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Flashcards in Revision 2 Deck (198):
1

what area is affected early in alzheimers

nucleus basalis of meynert (group of CHOLINERGIC neurones)

2

what is the treatments for alzheimers

acetylcholinesterase inhibitors- donzepezil, galantamine, rivastigime (monotherapies) for milf to mod
memantine (NMDA receptor antagonist) for severe/ AChEi CI

3

what mutation= 100% penetrance of huntingtons

40 or more CAG repeats

4

what types of inheritance does huntingtons have

genetic anticipation
autosomal dominant

5

what are parkinson plus syndromes

diseases that cause parkinsonism + other symptoms:
- multi system atrophy
- dementia with lewey bodies
- progressive supranuclear palsy
- corticobasal degeneration

6

what is multi system atrophy

group of disorders that progressively affect the central and autonomic nervous by system damaged oligodentrocytes (myelination) by accumulation of alpha synuclein

two types- MSA-P: characterised by parkinsons motor symptoms, deteriorates faster. MSA-C: cerebellar, lack of coordination and balance, intention tremor, slurred speech and difficulty swallowing (dysphasia)

both types characterised by autonomic symptoms- orthostatic hypotension, constipation, increased sweating, sleep apnoea, sexual dysfunction

7

what protein is found in dementia with lewey bodies

alpha synuclein

8

what are the symptoms of DLB

cognitive impairments, visual hallucinations, inability to focus, inflexible thinking and paranoia. DLB patients initially have these cognitive symptoms but also develop motor symptoms similar to PD such as bradykinesia, tremor, rigidity, and shuffling walk. Similar to PD, DLB patients also have REM sleep behavior disorder in which they act out their dreams.

9

what is progressive supranuclear palsy

chronic neurodegenerative syndrome which affects cognition, eye movements and posture

10

what are the symptoms of progressive supranuclear palsy

supranuclear (primarily vertical) gaze palsy
extrapyramidal - akinesia
cognitive dysfunction
postural instability

vague fatigue, HAs, arthralgia, dizziness, depression, modd changes, progressive dementia

11

what is a supranuclear palsy

the inability to look in a particular direction as a result of cerebral impairment:
-frontal lobe (frontal eye field)-> pontine horizontal gaze centre (PPRF) -> abducens nucleus-> lateral rectus
-occipital cortex-> oculomotor nucleus -> CN3 and medial longitudinal fasciulus -> pontine horizontal gaze centre

loss of voluntary movements of eye
as brainstem intact, all reflex conjugate eye movements normal

12

how do you distinguish a vertical gaze palsy from a cranial nerve palsy

both eyes affected
pupils unequal but fixed
no diplopia
reflexes intact

13

what is corticobasal degeneration

where multiple areas of the brain atrophy
begins around 60
start unilateral then go to other side
- poor coordination, rigidity, impaired balance, dysphagia
-personality changes, inappropriate behaviours, compulsive behaviours

14

what causes most postural tremors

essential- autosomal dominant inheritance, gets better when you drink alcohol

15

what is a treatment for an essential tremor

propanolol

16

what does an intention tremor suggest

cerebellar diseases

17

how does huntingtons usually present

strange movements and behavioural changes

18

what is sydenham chorea

form of chorea that is more common in females adolescents and linked to rheumatic fever (group A beta haemolytic strep infection)

19

what does myoclonus look like

brief electric shock like movements

e.g. 20 y/o guy gets milk but drops it= juveline myoclonic epilepsy

20

why is alzheimers linked to downs syndrome

alzheimers cause by beta amyloid precursor protein (insoluble, forms plaques which disrupt neuronal signalling) and the gene that codes for this is on chromosome 21 (trisomy 21= more production of amyloid= build up of plaques)

21

loss of dopaminergic neurones in the substantia nigra =?

parkinsons disease

22

what does the globus paladus alway inhibit

the thalamus - main job of direct pathway is to reduce this inhibition

23

what is the tremor like in parkinsons

resting
4-6 Hz
pill rolling
starts on one side then becomes bilateral

24

sudden onset bilateral parkisons with resting tremor= ?

drug induces parkinsonism

25

name two drugs that can cause drug induced parkinsons

dopamine antagonists: haloperidol, metoclopramide

26

what is hemiballism

wild movements of one arm/leg caused by an infarct of the subthalamic nucleus (part of the indirect pathway)

