Ck Neurology

7/25/2019 Ck Neurology

1/29

NEUROLOGY TiKi TaKa _____________________

. HEMORRHAGE -> HYPER-dense areas on CT. (WHITE.

. IN!ARCTION" -> HYPO-dense areas on CT. (#LACK.

. GAIT" IN NEUROLOGY$_____________________

%. !E"TINATING ----> PARKIN"ONI"M$___________________________________(Mas& 'ae - )rad*&inesia - res+in, +reor - ri,idi+*.. N.#. PARKIN"ONI"Ms ,ai+ -> !E"TINATING / HYPOKINETIC / "HU!!LING.

0. HIGH "TEPPAGE --> TA#E" 1OR"ALI"$_____________________________________(Ne2ro3 - Loss o' 4ro4rioe4+ion - 56e Ro)er, si,n.

7. "EMI-CIRCLE ----> "TROKE HEMIPLEGIA$_______________________________________(Add2+ed a8e+ed ar 9 E:+ended a8e+ed ;e,.

MU"CULAR 1Y"TROPHY$_________________________________________(Wea&ness o' ,;2+ea; 2s;es.

=. WI1E #A"E1 9 "HU!!LING -> NORMAL PR""URE HY1ROCEPHALU"$___________________________________________________________(Urine inon+inene 9 deen+ia.

. IP"ILATERAL ATA?IA -> CERE#ELLAR ATA?IA$____________________________________________T@e 4+ +ends +o 'a;; +oards +@e side o' +@e ;esionB(N*s+a,2s-H*4o+onia-1*sar+@ria-Loss o' oordina+ion-1*sdiado&o&inesia.

. "PA"TIC ----> UMNL UPPER MOTOR NEURON LE"ION$_________________________________________________("4ina; ord inD2r* or ere)ra; 4a;s*.

. "TAGGERING -> FE"TI#ULAR ATA?IA$____________________________________(Ass. i+@ na2sea 9 6oi+in,.

. TREMOR" IN NEUROLOGY$_______________________

%. RE"TING TREMOR" (PARKIN"ON$________________________________


2/29

A+ res+ - i4ro6es e a+i6i+*. Hi,@ 're2en* +reors =- H. Ass. e ri,idi+* 9 )rad*&inesia. Pi;; ro;;in, 2a;i+*.

NOT i6o;6in, +@e en+ire @ead.

0. E""ENTIAL TREMOR"$______________________ !ai;ia; in 24 +o =J o' ases. "+ar+s i+@ ne o6een+ in +@e 244er e:+rei+*. Wors+ a+ +@e end o' +@e ,oa; dire+ed a+i6i+* (e.,. rea@in, a 4en. In6o;6in, +@e en+ire @ead.

7. CERE#ELLAR TREMOR"$_______________________ In+ension +reors. ;o 'e2en* 7-< H. A8e+ +@e e:+rei+* 9 +@e W@o;e @ead.

N*s+a,2s 9 a+a:ia are 4resen+.

. TRIGEMINAL NEURALGIA$_______________________. Paro:*sa;B LIGHTENING PAIN on +@e 'ae.. "e6ere in+ense )2rnin, or e;e+ri s@o& ;i&e.. T:$ CAR#AMAEPINE.

. CERE#ELLAR TUMOR"$____________________. I4si-;a+era; a+a:ia (T@e 4+. 'a;;s +oards +@e side o' +@e ;esion.. I4si-;a+era; 2s2;ar @*4o+onia.. Ti+2)a+ion (!orard 9 )a&ard o6een+ o' +@e +r2n&.. N*s+a,2s.. In+en+ion +reors.. 1*sdiado&o&inesia (1i2;+* in 4er'orin, ra4id 9 a;+erna+in, o6een+s.

