Neurology - conditions Flashcards
(35 cards)
Name 6 signs and patient speak phrases for anterior horn cell disorders
UMN - increased reflexes and tone, positive babinski
LMN - fasciculations, weakness, wasting
“tripping, problems with buttons”
Name 3 UMN and 3 LMN symptoms in MND
UMN - increased reflexes, tone and babinski signs
LMN - fasiculations, muscle wasting, weakness
name a patient speak phrase and cause of parasellar syndrome
bashing both wing mirrors, period problems, not needing to shave as much
hypopituitarism
Which are the 4 main mononeuropathies?
carpal tunnel
ulnar
radical
axillary
How do patients describe neuropathic pain?
“pain wakes them up at night”
“tingling”
What are 3 components of 3rd nerve palsy and how does it occur?
fixed dilated pupil, decreased eye movements, ptosis
3rd nerve enters cavernous sinus, it can be compressed onto the apex of petrous of temporal bone
What is the patient speak phrase and test for proximal myopathy?
“hair, chair and stair” - struggle on hills
one legged squat, they struggle to lift their own weight
What is radiculopathy?
a pinched nerve
What are the most common radiculopathies?
C6 - elbow flexion strength, thumb sensation, biceps
C7 - elbow extension, middle finger and triceps
L5 - dorsiflexion, big toe and dorsum sensation
T1 - plantar flexion, little toe and sole and heel, ankle jerk
What are some patient speak phrases for myelopathy?
small movements go first
“treacle hands, struggle with buttons, walking on cotton wool, heavy legs which jerk at night” they wear velcro
How would a patient describe pain in radiculopathy and which arethe 4 main nerve roots affected?
“sharp and shooting” no on rest
C6, C7, L5, S1
What are the 3 main mononeuropahties and their signs?
carpal tunnel - worse at night
radial nerve - wrist drop
common perineal - dorsum loss of sensation
What is the definition of pyramidal weakness?
weakness in extensor of upper limb and flexors of lower limb
What are the patient speak phrases for proximal vs. distal muscle weakness?
Muscle (proximal) - trouble with chair, hair and stair
nerve (distal) - trouble counting money (loss of fine finger movements), tripping
What is Creuzfeld-Jakob Disease?
Human prion disease - neurodegenerative illnesses due to the accumulation of small infectious pathogens containing protein but no nucleic acid
- no cure, from infected meat
myoclonus, visual disturbances, cerebellar, pyramidal and extrapyramidal symptoms
What would weakness, with no abnormal pain or sensation, with increased reflexes and tone be?
MND
- also look for fasciculations
What would weakness, with no abnormal pain or sensation, without increased reflexes and tone be?
Myasthenia gravis
- look out for eye signs
What would weakness & abnormal pain and sensation & asymetrical weakness be?
MS
- worse in hot shower, multiple episodes, optic neuritis
What would weakness & abnormal pain and sensation & symetrical weakness be?
Guillan Barre syndrome
- post infective
What are some other causes of weakness?
abnormal K or Ca anaemia post-viral malignancy infection low cardiac output psychogenic inflammatory myopathy proximal myopathy
What would you assess in cerebellar examination?
gait (ataxia), speech (dysarthria), tremor
What are some causes of cerebellar disease?
inherited - Friedreich’s ataxia (recessive), spinocerebellar ataxia (dominant)
Acquired - toxic (alcohol, lithium), immune mediated (post-infectious cerebellitis), neurodegenerative (MSA-C has hot-cross bun sign on MRI), idiopathic sporadic ataxia
What is CIDP and how does it present?
chronic inflammatory demyelinating polyneuropathy
fatigue, decreased reflexes, sensory deficits, LMN signs
How would you test for CIDP?
EMG and NCS (slowed conduction in NCS) serum test to exclude autoimmune LP - anti-ganglioside antibodies nerve biopsy US of peripheral nerves TREAT: IVIG, plasmapheresis, corticosteroids, immunosuppressants