27

how is hemiballism treated

self limiting
treated over a few months with antipsychotics

28

parkinsonism with orthostatic hypotension and has a poor response to levodopa =?

multi system atrophy

29

where is the lesion in vascular parkinsons

infarcts in basal ganglia

30

how do the symptoms of vascular parkinsons differ from normal parkinsons

vascular is more prominent in the lower limbs, resting tremor in legs

31

what causes syndenhams

infection with group A beta haemolytic strep causes rheumatic fever- when infected antibodies from against basal ganglia and cause syndehams

32

clear CSF with normal opening pressure
oligoclonal bands present

MS

33

clear csf with normal opening pressure
lymphocytes present
high protein
normal glucose

viral

34

what are the signs of IIH

high CSF opening pressure
bilateral papilloedema (can progress to blindness)

35

what is the management for IIH

1st line weight loss
2nd line acetalozamide
3rd line shunt

36

is there CSF in the subarachonoid space

yes

37

yellow tinge in CSF 12 hours after haemorrhage = what type of haemorrhage

SAH

38

can SAH be spontaneous or traumatic

both

39

is viral meningitis more/less intense than bacterial/ TB meningitis

less intense

40

what are all meningitis' treated as until proven otherwise

bacterial

41

what is the Tx for viral meningitis

supportive

42

cloudy CSF
elevated opening pressure
neutrophils (aka polymorphs/ polymorph pleocytosis) present
high protein
low glucose

bacterial meningitis

43

opaque CSF
if left to settle forms a fibrin web
elevated opening pressure
lymphocytes present
high protein
low glucose

TB meningitis

44

best initial test to diagnose:
alzheimers

MMSE
-will have impaired recall
-lose short term memory
-retain long term memory
-eventually become disorientated to time, place and person

45

best initial test to diagnose:
frontotemporal dementia

MRI
-will show focal atrophy in frontal and superior temporal lobes

46

what is picks disease

FTD

47

how will FTD present

behavioural symptoms, self neglect, language (lose vocab)

48

what is FTD associated with

MND

49

how is FTD different from huntingtons

not inherited
has no chorea

50

best initial test to diagnose:
-vascular dementia

MRI
-shows long term damage from infarcts

51

what is the classic presentation of vascular dementia

step wise cognitive deterioration - result of multiple infarcts

52

which anti-epileptic drug:
used in pregnancy
SEs: rash, SJS

lamotrigine
(least teratogenic, given with folic acid)

53

which anti-epileptic drug:
used for treatment of absence seizures, blocks the thalamic T type Ca2+ channels

ethosuximide

54

what are absence seizures

usually happen in children
go completely blank
wont move/ remember it then snap out of it

55

which anti-epileptic drug:
Na+ channel activation
increase GABA concentration
should be avoided in women of childbearing age
used for majority of generalised seizures
SE: weight gain, alopecia
is a P450 enzyme inhibitor

sodium valoprate
(highly teratogenic)

56

what is a simple partial seizure

mini electrical disturbance in part of the brain
will have awareness of what is happening
can be motor (frontal lobe), visual (occipital lobe), sensory (parietal)

57

what is a complex partial seizure

involves a bigger bit if the brain
may have aura- hear/ see feel something abnormal/ will have de ja ve (with itself can be seizure)
then loss of awareness
confusion/ drowsiness after seizure = the post ecter phase

(aura, loss of awareness, post ecter ohase)

58

what type of seizures is an absence seizure

generalised

59

what is the tonic phase of a seizure

stiffening of whole body, stiff, rolling eyes back

60

what is the clonic phase of seizure

jerky movements

61

what does loss of awarness in a seizure mean

it cannot be a simple partial

62

what is a generalised seizure

seizure type characterised by loss of consciousness, widespread motor manifestations of tonic contractions followed by clonic jerking movements, and a suppressed level of arousal following the event (post ecter phase)

May either reflect an underlying generalised-onset epilepsy or focal epilepsy that has secondarily generalised.

