Neurological Conditions Overview

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Questions and Answers

What is the most common pathological mechanism of intracerebral hemorrhage?

  • Anterior venous malformation
  • Aneurysm
  • Hypertension with anterior sclerosis (correct)
  • Tumor

Which condition is characterized by recurrent episodes of sudden skeletal muscle paralysis?

  • Polymyositis
  • Myotonia congenita
  • Pseudohypertrophy muscular dystrophy
  • Hypokalemic periodic paralysis (correct)

Which option is not associated with cerebrally-mediated syncope?

  • Vascular vagal syncope (correct)
  • Aortic arch syndrome
  • Hypertensive encephalopathy
  • Severe cerebral arterial occlusion

Which is the most common form of motor neuron diseases (MNDs)?

<p>Amyotrophic lateral sclerosis (ALS) (B)</p> Signup and view all the answers

What is the first choice for the initial treatment of children with absence seizures?

<p>Valproate (VPA) (C)</p> Signup and view all the answers

Which of the following is not a neurodegenerative cause of Parkinsonism?

<p>Vascular parkinsonism (D)</p> Signup and view all the answers

What is the most likely diagnosis for a 25-year-old male with paroxysmal headache, visual aura, and effective ergotamine treatment?

<p>Typical migraine (C)</p> Signup and view all the answers

Which artery is known to cause Broca's aphasia when occluded?

<p>Middle cerebral artery (C)</p> Signup and view all the answers

Which examination is the first choice for patients with severe headache?

<p>Computed Tomography (CT) (A)</p> Signup and view all the answers

What is the clinical manifestation of acute facial neuritis?

<p>All facial expression muscles twitch on one side (D)</p> Signup and view all the answers

What type of headache does the 28-year-old woman likely have?

<p>Headache attributed to low cerebrospinal fluid pressure (D)</p> Signup and view all the answers

Which muscle group is generally not involved in polymyositis?

<p>Respiratory muscles (B)</p> Signup and view all the answers

Which symptom is not characteristic of Wallenberg syndrome?

<p>Aphasia (D)</p> Signup and view all the answers

What is the most common pathogenesis of cerebral thrombosis?

<p>Atherosclerosis (C)</p> Signup and view all the answers

At what time point is Status Epilepticus defined after seizure onset?

<p>10 minutes (A)</p> Signup and view all the answers

If a person's cold receptors do not convert cold stimuli into sensory signals, what is the issue?

<p>Transduction (A)</p> Signup and view all the answers

What is the most common type of migraine?

<p>Migraine without aura (C)</p> Signup and view all the answers

Which treatment is considered the most effective initial therapy for Parkinson's disease?

<p>Levodopa (D)</p> Signup and view all the answers

Which examination can help differentiate between Essential Tremor (ET) and Parkinson's Disease (PD), especially in tremor-dominant cases?

<p>DaTSCAN (C)</p> Signup and view all the answers

Which of the following is NOT a treatment for Benign Paroxysmal Positional Vertigo (BPPV)?

<p>Increase sleep (B)</p> Signup and view all the answers

What is the significant risk factor for developing Alzheimer's disease?

<p>Age (A)</p> Signup and view all the answers

Which cranial nerve is NOT classified as a pure motor nerve?

<p>Trigeminal nerve (B)</p> Signup and view all the answers

In the presence of left eye blepharoptosis and other listed symptoms, where is the likely lesion located?

<p>Left oculomotor nerve (C)</p> Signup and view all the answers

Which statement reflects a component of medical history that should be included for an epilepsy patient?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following is not considered a systemic disease associated with seizures?

<p>Idiopathic epilepsy (A)</p> Signup and view all the answers

What is typically the first symptom of Alzheimer's disease?

<p>Memory loss (A)</p> Signup and view all the answers

In myasthenia gravis, where is the primary lesion located?

<p>Neuromuscular junction (A)</p> Signup and view all the answers

Which manifestation is not associated with syringomyelia?

<p>Painless ulcers of the hands (B)</p> Signup and view all the answers

An injury resulting in contralateral hemiplegia, hemianesthesia, and hemianopia is likely at which site?

<p>Internal capsule (B)</p> Signup and view all the answers

Which segment of the spinal cord is most commonly affected in anterior spinal artery infarction?

<p>Middle and lower thoracic cord (C)</p> Signup and view all the answers

What is the preferred surgical treatment for Parkinson's disease?

<p>Deep brain electrical stimulation (DBS) (A)</p> Signup and view all the answers

In the case of a dilated pupil with absent light reflex on one side, which is likely the affected nerve?

<p>Ipsilateral oculomotor nerve (A)</p> Signup and view all the answers

What is a common clinical feature associated with acute myelitis?

<p>All of the above (D)</p> Signup and view all the answers

What characteristic is typically associated with sensory disorders in acute myelitis?

<p>Peripheral sensory disorder (A)</p> Signup and view all the answers

Which sensory signal does not travel to the thalamus before reaching the cerebral cortex?

