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Flashcards in Week 3 Neuro Deck (26)
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1

Infantile spasms Sxs

Sudden flexion and adduction of arms, few seconds many times daily

2

Absence seizures Sxs

Typical: Ages 4-12 yrs, no falling or convulsions, many times daily with eyelid fluttering, neuro and cognitive exams normal
Atypical: under 4 yrs, assoc w Lennox Gastaut, LOC complete, hx of damage to nervous sys, seizures into adulthood

3

Tonic clonic seizures

Outcry->LOC/falling--> tonic contraction with clonic motions, tongue biting, frothing, 1-2 min

4

Atonic seizures

Children (assoc w Lennox-Gastaut), LOC, fall to ground

5

Myoclonic seizures

Brief, lightening like jerks of a limb, bilateral or unilateral

6

Partial seizures

Excess neuronal discharge from one cerebral cortex, usu from structural abnormalities
Simple or complex

7

Simple partial seizure

Motor and sensory seizures= structural brain disease... Work up!!
Motor: contralateral face, trunk, limbs with clonic movement and Jacksonian March
Sensory: parasthesias or tingling in extremity/face assoc with distortion of body image

8

Complex partial seizure

Originate in temporal lobe, aura prodrome

9

Postictal state

After a generalized seizure: deep sleep, headache, confusion, muscle soreness

10

History questions for seizure dx

Sxs, prior head trauma or CNS infection, drug use or withdrawal, family hx

11

Brain abscess

Due to sinusitis, mastoiditis, head wound, sepsis
Sxs: headache, nausea, vomiting, lethargy, fever, seizures

12

Encephalitis

Inflammation of brain parenchyma, due to virus (rarely helminthic)
Sxs: fever, headache, seizures, neuro deficits
Dx: MRI and CSF testing

(Eg rabies: hydrophobia with ascending paralysis)

13

Subdural empyema

Due to sinusitis, ear infection, cranial trauma, bacteremia (rare)
Sxs: fever, lethargy, focal neuro deficit, seizure

14

Creutzfeldt-Jakob Dz

Prion dz, variant from meat with bovine spongiform encephalopathy (Mad Cow)
Suspect in elderly pts with rapidly progressing dementia esp with ataxia or myoclonus

15

Bacterial meningitis

Rapidly progressing, N. Meningitidis or Strep pneumoniae
Sxs: severe! Malaise, fever, irritability, vomiting, fever, headache, seizures in 40% children

16

Viral meningitis

Due to enterovirus or HSV
Sxs: fever, myalgia, GI or resp sxs, headache, fever, nuchal rigidity

17

Essential tremor

FHx in 50%, with voluntary movement, bilateral, alcohol alleviates

18

Tremor red flags

Abrupt onset, under 50yrs with no family hx, neuro deficits, tachycardia and agitation

19

Generalized seizures

Electrical discharge involves cortex of both hemispheres, often due to metabolic disturbances
Infantile spasms, absent seizures (petit Mal), tonic-clonic (grand Mal), atonic, myoclonic

20

Huntington Dz

Neuronal loss in basal ganglia --> dementia then chorea, tics, myoclonal disturbances, facial grimacing

21

Parkinson Dz

Bradykinesia, resting tremor, cogwheel rigidity, postural reflex impairment, coarse tremor

Due to Lewy bodies

22

Multiple Sclerosis

20-40 yrs, paresthesias in 1+ extremities, weakness or clumsiness of leg or hand, stiffness, gait disturbances

PE: Opthalmoplegia, central scotoma, wide gait, hyper reflexive DTRs

23

Myasthenia Gravis

Age 20-40yrs (F), Episodic muscle weakness, fatigabilify, ptosis, diplopia

Dx: serum anti-AchR Abs and EMG

24

Guillain Barre syndrome

Sxs: paresthesias of feet then hands, rapid severe muscle weakness (symmetric), respiratory paralysis
PE: sinus tachycardia, urinary retention, no DTRs

25

Amyotrophic Lateral Sclerosis

Lou Gehrig's Dz.
Sxs: random, asymmetric cramps, weakness, muscle atrophy. Fasiculations, hoarseness, dysphagia
PE: hyper reactive DTRs, + Babinski
Dx: clinically

26

Gliomas

Primary tumors in brain parenchyma