63

what are non epileptic seizures

not caused by abnormal electrical activity in brain
can be psychogenic
will not have post ecter phase
movement is not coordinated

64

what treatment for non generalised seizures

(simple and complex partial seizures)
carbamazepine

65

what is the first line Tx for absence seizures

sodium valporate/ ethosuximide

66

1st line for generalised tonic clonic seizure

sodium valporate

67

what is status epilepticus

seizure lasting more than 30 mins

68

what is the Tx for status epilepticus

at 5 mins give IV lorazepam

69

best long term management:
uncontrolled hypertensive who develops a stroke

antihypertensives
BP control

70

best long term management:
patient who has a seizure due to a CVA

carbamazepine

71

best long term management:
patient with an ischaemic stroke is found to have AF

warfarin

72

best long term management:
ischaemic stroke

(acute treatment is aspirin in first 2 weeks)
lifelong clopidogrel

73

most useful Ix to order:
65 y/o male patient presents to the clinic with double vision and ptosis
he has weakness that gets worse during the day

anti AChR (acetylchonine receptor) antibodies
(diagnosis here is myasthenia gravis- antibodies against post synaptic channels, affects the eyes)

74

what are the features of lambert eaton syndrome

auto immune condition against pre synaptic channels
weakness of limb muscles
associated with small cell lung cancer

75

what antibodies for lambert eaton

anti musk

76

which medication:
20 y/o female with tonic clonic seizures which wants to conceive soon

lamotrigine

77

which medication:
patient with epilepsy on medication presents with these SEs- blurred vision, vertigo and blood results reveal a hyponatremia

carbamazepine

78

which medication:
a mother has noticed her 8 y/o daughter has been day dreaming and not paying attention
after discussing with GP an EEG was organised which revealed a 3Hz spike wave

ethosuxomide

79

best management:
58 year pld man with ischaemic heart disease requires treatment for an acute migraine attack that has not responded to paracetamol

high dose NSAIDs with antiemetic

80

best management:
25 year old male who presents with right sided supraorbital pain and ipsilateral ptosis and miosis
pain lasts 30 mins and usually occurs at same time every night

high flow oxygen with SC sumatriptan
(diagnosis is a cluster HA)

long term management for cluster HAs is verapamil

81

what are the features of a cluster HA

Stabbing pain around orbit or in temporal lobe. Have circadian rhythm, last 30 mins to 3 hours.

82

how long do migraines last

5-72 hours if untreated

83

what part of head to migraines affect

are hemicranial

84

best management:
55 year old female patient presents with left sided supraorbital pain with ipsilateral nasal congestion. This occurs about 20 times a day and lasts about 10 minutes

indomethacin
(diagnosis is paroxysmal hemicrania)

85

how is paroxysmal hemicrania different from cluster HAs

occurs more frequently
lasts shorter amount of time

86

how do you control vomiting in a patient with parkinsons

domperidone (is a dopamine antagonist but doesnt cross BBB)

87

what medication:
Patient on therapy for parkinsons develops acute psychosis

quetiapine
pick secondary generation antipsychotics as first gen will worsen parkinsons

88

what medication:
dyskinesia is a SE of this drug used in the treatment of parkinsons

levodopa
acts as dopamine for the brain but over time can cause excessive unwanted movement (dyskensia)

89

how is dyskensia prevented when levodopa is given

not given on its own, given with dopadecarboxylase inhibitor which prevents peripheral conversion of the drug to dopamine

90

what medication:
1st line for parkinsons

levodopa

91

causative organism:
pregnant lady presents with signs of meningism
culture reveals gram +ve flagellate rods

listeria
(tends to affect young babies, elderly and pregnancy women)

92

how is listeria meningitis treated

amoxicillin

93

Causative organism:
18 y/o uni student presents with stiff neck, photophobia and fever
cultures reveal a gram -ve diplococcus

neisseria meningitidis

94

what is the excitatory neurotransmitter

glutamate

95

what is the inhibitory neurotransmitter

gaba/glycine

96

name two opioid antagonists

naloxone and naltrexone

97

what are alpha and delta nerve fibres

mechanical/ thermal nociceptors that are thinly myelinated (first response- sharp pain)

98

what are C fibres

unmyelinated
are second response- throbbing pain

99

what is the role of astrocytes

maintain BBB

100

what is the role of oligodendrocytes

myelination of CNS

101

what is the role of schwann cells

myelination of PNS

102

what is the role of ependymal cells

CSF regulation

103

what is the role of microglia

phagocytes

104

what is the role of the inf and sup articular processes on vertebrae

mobilise with adjacent vertebrae via synovial facet joints

105

where on a vertebrae does the rib articulate

transverse processes

106

where do the anterior and posterior rami supply

anterior- anterolateral body wall
posterior- posterior body wall

107

is the anterior or posterior rami bigger

anterior

108

which part of the grey matter butterfly gives of anterior roots

top wings

109

name the ascending tracts

dorsal column- fasiculus gracilis and cuneatus
dorsal and ventral spinocerebellar tract
fasciculus proprius
spinothalamic and spinoreticular tract

