Flashcards in Neurology Deck (37):
What kind of aura would you expect for epilepsy?
Deja vu/Jamais vu
Which cranial nerves may be affected by a cavernous sinus thrombosis?
3, 4, 5, 6
5 is particularly associated with pain and loss of corneal reflex
Give 5 causes of any cranial nerve palsy.
Give 3 causes of a unilateral Ptosis. Will they be partial or complete?
Horner's - partial
CN 3 palsy - complete
Give 3 causes of a bilateral Ptosis.
What are the features of a cranial nerve 3 palsy?
Eye down and out
What are the signs of Horner's syndrome?
Miosis (constricted pupil)
How would you differentiate between Bell's palsy and a umn facial nerve palsy?
If frontalis is spared then it is umn stroke.
Due to bilateral innervation of this muscle.
What are the bulbar signs? What are they indicative of?
Slurred speech, dysphagia, absent gag reflex.
LMN damage to CN9-12 in medulla
What is your differential for a CN1 problem?
What is your differential for monocular blindness?
Ophthalmic artery thrombus
Giant cell arteritis
What is your differential for bitemporal hemianopia?
Aneurysm in the circle of Willis
What is your differential for a homonymous hemianopia?
Anything behind the chiasm:
What is your differential for a CN5 problem?
What is your differential for a CN8 problem?
What kind of aura would you expect for a simple vasovagal faint?
What are the myotomal roots of the reflexes?
Ankle - S1/2
Knee - L3/4
Biceps and brachioradialis - C5/6
Tricep - C7/8
What are the cardinal signs of Parkinson's?
Rigidity (cog wheel)
Resting tremor (pill rolling)
May also have masked fascies and slurred speech.
What are the signs of a cerebellar lesion?
Speech - slurred
What are the signs of an ulnar nerve lesion?
LMN signs in fourth and fifth fingers
What are the signs of a median nerve lesion?
LMN signs in the thenar muscles and palmar surface
What are the signs of a radial nerve lesion?
Wrist drop and weakness of extension of the elbow
What are the signs of an upper motor neuron lesion?
Spastic muscle weakness
What are the signs of a lower motor neuron lesion?
How would you grade muscle weakness?
0 - no movement
1 - flicker
2 - unable to move against gravity
3 - unable to move against resistance
4 - reduced power, able to move against resistance
5 - normal
What birth injury causes damage to the upper brachial plexus? How does it present?
Erbs = waiters tip
Arm internally rotated
What birth injury causes damage to the lower brachial plexus? How does it present?
Wasting of small muscles in hand - claw
Flexion of the elbow and wrist
Horner's may accompany
Give 5 causes of peripheral neuropathy?
Uraemia (kidney failure)
Give 4 causes of foot drop.
Common peroneal nerve palsy
Motor neurone disease
What is syringomyelia? How does it present?
Blockage of CSF in spinal canal - syrinx
Affects spinothalamic tracts as they cross
Loss of pain and temperature on both sides in a cape like pattern.
What is brown squared syndrome and how does it present?
Lateral hemi section of the spinal cord
Lose vibration and proprioception on same side
Lose pain and temperature and crude touch on opposite side.
What is cauda equina? How does it present?
Damage to the lumbar region L1-5 can also damage the sacral nerve roots.
Leads to saddle anaesthesia, urinary incontinence, sexual dysfunction, motor and sensory deficits.
What is the differential for a positive Romberg test?
NOT cerebellar, they will not balance with eyes open.
Lesion to dorsal columns (proprioception) eg Neurosyphilis
Give three types of gait and what causes them.
Festinating - Parkinson's
Trendelenberg - superior gluteal nerve palsy or fractured neck of femur
Antalgic - arthritis
Give four types of tremor and what causes them.
Intention tremor - cerebellar lesion
Resting tremor - Parkinson's
Flapping - metabolic
Drug induced - anti psychotics
What are the main causes of carpal tunnel syndrome?
Repetitive strain injury