Neurology eye (delta) Flashcards Preview

Neurology > Neurology eye (delta) > Flashcards

Flashcards in Neurology eye (delta) Deck (68)
Loading flashcards...
31

What is lateral medullary syndrome (wallenberg's syndrome)?

Ischaemia of lateral part of medulla due to blockage of posterior inferior cerebellar artery or vertebral artery

32

What are the clinical features of wallenberg's syndrome?

Damage to vestibular nucleus; vertigo, vomiting, nystagmus
Damage to descending symp tract; ipsilateral horner's
Damage to spinal trigeminal; ipsilateral loss of pain/temp and loss of corneal reflex
Damage to spinothalamic tract; contralateral loss of pain/ temp in trunk and limbs
Dysphagia
Horseness

33

What is adie's pupil?

Loss of postganglionic parasymp innervation to iris sphincter and ciliary muscle

34

What are the clinical features of adie's pupil?

Dilation and blurring on near vision
Light reflex absent or slow

35

What is Holmes-Adie syndrome?

Diminished or absent deep tendon reflex of lower limbs + adie's pupil +/- orthostatic hypotension

36

Ix for Adie's pupil

Slit lamp
0.125% topical pilocarpine. Adie's pupil will constrict while normal pupil won't

37

What causes argyll robertson pupil?

Neurosyphilis
Diabetes

38

What are the clinical features of argyll robertson pupil?

Bilateral, irregularly small pupils
Will NOT react to light
Normal accommodation

39

Will argyll robertson pupils constrict to 0.1% pilocarpine?

No

40

Causes of chiasmatic lesions?

Large pituitary adenomas
Craniopharyngiomas
Tuberculum sellae meningioma

41

What visual field defects will chiasmatic optic nerve cause?lesions

Bitemporal hemianopia

42

What will visual field defects will lesions at the optic tracts cause?

Contralateral homonymous hemianopia

43

What visual field defects will lesions at the optic radiations cause?

Temporal; contralateral superior homonymous quadrantanopia
Parietal; contralateral inferior homonymous quadrantanopia
Main radiations; contralateral homonymous hemianopia

44

What visual field defects will lesions at the occipital cortex cause?

Contralateral homonymous hemianopia with macular sparing
Congruous homonymous macular defects if posterior head injury

45

Features of 3rd nerve palsy?

Ptosis
Abduction and depression with ophthalmoplegia
Dilated pupil and accomodation abnormality

46

What causes a painful 3rd nerve palsy?

Posterior communicating artery anurysm

47

Causes of 3rd nerve palsy?

Diabetes and hypertex; affect blood supply to nerve
Posterior communicating artery aneurysm (painful)
Trauma
Uncal herniation

48

What is weber's syndrome?

Stroke affecting ventral midbrain; characterised by ipsilateral 3rd nerve palsy with contralateral hemiapresis

49

What is benedikt's syndrome?

Form of stroke affecting dorsal midbrain characterised by ipsilateral 3rd nerve palsy with contralateral tremor, ataxia or chorea (red nucleus)

50

Clinical features of 4th nerve palsy?

Vertical diplopia
Hypertropia
Depression of eye is limited
Compensatory head tily

51

Causes of 4th nerve palsy?

Congenital
Trauma

52

Clinical features of 6th nerve palsy

Horizontal double vision
Esotropia in primary position
Abduction limited

53

Causes of 6th nerve palsy?

Diabetes and hypertx
Increased ICP; abducens passes over petrous tip and so can easily be squashed by increased pressure

54

What is the pathology of myasthenia gravis?

Autoimmune disease of ACh receptors at post-synaptic NMJ

55

Clinical features of myasthenia gravis

Ptosis; bilateral
Cogan lid twitch
Diplopia
Ophthalmoplegia
Fragility and weakness or muscles of facial expression and proximal limb muscles

56

Ix for myasthenia gravis

Ice test; ptosis imrpvoes
Antibodies; anti-ACh receptor antibody and MUSK antibody
EMG and muscle biopsy
Imagine of thorax for thymoma

57

Mx for myasthenia gravis?

Pyridostigmine
Steroids
Immunomodulators
Surgery if thymoma present

58

Features of myotonic dystrophy

Delayed muscular relaxation and muscle wasting
Early onset cataract
Ptosis
Hypermetropia

59

What causes myotonic dystrophy?

AD
Trinucleotide repeat on chromosome 19

60

Cause of NF1

AD
Mutation in NF1 gene on chromosome 17