<p>Vision (B)</p> Signup and view all the answers

What is the most likely diagnosis for a patient with facial asymmetry and weakness in the left side of the face?

<p>Left facial neuritis (B)</p> Signup and view all the answers

What does cerebrospinal fluid analysis typically show in Guillain-Barre syndrome?

<p>Increased protein and normal cell count (A)</p> Signup and view all the answers

Which medication is recommended for patients with myasthenia gravis?

<p>Neostigmine (B)</p> Signup and view all the answers

What segment of the spinal cord is associated with Horner's syndrome?

<p>C5-C8 (D)</p> Signup and view all the answers

Which of the following diseases is both terminal and neurodegenerative?

<p>Parkinson's disease (D)</p> Signup and view all the answers

What is NOT a symptom typically associated with cerebellar ataxia?

<p>Chorea (B)</p> Signup and view all the answers

Which statement about glossopharyngeal nerve lesions is correct?

<p>Loss of taste (ageusia) on the posterior one third of the tongue (D)</p> Signup and view all the answers

Which symptom is characteristic of bulbar paralysis?

<p>Dysphagia (A)</p> Signup and view all the answers

Which option does NOT accurately reflect a symptom of facial nerve involvement?

<p>Loss of sensation in the posterior tongue (C)</p> Signup and view all the answers

What is included in the definition of epilepsy according to current diagnostic conditions?

<p>One provoked seizure with a future recurrence risk of at least 60% (B)</p> Signup and view all the answers

Flashcards

Intracerebral hemorrhage cause

Hypertension is the most common cause of intracerebral hemorrhage.

Hypokalemic periodic paralysis

A condition causing sudden muscle paralysis, often recurring.

Cerebral syncope cause

Severe cerebral arterial occlusion is a cause of cerebral syncope; other include: aortic arch syndrome and hypertension encephalopathy.

Most common Motor Neuron Disease (MND)

Amyotrophic lateral sclerosis (ALS) is the most common type of MND.

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Absence seizure treatment (children)

Carbamazepine (CBZ) is often the first-line treatment for absence seizures in children.

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Parkinson's related neurodegenerative condition

Vascular parkinsonism is a neurodegenerative condition that can cause Parkinson's-like symptoms.

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Migraine characteristics

Migraines are characterized by recurrent headaches, usually unilateral, throbbing; often accompanied by nausea, vomiting, and visual symptoms.

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Broca's aphasia Artery

Broca's aphasia is associated with damage to the middle cerebral artery.

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Most effective Parkinson's treatment

Initial treatment for Parkinson's disease is typically a dopamine agonist, though levodopa is also commonly used.

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Migraine type most common

Migraine without aura is a more prevalent type of migraine than those with aura or other basal/chronic forms.

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ALS gender incidence

Men and women are affected by Amyotrophic Lateral Sclerosis (ALS) at roughly equal rates.

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BPPV treatment excludes

Medications are generally not used as a primary treatment for Benign Paroxysmal Positional Vertigo (BPPV).

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Pure motor cranial nerve exclusion

The Trigeminal nerve is not a pure motor cranial nerve; it has both motor and sensory functions.

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Spinal cord compression symptom exclusions

Loss of vision is not typically a symptom of spinal cord compression.

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Oculomotor nerve lesion location

A lesion in the left oculomotor nerve is implicated by left eye ptosis and dilated pupil, with impaired inward/upward eye movement that is limited downwards.

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Key Alzheimer's risk factor

Age is a significant risk factor for developing Alzheimer's disease.

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Epilepsy diagnosis criteria

At least two unprovoked seizures occurring more than 24 hours apart, or one unprovoked seizure with a high probability of future seizures, or a diagnosis of an epilepsy syndrome.

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Cerebellar ataxia symptom

Nystagmus, involuntary eye movements, is not a typical symptom of cerebellar ataxia.

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Glossopharyngeal nerve lesion

Loss of taste sensation on the posterior one-third of the tongue is a characteristic feature of glossopharyngeal nerve lesions.

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Hearing disorder categories

Hearing disorders encompass deafness, tinnitus (ringing in the ears), and hyperacusis (increased sensitivity to sound).

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Facial nerve lesion symptoms

Lesions of the facial nerve can manifest as an inability to frown, close the eye, or form a nasolabial fold, and drooping of the mouth corner.

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Systemic diseases causing seizures (excluding)

Idiopathic epilepsy is not a systemic disease related to seizures, unlike hypoglycemia, hyponatremia, or hypocalcemia.

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First sign of Alzheimer's Disease

Memory loss is the first noticeable symptom of Alzheimer's disease.

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Myasthenia Gravis lesion location

Myasthenia gravis affects the neuromuscular junction, the connection between nerve and muscle.

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Syringomyelia symptom NOT included

Hemiplegia and hemianesthesia (one-sided weakness/numbness) are not typical symptoms of syringomyelia, unlike dissociated sensory loss, weakness, painless ulcers, and neurogenic arthropathies.

