Neurology Flashcards
(53 cards)
Tests to do if query myasthenia gravis
Short acting anticholinesterase agent in MG would transiently improve symptoms.
Do chest imaging to rule out thymoma
Do CT brain
Blood as,pale for anti acetylcholinesterase antibodies
Problems with MG
Progressive fatiguable weakness
They also have problems with mastication, talking, drinking, swallowing. Aspiration pneumonia and resp failure can result as unable to clear secretions
Neuro systems review
Headaches Altered vision Fits, faints, funny turns Hearing difficulties Memory problems Speech and swallowing difficulties Weakness Numbness or tingling Incontince or retention Erectile dysfunction Balance or coordination difficulties How is it affecting ADLs FH
Progressive weakness without sensory loss. Arm twitching. Legs giving way. Change in speech. Father died when in 30s.
Amyotrophic lateral sclerosis- UMN AND LMN lesions. Some genetic component but sporadic mutations more common
Severe painful unilateral headaches. No warning. Eye watering, nasal stuffiness. No symptoms between headaches. Usually at night.
Cluster headache
Tight band like headache precipitated by stress
Tension headache
Brief stabbing pain when chewing or brushing teeth
Trigeminal neuralgia
Photophobia, neck stiffness, fever, headache
Meningitis
Sudden onset excruciating headache. Reaches climax within minutes
Subarachnoid haemorrhage
Unilateral landing headshcem multiple triggers, lasts for hours, aversion to bright lights, can be preceded by aura
Migraine
20 minute unilateral debilitating headache p. Retro orbital pain with red eye and watering
Cluster headache
Headache triggered by changes in position or exertion. Changes in vision or headache with leaning forward, coughing, sneezing
Raised Icp- SOL- tumour, abscess. Hydrocephalus
Pain around eyes with blurred vision and halos around lights
Acute angle closure glaucoma
Scalp tenderness, unilateral. Jaw claudication .
Temporal arteritis
Red flags for headaches
Sudden onset High severity Fever New onset neurological deficit New onset cognitive dysfunction Change in personality Impaired GCS recent head trauma Headache triggered by cough, sneeze, exercise or change in posture Headache with halls around lights Headache with jaw claudication
LOC triggered you vigorous exercise in a young person
Hypertrophic cardiomyopathy or cardiogenic syncope
Triggered by pain, fear, prolonged standing. Preceded by pallor, nausea, sweating, no confusion afterwards
Vaso vagal
Triggered when standing up
Postural hypotension
Collapse on shaving or turning head
Carotid sinus sensitivity
Crying out, falling to floor, period of stiffness followed by rhythmic jerking that gradually decreases in amplitude and frequency, period of confusion after
Generalised tonic clinic seizure
LOC, pale and sweaty beforehand, jerking of limbs, eye rolled back short duration, no confusion
Vaso vagal
Violent shaking, head moving side to side , arching back, episodes of stillness before starting again, forced eye closure
Psychogenic non epileptic struck
Facial weakness on right side, motor weakness on left
Right side brainstem lesion
Left weakness and sensory changes
Right hemisphere lesion