110

name the descending tracts

medial longitudinal fasciculus
lissauers tract
lateral and ventral corticospinal tracts
rubrospinal tract
pontine reticulospinal tract
meduallry reticulospinal tract
lateral vestibulospinal tract
tectospinal tract

111

summaries the DCML

fine touch
conscious proprioception
fibres cross in the medulla

112

summarise the spinothalamic tract

pain, temperature, deep pressure
fibres cross segmentally

113

summarise the corticospinal tract

fine precise movement, particularly of distal limb muscles
forms on the medulla - pyramidal tract
85% of fibres cross in the caudal medulla at the decussation of the pyramids

114

where is the primary somatosensory cortex

post central gyrus in the temporal lobe

115

where is the primary motor cortex

pre central gyrus, frontal lobe

116

where is the lesion in decoricate posturing

(flexor)
cervical spinal tract/ cerebral hemisphere
rubrospinal tract dominant
(decorate things red at christmas)

117

where is the lesion in decerebrate posturing

(extensor)
midbrain/ pons
vestibulospinal tract prominant

118

from medial to laterla in the primary motor cortex, list the parts of body controlled by each bit of brain

foot
hip
trunk
arm
hand
face
tongue
larynx

119

what is the role of the basal ganglia

modulates motor control

120

what makes up the basal gamglia

caudate
putamen
globus pallidus
subthalamic nucleus
substantia nigra

121

what are the functions of the frontal lobe

voluntary movement
reasoning
executive function
personality
inhibition
initiative
expressive language
habit learning
emotional control

122

what are the functions of the parietal lobe

knowing left from right
reading
writing
body orientation
calculation
two point discrimination
graphaethesia

123

what do lesions in the DOMINANT parietal lesion cause

dysphasia
dyscalculia
dyslexia (difficuly learning to read. interpret words, letters and symbols)
apraxia
agnosia
gerstmann syndrome (acalculia, agraphia, finger anomia, difficulty in differentiation of right and left)

124

what is apraxia

inability to perform complex movements in the presence of normal motor, sensory and cerebellar function

125

what is agnosia

tactile- inability to recognise or discriminate objects through touch

126

what is agraphia

inability to write

127

what is finger anomia

cant recognise own or other peoples fingers

128

what does a lesion in the NON DOMINANT parietal lobe cause

spatial disorientation
constructional apraxia
dressing apraxia
anosognosia (lack of self awareness of own medical illness)

129

what are the functions of the temporal lobe

understanding speech
memory
hearing
emotions
sense of identity
recognising faces

130

what do strokes in the dominant half of brain often have

language affected which has major implications for rehab

131

what is the acute treatment for an ischaemic stroke

Alteplase clot buster 0.9 mg/kg (max 90mg)
10% over 60 mins
Rest over 8 hours
MUST be given within 4.5 hours of symptom onset

132

what is a TACS

total anterior circulation stroke
all three of:
-unilateral weakness and/or sensory weakness of face, arm and leg
-homonymous hemianopia
-higher cerebral dysfunction (dysphasia, visuospatial disorder)

133

what is a PACS

partial anterior circulation syndrome
two of:
-unilateral weakness and/or sensory weakness of face, arm and leg
-homonymous hemianopia
-higher cerebral dysfunction (dysphasia, visuospatial disorder)

134

what is a POCS

posterior circulation syndrome
one of:
-cerebellar/ brainstem syndrome
-loss of consciousness
-isolated homonymous hemianopia

135

what is a LACS

lacunar syndrome (subcortical stroke due to small vessel disease)
one of:
-unilateral weakness and/or sensory deficit of face and arm, arm and leg or all three
-pure sensory stroke
-ataxic hemiparesis

136

what do subdural haematomas look like on MRI

banana

137

explain the slow onset of symptoms in a subepidural haematoma

bridging veins rupture
these are low pressure so blood spreads around brain before displacing it, gradual increase in symptoms

138

what vessel is classically ruptured in an extradural haemorrhage

middle meningeal artery (runs under pterion)

139

what is the formula for cerebral perfusion pressure

CPP= MAP - ICP

140

how do you remember how much each segment of the GCS scores

eyes (four letters)
speak (five letters)
motor (M6 motorway)

