Flashcards in Neurology 2 Deck (41):
1
what is focal neurology?
the effect of the brain injury
2
what is hemiplaegia?
a complication with the motor cortex
weakness in limbs and face
increased tone and increased reflexes
3
motor cortex problems may affect what else?
swallowing - dysphagia
speech - dysarthria
4
what is hyperparasthesia?
excessive physical sensitivity
caused by a problem with the sensory cortex
pain syndromes
5
what hemisphere of the brain dominates speech?
left
broca/wenickes area
6
dyspraxia - problems with sequencing may arise from what area of the brain?
frontal lobe
left hemisphere
7
what is hemianopia?
loss of vision
8
what is ataxia?
where does it come from?
what can it cause?
loss of co ordination
stems from cerebellum
intention tremor/cerebellar gait
9
what is the function of the basal ganglia?
what can go wrong with them?
control movement
increased tone
slowness of action - bradkykineasia, tremor
10
what is a stroke?
disorder of vascular supply to the brain
11
what are strokes commonly caused by?
infarction - artherosclerosis/cardiac emboli
10 % haemorrhage
12
types of infarction?
TIA
completed stroke - persisting neurological defecit
13
what is the main factor for a stroke caused by a bleed?
hypertension
usually more severe
14
what do clinical features of a stroke depend on?
site of infarction
15
what are some clinical signs of a stroke?
hemiplegia
hemianopia
dysarthia/dysphasia
dysphagia
dyspraxia
cognitive impairment
confusion/seizure/impaired consciousness
16
what do you use to diagnose a stroke?
CT
17
what are the outcomes of a stroke?
33% death
33% significant disability
33% recovery
18
what kind of surgery can be done on a stroke patient?
carotid endarterectomy
19
what is the long term treatment for a stokes patient?
antiplatelets/ warfarin if AF/ NOAC
address high bp/cholesterol/smoking/diabetes
20
types of rehab treatment on offer to strokes patients?
occ therapy
physio
speech therapy
dieticians
social workers
21
what type of nutritional support can stroke patients get?
naso gastric tube
percutaneous endoscopic gastronomy
22
what is parkinsons disease?
degeneration of dopaminergic neurones in the basal ganglia
underlying cause is unclear
23
what are some clinical features of parkinsons disease?
bradykinesia - slow movement/initiation/reduced movement range
rigigity - increased muscle tone
tremor - low frequency
slow speech
mask like face
shuffling gait and falls
swallowing problems
difficulty with fine motor tasks
24
what are the medical treatments of parkinsons disease?
surgical treatments?
rehab treatments?
- dopaminergic drugs - direct replacement/agonists
- stereotactic
- physio and occ therapy
25
what is essential tremor?
often hereditary
may be unilateral
worse on action
annoying/embarassing rather than disabling
improves with alcohol
26
what drugs can be used to treat essential tremor?
beta blocker
primidone
27
what is multiple sclerosis?
auto immune destruction of CNS
loss of myelin - demyelination
28
what is the epidemiology of MS?
predominently caucasians / Northern Europeans/ more likely women over men/mean age onset @30 years
29
Clinical features of MS?
depends on area of myelination
loss of vision in one eye - double vision
changes in sensation
ataxia
weakness
initial recovery common
30
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
31
what investigations are used to diagnose MS?
clinical
lumbar puncture
MRI
32
how to treat acute episodes of MS?
high dose steroids
reduce relapse rate with B interferon
33
how to treat ongoing MS?
rehab and support
symptom control - anti spasmosdics, catherterisation
34
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
35
what are the effects of loss of peripheral nerve function?
loss of sensation
loss of power
36
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
37
what is motor neurone disease?
destruction of motor neurones
70 in 100000
more common in males
38
what are some clinical features of motor neurone disease?
limb weakness
swallowing problems
39
how to diagnose motor neurone disease?
clinical
neurophysiology
40
how to treat motor neurone disease?
medications have limited value
mainly supportive - feeding tubes
41