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Neurology Flashcards

1
Q

Foster Kennedy-Syndrome

A

Tumour of the frontal lobe - optic nerve compression - personality change

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2
Q

Gerstmann Syndrome

A

Dominant, angular gyrus Acalculia, agraphia, L-R disorientation, fingeragnosia (AALF)

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3
Q

Frontal Lobe

A

MOTOR personality primitive reflexes expressive dysphasia (dominant) anosmia optic nerve compression gait apraxia *Foster-Kennedy syndrome

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4
Q

Parietal lobe

A

SENSORY Sensory, visual spatial inattention Construction, dressing apraxia Lower quadrantanopia *Gerstamann’s syndrome

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5
Q

Temporal lobe

A

AUDITORY Receptive dysphasia upper quadrantanopia memory loss *Alzheimers

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6
Q

Occipital lobe

A

HOMONOMOUS HEMIANOPIA Alexia (without agraphia) *Anton’s syndrome

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7
Q

Anton’s Syndrome

A

bilateral occipital lobe infarcts from occlusion of the basilar arterial occlusion - Cortical blindness with confabulation

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8
Q

non-fluent, expressive, Broca’s aphasia

A

Dominant frontal lobe able to comprehend, paucity of words, know that they want to say Frustrated Transcortical motor*

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9
Q

fluent, receptive, Wernickes

A

Dominant temporal lobe incomprehensible fluent speech not frustrated Transcortical sensory*

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10
Q

Able to repeat a phrase but not to create a phrase..

A

Conduction aphasia arcuate fasiculus

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11
Q

Horner’s syndrome

A

Ptosis myosis (constriction) anhydrosis

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12
Q

Brainstem rules of 4

A
  1. 4 CNs in each location: I-IV above the pons; V-IIIX Pons, IX-XII Medulla 2. 4 Medial structures begin with M 3. 4 Side structures that begin with S 4. 4 medial motor nuclei dive into 12: 3, 4, 6, 12
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13
Q

4 medial brain stem structures

A
  1. Motor pathway 2. Medial lemniscus 3. Medial longitudinal fasicularis (MLF) 4. Motor nucleus
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14
Q

4 side brainstem structures

A
  1. Spinocerebellar tract 2. Spinothalamic tract 3. Sensory nucleus of CNV 4. Sympathetic tract
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15
Q

CNI

A

Olfactory

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16
Q

CNII

A

Optic Afferent pupil

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17
Q

CNIII

A

Occular motor Efferent pupil Levator palperbrae Superior, inferior, medial rectus Inferior oblique *Medial midbrain

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18
Q

CNIV

A

Trochlear Superior oblique (depression and intorsion) *Medial midbrain

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19
Q

CNV

A

Trigeminal - face sensation - muscles of mastication *Lateral Pons

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20
Q

CNVI

A

Abducens Lateral rectus *

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21
Q

CNVII

A

Facial - muscles of facial expression - stapedius - sensation of anterior 2/3 of tongue

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22
Q

CNVIII

A

Vestibulocochlear hearing and balance

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23
Q

CNIX

A

Glossopharyngeal middle ear, 1/3 tongue some swallowing

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24
Q

CNX

A

Vagus - Sensation of pharynx, larynx, oesophagus, thoracic, abdominal viscera - Motor of soft palate, pharynx, larynx