141

what is the minimum GSC score

3

142

what GCS score= coma

<8

143

what are the headache red flags

new onset headache >55
known/ previous malignancy
immunosuppressed
early morning HA
excerbation by valsalva
significant trauma in Hx
coagulopathy with trauma

144

what is the management for migraines

Diary to find triggers – then exclude triggers
NSAIDS eg 900mg Aspirin
Triptans (oral first) - must be at start of headache and repeated only once.
More than 3 attacks in a month – prophylaxis:
-Propranolol
-Topiramate (loads of side effects, start slow)

Remember contraception issues in women

145

what are the symptoms of trigeminal neuralgia

severe stabbing unilateral pain, v severe
Duration: 1sec to 90 secs
Frequency: 10 to 100 day
Bouts pain may last from a few weeks to months before remission
more common in females
any frequency
cutaneous trigger

146

what is the main drug used to treat trigeminal neuralgia

P450 inducer

147

what can trigger cluster HAs

alcohol

148

what are the features of a cluster HA

more common in males
boring pain
V. severe
orbital
15-180 mins
1-8 per day
autonmic features

149

what are the features of paroxsymal hemicrania

more common in females
boring pain
v severe
orbital
lasts 2-45 mins
1-40 per day
autonomic features
responds to endomethicin
mechanical trigger

150

what are the features of SUNCT

(short lasting unilateral neuralgiform HA with conjunctival injection and tearing)
more common in women
stabbing pain
severe
orbital
15-120 seconds
1 a day- every 30 hours
autonomic features
cutaneous trigger

151

what are the features of a stabbing/ icepick headache

more common in females
stabbing pain
severe
anywhere in head
lasts <30 secs
any prequency
autonomic features
no trigger
responds to indomethicin

152

summarise brown sequard syndrome

hemicord lesion

-lateral corticospinal tract damage = ipsilateral UMN weakness
-posterior column= ipsilateral vibration and proprioception loss
-anterolateral system= contralateral pain and temperature loss

153

describe the symptoms seen in central cord syndrome

centre part of spinal cord affected
in small lesions- spinothalamic tract fibres that cross the anterior white matter commisure are interrupted = bilateral pain and temp loss at affected levels, below this cord function intact = cape like distribution

large lesions- corticospinal, spinothalamic and dorsal column may be affected aswell= upper motor neurone pattern of deficit below the level of injury (interrupted corticospinal), with spastic paralysis and urinary retention, and a LMN deficit pattern at level of injury (damage to ant horn cells)
upper extremities more affected than lower as fibres more central

154

which nerve is at risk of injury:
colles fracture

median

155

which nerve is at risk of injury:
ant shoulder dislocation

axillary

156

which nerve is at risk of injury:
humeral shaft #

radial (in spiral groove)

157

which nerve is at risk of injury:
posterior dislocations of hip

sciatic

158

which nerve is at risk of injury:
supracondylar # of the elbow

median (anterior interosseous branch)

159

which nerve is at risk of injury:
bumper injury to the lateral knee

peroneal nerve (fibular)

160

what differentiates back ache from sciatica

back ache can radiate to buttock and thigh but not below the knee like sciatica can

161

what are the symptoms of an L3/4 prolapse

> L4 root entrapment > pain down to medial ankle (L4), loss of quadriceps power, reduced knee jerk

162

what are the symptoms of an L4/5 prolapse

L5 root entrapment > pain down dorsum of foot, reduced power Extensor Hallucis Longus and tibialis anterior

163

what are the symptoms of an L5/S1 prolapse

S1 root entrapment > pain to sole of foot, reduced power planarflexion, reduced ankle jerks

164

what is the role of broca and wernickes areas

brocas- speech production
wernickes- speech comprehension

165

what are the SEs of sodium valporate

increased appetite= massive weight gain
alopecia
teratogenic (neural tube defects, cleft lip and palate, cardiovascular abnormalities, genitourinary defects, developmental delay, endocrinological disorders, limb defects, and autism)

166

what is lamotrigine first line for

focal seizures (carbamazepine is 2nd line)
women with generalised seizures

167

what are the SEs of lamotrigine

rash
HA
dry mouth

168

what is levetiracetam

epilepsy management
2nd line in women of childbearing age
Good 3rd line alternative after sodium valproate and lamotrigine
Quite well tolerated – tiredness apathy weight gain

169

what are the key symptoms of MS

Optic neuritis, Sensory symptoms, Lr urinary tract dysfunction, Pyramidal dysfunction (Tone+, spastcicity, F of UL, E of LL)
At least 2 episodes suggestive of demyelination + Dissemination in time and place

