stroke patients get?
naso gastric tube
percutaneous endoscopic gastronomy
what is parkinsons disease?
degeneration of dopaminergic neurones in the basal ganglia
underlying cause is unclear
what are some clinical features of parkinsons disease?
bradykinesia - slow movement/initiation/reduced movement range
rigigity - increased muscle tone
tremor - low frequency
mask like face
shuffling gait and falls
difficulty with fine motor tasks
what are the medical treatments of parkinsons disease?
- dopaminergic drugs - direct replacement/agonists
- physio and occ therapy
what is essential tremor?
may be unilateral
worse on action
annoying/embarassing rather than disabling
improves with alcohol
what drugs can be used to treat essential tremor?
what is multiple sclerosis?
auto immune destruction of CNS
loss of myelin - demyelination
what is the epidemiology of MS?
predominently caucasians / Northern Europeans/ more likely women over men/mean age onset @30 years
Clinical features of MS?
depends on area of myelination
loss of vision in one eye - double vision
changes in sensation
initial recovery common
what are the two forms of MS?
- Relapsing/Remitting - diff areas affected at diff times/ partial or complete recovery in between
- Chronic Progressive - Cumulative damage - loss of mobility/incontinence/pressure sores/fatigue/dementia
what investigations are used to diagnose MS?
how to treat acute episodes of MS?
high dose steroids
reduce relapse rate with B interferon
how to treat ongoing MS?
rehab and support
symptom control - anti spasmosdics, catherterisation
what is peripheral neuropathy?
loss of peripheral nerve function
-generalised - glove and stokcing, multiple causes - diabetes mellitus/drug side effect
- specific nerve/nerve roots - often pressure effect - trauma/tumour
what are the effects of loss of peripheral nerve function?
loss of sensation
loss of power
what is bells palsy?
lower motor neurone palsy of facial nerve
thought to be viral
oral steroids within 72 hours improve outcome
need eye care
what is motor neurone disease?
destruction of motor neurones
70 in 100000
more common in males
what are some clinical features of motor neurone disease?
how to diagnose motor neurone disease?
how to treat motor neurone disease?
medications have limited value
mainly supportive - feeding tubes