Neurology Flashcards
Typical seizures in alcohol withdrawal?
Generalised tonic-clonic seziures
What can cause peripheral neuropathies?
Chemotherapy agents -chalk based etc Poorly controlled diabetes Alcoholism Thiamine/B12/folate deficiency Infections - lyme disease, shingles, epstein-barr virus, hepatitis C and HIV. Autoimmune diseases - Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis. Trauma Met disease Charcot-Marie Tooth
Common findings on EEG
Look up!
Why do you get pain in the back and down the legs with S1 radicular pain?
Pain fibres within muscle innervation area are interpreted as being activated due to nerve root impingement
(Not dermatomal/not skin/sciatic nerve)
Causes of radiculopathy?
Disc herniation Osteophytes Tumour - compression/fracture Inflammatory conditions Infection - epidural abscess/herpes zoster
Radicular pain - prognosis?
Most people improve 6-8 weeks
80% lifetime risk
Why anoreflexic initially when spinal cord transected/damaged?
Deporalisation due to cascade of damage
Central cord syndrome?
Elderly people (stenotic spinal canals) - cape-like distribution and motor deficit in hands (fibres most medial)
Causes of acute spinal cord compression?
Trauma
Metastatic disease - pathological fracture
Haematomas
TB spine
How long does Gabapentin/amitriptyline take to work?
2-6 weeks
Clinical features of hemicrania continua
Rigidly side-locked
Older adults
Excellent treatment response to endomethacin (lots of side effects so makes it difficult to justify treatment - renal/GI etc)
Variation of hemicrania continua?
Paroxysmal hemicrania
Children sex ratio of migraine?
1:1
Types of migraine aura?
Visual, auditory, dysphasia, paraesthesia, vertigo
Typical length of aura?
20-30 minutes
Typical food triggers of migraine?
Cheese/red wine - typically hypoglycaemic?
Clinical definition of migraine?
Throbbing headache of moderate-severe intensity plus 2/3:
photophobia, phonophobia and osmophobia
Typically lasts longer than an hour
What auras more associated with epilepsy?
Temporal lobe - rising epigastric sensation/deja vu etc etc
What makes focal symptoms/signs more likely to be migraine?
If spreading around ie not limited to one vascular territory
Limitations of ACE?
Must have good vision/be able to read
Scores only actually evidence-based for Alzhemier’s
How to differentiate between cerebellar ataxia and sensory ataxia?
For sensory ataxia:
+ve Rhomberg’s sign - can do if eyes open but not if eyes closed
Also absence of other cerebellar signs
Elderly person is light-headed and faint after turning head frequently in a busy supermarket?
Small vessel ischaemic disease
What drugs cause long QT syndrome?
Macrolides - clarithromycin
Quinolones (also tendonopathies/reduce seizure threshold)
Anti-arrthymics - Class 1 and 3 (upstroke and downstroke)
Anti-psychotics (also reduce seizure threshold)
Anti-depressants - SSRIs (citalopram particularly) and TCAs
Methadone
Antimalarials - quinolone and ?
What non-drug causes of long QT syndrome are there?
Hypothermia
SAH
Myocardial ischaemia
Hypokalaemia/hypomagnesia/hypocalcaemia