170

what will be seen on blood tests for MS

nothing

171

what for acute Tx for MS flare

steroids

172

what are the treatment options for parkinsons

levodopa (with dopadecarboxylase inhibitor)
monoamine oxidase B inhibitor
dopamine agonist

can add on
catechol-o-methyl transferase inhibitor (prolongs actions of levodopa)

173

what are the symptoms of parkinsons

Gait - shuffling, slow turning with multiple steps, trouble with doorways, stooped over, reduced arm swinging, fenestration

Also non-motor features: EARLY - Hyposmia (reduced smell),
Constipation,
REM sleep disturbance (can act out dreams)
depression – V V common and pronounced generally

LATE - Dementia (it is Lewy body dementia if within the first 2 years, otherwise is parkinsons disease dementia)
Everyone gets some form of cognitive decline over time with parkinsons disease.

cog wheel rigidity
resting tremour)
positive froment's maneuver (rigidity increases in examined body segment by voluntary movement of other parts),
micrographia,
bradykinesia,
hypomimia (decreased facial expression),
hypophonia (quieter voice)

174

which generation of antipsychotic is clozapine

2nd - is an atypical

175

name extrapyramidal drugs

(dopamine antagonists)
all antipsychotics- typicals (haloperidol) worse than atypicals (clozapine)

metoclopramide
domperidone

176

what is the main down fall of atypical antipsychotics

weight gain and metabolic syndrome

177

what causes meningitis in neonates

listeria, group B streptococci, E. coli

178

what causes meningitis in children

H influenza

179

what causes meningitis in ages 10-21

meningococcal

180

what causes meningitis in >21s

pneumococcal > meningococcal

181

what causes meningitis in the elderly

pneumococcal > listeria

182

what causes meningitis in immunocompromised

S. pneumoniae, N. meningitidis, Listeria, aerobic GNR (including Ps.aeruginosa)

183

what causes meningitis in patients who have had neurosurgery/ open head trauma

staphylococcus, gram -ve rods
S. aureus, S. epidermidis, aerobic GNR

184

what causes meningitis in patients with a # of the cribiform plate

pneumococcal
(S. pneumoniae, H. influenzae, beta-hemolytic strep group A)

185

what causes meningitis in patients who have a CSF shunt

S. epidermidis, S. aureus, aerobic GNR, Propionibacterium acnes

186

what is the management for meningitis

Ceftriaxone I.V 1.2mg bd +/- amoxicillin if over 60 (listeria cover)

Penicillin allergy:
Chloramphenicol + Vancomycin +/- co-trimoxazole (listeria cover)

If it is meningococcal - additional steroids are not required but everyone gets it until its established

187

what is the treatment for status epilectus

1st stage (0−10 minutes):
-Secure airway and resuscitate
-Administer oxygen
-Assess cardiorespiratory function
-Establish intravenous access – get help to hold site still
-Glucose (50 ml of 50% solution) and/or intravenous thiamine if appropriate

Pre-hospital - Diazepam 10−20 mg per rectum
1mg Midazolam buccally

In hospital - Lorazepam IV 0.1mg/kg with 4mg bolus (don’t worry about dose)
if unable to get IV access, go to rectal diazepam
This stage call MUST call senior/ICU

Established (20mins or more despite therapy) – IV phenytoin or fosphenytoin
MUST CALL ICU!!!

188

what is the mnemonic for things that can cause cerebellar symptoms

DAISIES
Demyelination
Alcohol
Infarction
SOL- schwannoma
Inherited (wilsons, fredricks ataxia)
Epilepsy medication
(multiple) System atrophy

189

what is rhombergs testing

proprioception and sensory ataxia
wont be able to stay balanced with eyes shut

190

what type of nystagmus in cerebellar disease

horizontal

191

what is speech like in cerebellar disease

slurred staccato

192

what is the fast phase of nystagmus going towards

the side of the lesion

193

what happens to the tremor in parkinsons when counting back from 100

gets worse- gets worse on concentration

194

what type of tremor might a dopamine agonist cause

bilateral

195

can patients with parkinsons draw a neat circle

yes- have RESTING tremor

196

what does a babinski +ve test mean

claw out
UMN lesion

197

what is a bovine cough seen in

vagus nerve lesions

198

what disease are tongue fasciculations seen in

MND