Flashcards in Neurology Deck (280)
Difficulty standing on toes, reflexes dec'd
Wrist drop -
Peroneal nerve comopression
Antibody induced acute polyneuropathy - occurs in
Yound pt with ankle sprain - takes NSAIDs - extreemm tenderness when bed sheet touchs - exam bluish discoloration - dx?
Complex regional pain syndrome - reflex sympathetic dystrophy
If pt with patchy deminralization - bisphosphonates are effective - treatment even in absense of osteoporosis
19yo playing football has a sudden imopact and falls to ground - appears confused upon immediate exam - no LOC, 15 minute later normal cognition and vision and finger -nose test - wtd?
Can go back and play (no LOC)
20yo playing football - concussive injury - no LOC - in daze on immediate exam - 20 min later alert and oriente but with some amnesia which resooles 15 min later
Monitor closely, if no sx for week then can play again
24yo had a concussioni playing ice hockey - lost conciousness x 30 sec - upon waking alert, oreient, figner to nose normal - vision fnorma - WTD (less than 1 min LOC with normal physical exam)
Send hoem with family observation withold from competition - if remains asx can back to play in 1 week
24yo had concussion playing contact sports, lost consiounes x 20 sec and waking up was in daze which cleared up on wya to ER (less than one min LOC, abn physical exam upon awakening
ER eval with CT/MRI - withdraw from competition - if asx can go back to play in 2 weeks
Concussion with LOC > 1 min with nromal phsyical
ER eval with CT/MRI - withold from competition - if still asyxmt back to play in 2 weeks
1. Tonic Clonic - valproate, lamotrigine, levetiracetam, topriamate
2. Absense/Petit mal:
without aura or post ictal sx, 3 sec spike and wave patternon EEG
tx: ethosuximide, valproate, lamotrigine
1. Simple - focal seizure affects small volume of cortex, no LOC (psychic sensation, deja vu
2. Complex - involves large enough cortex to cause loss of conciousness
tx: Carbamazepine, phenytoin, valproate, levetiracetam, lamotrigine, gabapentin(adjunctive)
Medications that cause seizures
Imipenum, tramadol, bupropion, haldol, meperiridine, PRBC
Partial: Carbamazepine, phenytoin, valproate, levetiracetam, lamotrigine, gabapentin
Best Anti-sz med for elderly
Best anti-Sz med for with liver dz
Best anti Sz medication in pregnancy
What antiseizure medication causes kidney stones
After the first seizure - best dx imaging is...
CT if neg -> MRI
Then do EEG (epileptiform spike +- slow waves
NORMAL EEG does NOT r/o seizure d/o
Pt makign presentation to supervisor slumps over in chair, diaphretic, has jerks of arms nad legs several times - completely recovers in 30 sec and has pallor, BP normal, cardiac/neuro exam normal dx?
Pt in dental chair passes out andhas jerky movement o arms and legs, completely recovers in 30 sec - diaphoretic - similar episode once before
22yo h/a, smells of burnign rubber, feels strange, no convulsions seen dx?
partial seizure/psychomotor epilepsy
Pt has generalized seuzures not better with dilantin - serum Ca low, ca cl injections don't help wtd?
Iv Mg SO4
22yo with weird sensation in stomach followed by sudden freezing, swallowing chewing, lip smacking - minute later she starts talking and doesn't recall eepsode
30yo F brought to office - say having recurrent spells of starting for several seconds the haveing intense familiarity with surrounding sand strangers most likely affected lobe is?
Young woman with epigastric rising sensation - most likely dz?
simple partial seizure
temporal lobe (deja vu)
22yo F with husband and narrating complaint then her leg starts jerking which gets wors and on /off x several minutes - then SOB, then holds head tight afte r3 min jerking stops and feels dizzy and has headache dx?
55yo brought in by family - having episodes when staring blankly for several seconds then shakes hand repeately fo rfew minutes then feels tired - no focal neuro deficits, MRI normal wtd?
Sleep deprived EEG
dx: Complex partial
Pt with onset of seziure of left arm and then spreads to left leg - after episode wk of left arm and leg dx?
starts at arm and marches toward leg in terms of sx (begin with fingers - end with legs) - NO LOC
Treatment of status epilepticus (sz >30min or LOC between 2 mor more seizures
1. IV glucose + thiamine
3. Loading dose Phenytoin or Fosphenytoin
4. Maximize Phenytoin
6. General anaestheia/neruomuscular blockade
Pt with new monset seizure - post ictal state recommendation?