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25
CNXI
Accessory SCM and traps
26
CNXII
Hypoglossal Tongue movement
27
Arm & leg weakness on R Loss of vibration on R Tongue weakness and atrophy on L ? lesion
Anterior Medial Medulla Supplied by the vertebral artery Dejerine Syndome - Ipsilateral hypoglossal palsy - Contralateral hemiparesis - Contralateral lemniscal loss
28
Ipsilateral CN lesion + Contralateral hemiparesis what level is the lesion?
Brainstem
29
Ipsilateral occulomotor nerve + contralateral hemiparesis where is the lesion?
Midbrain Weber's syndrome Vessel: PCA
30
Ipsilateral UMN signs + loss of vibration proprioception Contralateral pain and temp loss
Brown-Sequard Syndrome
31
Foot drop + inversion weakness
L5 L5 radiculopathy: Weakness in toe \>foot + inverter weakness Loss sensation to medial foot + lateral leg (dermatome) Reflexes intact
32
Foot drop + eversion weakness
Common pEronEal nerve Reflexes and sensation intact
33
Foot drop + loss of anke jerk
Sciatic nerve + loss of sensation to lateral leg, dorsum and sole of foot
34
Wallenberg's syndrome + Lateral Medullary
Ipsilateral loss of pain and temp face Contralateral los of pain and temp body Ipsilateral cerebellar signs Occasionally hiccups
35
Sodium valortate and which antibiotic?
carbopenums - avoid!! induces +++
36
Balint Syndrome
Bilateral Parietal-Occipital lobe lesions (PCA) Bilateral loss of voluntary but not reflex eye movements
37
Most common side effect of levadopa
nausea and vomiting
38
Amantadine
enhances dopamine release
39
Symptomatic partial epilepsy
Focal onset seizures Normal intellect Lesions of the cortex Rx Carbamazepine +/- neurosurgery TLE 2' to hippocampal sclerosis Autosomal dominant frontal lobe epilepsy
40
Idiopathic generalised epilepsy
Generalised seizures Normal intellect Inherited ion channelopathies Juvenile onset myoclonic epilepsy Na Valproate ist line
41
Symptomatic secondary generalised epilepsy
Frequent severe generalised seizures ? mechanism +/- lesion Intellectual disability Lennox-Gastaut syndrome
42
Riluzole
sodium channel blocker that inhibits glutamine release disease modifying drug for MND - slows progression
43
Femoral nerve
L2,3,4 Quads Inner thigh sensation Knee Jerk
44
Anti-yo
cerebellar syndrome breast and ovarian
45
Foot drop L5
weakness to eversion and inversion normal NCS neurogenic EMG
46
Foot drop common peronneal nerve compression
+ weakness to eversion EMG changes confined to below the knee squatting/surgery fibular neck
47
Foot drop from sciatic nerve compression
EMG abnormal above the knee Post surgery / dislocation
48
Lumbar canal stenosis
leg and buttock pain worse up hill need to stop and sit down
49
Median nerve
sensory latency changes 1st motor changes 2nd axonal loss (reduced amplitude)
50
Ulnar compression
elbow deep branch in the palm
51
Radial nerve compression
Wrist drop with preserved flexion! ddx radiculopathy =\> loss of flexion
52
Brachial neuritis (plexopathy)
unilat shoulder pain then weakness carrying heavy backpack patchy changes on EMG/NCS winging of scapular (long thoracic nerve)
53
Progressive motor weakness - sensory involvement excludes..
MND MG MMN
54
Split hand
Wasting of FDIO + thenar eminance preserved hypothenar =\> cortical wasting =\> MND
55
Loss of reflexes =
neuropathy \*Except MMN preserved
56
Involvement of individual peripheral nerves?
MMN (motor only) mononeuritis multiplex (pain)
57
Neck flexion / extension weakness
Predominantly muscular conditions MG/MND/myopathies
58
Bulbar / respirator involvement?
MG MND
59
Proximal predominant weakness?
Myopathy \*CIDP
60
decr reflexes & weakness \> wasting motor \> sensory
likely demyelinating ie CIDP
61
NCS: decreased amplitude absent sural sensory potential
axonal loss
62
NCS: decreased velocity dispersion
demelination
63
NCS: peripheral demyelination
absent or prolonges F waves
64
NCS: \> 50% drop in amplitude
= focal block compression vs demyelination
65
EMG: absence of activity
normal
66
EMG: Neurogenic
Spont: fibrilations & sharp waves, fassiculations Morph: Large amplitude, increased duration, polyphasic Recruitment: Decreased, with gaps between the motor units
67
EMG: myopathic
Spont: fibillaltions and positive sharp waves Morph: small amplitude Recruitment: increased/early recruitment (short thick waves)
68
EMG: dive bomber sound
myotonia = myopathic EMG
69
EMG Fassiculations
Typically occur in neurogenic conditions in which the axons are sick or dying - MND - CIDP -Chronic nerve entrapments
70
Would you see upper or lower MN signs in primary lateral sclerosis?
UMN
71
Would you see upper or lower MN signs in primary muscular atrophy?
LMN
72
What is anti-MOG disease?
Anti-Myelin oligodendracyte glycoprotien MS or ADEM Can cause NMO Rx steroids/plasmapheresis
73
What is anti-AQP4?
NMO Optic nerve and spinal cord Rx steroids/plasmapheresis
74
Leber's hereditary optic neuropathy
Hereditary visual loss Mitochondrial inheritance
75
Biceps reflex
C5
76
Brachioradialis reflex
C6
77
Triceps reflex
C7
78
Patellar
L4
79
Achillies
S1
80
C5 radiculopathy
Muscle weakness: shoulder abduction, external rotation, elbow flexion and forearm supination Sensory loss: Lateral arm (axilla) Reflexes: C5, C6 Pain: neck, shoulder, scapular
81
C6 radiculopathy
Muscle weakness: shoulder abduction, external rotation, elbow flexion, forearm supination and PRONATION Sensory loss: lateral forearm, thumb and index finger Reflexes: Biceps C5, BR C6 Pain: neck, shoulder, scapula, LATERAL ARM AND HAND
82
C7 radiculopathy
Muscle weakness: elbow and wrist extension (radial), forearm pronation and wrist flexion. Sensory loss: index and middle finger palm Reflexes: Triceps C7 Pain: neck, shoulder, MIDDLE FINGER, hand
83
C8 radiculopathy
Muscle weakness: finger extension, wrist extension (ulnar), distal finger flexion, extension, abduction and adduction, distal thumb flexion. Sensory loss: Medial forearm, medial hand, 4th and 5th digits Reflexes INTACT Pain: neck, shoulder, MEDIAL forearm and hand, 4th and 5th DIGITS
84
T1 radiculopathy
Muscle weakness: thumb abduction, distal thumb flexion, finger abduction and adduction. Sensory loss: Anterior and medial forearm Reflexes INTACT Pain: Neck, medial arm and forearm
85
Highest risk factor for stroke?
Age risk doubles each successive decade after 55
86
Highest modifiable risk factor for stroke?
HTN Rx 33-44% risk reduction
87
Charcot Mary Tooth
Hereditary sensory motor neuropathy Distal weakness \> sensory - Peripheral neuropathy (glove and stocking) Pes cavus foot deformity HSMN 1 - hypertrophic myelin, onion bulbs (slow NCV) with secondary axonal degeneration HSMN2 - neuronal type degeneration (normal NCV)
88

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