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Contralateral hemiplegia in injury

Internal capsule injury often leads to contralateral hemiplegia, hemianesthesia, and hemianopia (loss of vision).

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Common Anterior Spinal Artery Infarction segment

Upper thoracic spinal cord segments are most frequently affected by anterior spinal artery infarction.

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Parkinson's Disease surgical treatment

Deep brain stimulation (DBS) is the preferred surgical treatment for Parkinson's disease.

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Cerebral emboli source

Carriogenic embolism is the most frequent origin of cerebral emboli.

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First choice exam for severe headache

Computed Tomography (CT) scan is the initial imaging test for patients with severe headaches.

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Acute facial neuritis symptom

Twitching of all facial muscles on one side of the face is a key symptom of acute facial neuritis.

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Headache due to low CSF pressure

Headache caused by a decrease in cerebrospinal fluid pressure, often after a neck injury.

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Muscles NOT involved in Polymyositis

Respiratory muscles are generally not affected by polymyositis, unlike other proximal limbs muscles

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Wallenberg syndrome exception

Aphasia (language impairment) is not a characteristic symptom of Wallenberg syndrome.

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Common cause of cerebral thrombosis

Atherosclerosis (hardening of the arteries) is a common cause of cerebral thrombosis.

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Status epilepticus time point T1

The time point T1, in the definition of Status Epilepticus (SE), is 10 minutes after seizure onset.

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Problem with cold stimuli conversion

If cold receptors fail to transmit cold stimuli into sensory signals, this issue lies in the transduction process in which the stimulus is converted into a signal.

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Acute Myelitis Clinical Features

Characteristic symptoms of a sudden spinal cord inflammation, often involving cross-sectional sensory loss and motor weakness.

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Sensory Signals to Thalamus

Signals from most senses (except vision) travel to the thalamus before reaching the cerebral cortex in the brain for interpretation.

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Left Facial Neuritis Symptoms

Facial paralysis, characterized by drooping mouth, inability to close eye, and other facial manifestations on the affected side. Often involves pain in ear or forehead.

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Guillain-Barre Syndrome CSF

Elevated protein levels, but normal cell counts, in the cerebrospinal fluid (CSF).

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Myasthenia Gravis Treatment

Neostigmine is a crucial drug used to treat muscle weakness symptoms in myasthenia gravis.

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Horner's Syndrome Spinal Segment

Horner's syndrome is associated with damage to the C5-C8 spinal cord segments.

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Neuroimaging in Seizures

Neuroimaging (e.g., MRI) is recommended in cases of suspected seizures, varying ages and types, including generalized and focal seizures, especially when AEDs are ineffective or if localized brain damage is suspected.

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CNS Infection Types

Central nervous system (CNS) infections are categorized by their time course: acute, subacute, and chronic.

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Study Notes

Neurological Conditions

  • Fisher syndrome: Key feature is flaccid paralysis of limbs with bilateral facial paralysis.
  • Lower motor neuron injury: Characterized by decreased tendon reflexes, flaccid paralysis, and muscle atrophy.
  • Migraine: Severe, intermittent pain above and behind the eye, often accompanied by tearing, conjunctival irritation, and nasal congestion. Alcohol can trigger or exacerbate the pain.
  • Extrapyramidal system: A system of neural circuits, basal ganglia are part of this system

Neurological Conditions, Continued

  • Subacute combined degeneration: Caused by vitamin B12 deficiency.
  • Parkinson's disease: Motor features include static tremor, rigidity, and gait stiffness.
  • Epileptic seizures: are transient, stereotyped, and repetitive
  • Intracerebral hemorrhage: Most common cause is aneurysm.

Neurological Conditions, Additional

  • Acute myelitis: Treatment should not include antibiotics.
  • Multiple sclerosis: Acute exacerbations can be treated with corticosteroids. (This also appears to be a characteristic of other conditions like Parkinson's, though this should not be taken as definitive treatment.)
  • Cerebral embolism: Aorta, Cariogenic embolism, or middle cerebral artery are the most common causes.

Neurological Conditions, Diagnoses

  • Migraine: Diagnosed through patient history and physical examination
  • Tension-type headache: Diagnosed through history and normal physical exam.
  • Cluster headaches: Diagnosed with a thorough history, with an emphasis on an abnormal profile
  • Alzheimer's disease: Various risk factors. Age is considered the key risk factor.
  • ALS: Men and women are equally affected.

Neurological Conditions, Investigations

  • Spinal cord compression: Signs include back pain, paralysis, reduced sensation, and sphincter disturbances.
  • Neurodegenerative cause of Parkinson's: Dementia with Lewy bodies, Multiple system atrophy, and vascular parkinsonism can all be potential causes.
  • Epilepsy: A complete medical history must be taken, including the details of seizures and the presence of aura.
  • Cerebrovascular accident: Imaging tests may be used to rule out other conditions

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