. INTRA-CRANIAL HEMORRHAGE$___________________________. HYPERTEN"ION is +@e os+ i4. ris& 'a+or.. !oa; ne2ro;o,ia; si,ns de6e;o4 s2dden;* 9 ,rad2a;;* orsen o6er ins +o @o2rs.. T@e de,ree o' s*4+os is no+ a:ia; a+ onse+ ( "AH or e)o;i s+ro&e.. "*4+os s+ar+ d2rin, nora; a+i6i+* (a* )e 44+ )* se:.. "i+e o' INTRA-CRANIAL HEMORRHAGE ------> NEUROLOGICAL !IN1ING"$

_________________________________________________________________%- #A"AL GANGLIA (PUTAMEN$___________________________ Hei-4;e,iaB @ei-sensor* ;oss. Hoon*o2s @eiano4siaB ,ae 4a;s*. "+24or 9 oa.


3/29

0- THALAMU"$

______________ Hei-4aresisB @ei-sensor* ;oss.

E*es de6ia+e Toards @ei4aresis. UP-GAE 4a;s*.

(Non-rea+i6e io+i 424i;s.7- CERE#ELLUM$

______________ NO @ei4aresis. GAIT ATA?IA. OCCIPITAL HEA1ACHE (5na2sea 9 6oi+in,. Gae 4a;s* (+@ CN. 4ara;*sis !aia; ea&ness.


4/29

. Me+i2;o2s sear@ 9 reo6a; o' +@e +i& res2;+s in i4ro6een+ 9 o4;e+ereo6er*.

PARA-NEOPLA"TIC 3YN1ROME" Q_____________________________

.%. MYA"THENIA GRAFI"$______________________. !ea;e % - 0= *s.. NEURO-MU"CULAR SUNCTION 1I"EA"E.. M2s;e ea&ness a'+er a 4eriod o' 2s;e 2se.. 1*sar+@ria - 1*s4@a,ia.. 1roo4in, e*e;ids (P+osis - 1i4;o4ia (1o2);e 6ision. E:+rao2;ar sin6o;6een+.. Genera;ied ea&ness a* de6e;o4 (+r2n&s - ars - ;e,s. #2;)ar sin6o;6een+.. RE"OLUTION O! MU"CULAR WEAKNE"" i+@ RE"T is +@e HALLMARK o' M*as+@enia,ra6is.

. 1:$ CT "CAN CHE"T is MAN1ATORY +o e:;2de THYMOMA.. T:$ Ora; ANTI-CHOLINE"TERA"E" e.,. PYRI1O"TIGMINE 9 NEO"TIGMINE.. I2nos244ressi6e a,en+s 9 +@*e+o* a* ind2e reission.. MYA"THENIC CRI"I" a* o2r res2;+in, in se6ere ea&ness o' +@e res4ira+or*2s;es.. T: i+@ EN1OTRACHEAL INTU#ATION 9 i+@draa; o' an+i-@o;ines+erases.

.0. LAM#ERT EATON 3YN1ROME$___________________________. HVO o' aner os+;* LUNG CANCER (Hea6* so&in, - ei,@+ ;oss - a;aise - ;2n,ass.. "a;; e;; arinoa.. Pro:ia; s ea&ness.. A2+o-an+i)odies dire+ed a,ains+ +@e 6o;+a,e ,a+ed a;i2 @anne;sB. ;eadin, +o -- Ae+*;@o;ine re;ease i+@ 4ro:ia; s ea&ness.. 1:$ E;e+ro-4@*sio;o,ia; s+2dies.. T:$ P;asa4@aresis 9 i2nos244ressi6e +@era4*.

. N.#. MYA"THENIA GRAFI"$_________________________. A2+o-an+i)odies a,ains+ +@e (4os+-s*na4+i ree4+ors.. INTACT dee4 +endon ree:es.

. N.#. LAM#ERT-EATON 3$________________________. A2+o-an+i)odies a,ains+ +@e (4re - s*na4+i ree4+ors.. LO"" o' dee4 +endon ree:es.

.7. 1ERMATOMYO"ITI"VPOLYMYO"ITI"$___________________________________. MU"CLE !I#ER INSURY.. "*e+ri 9 ore 4ro:ia; s ea&ness.


5/29

. Ass. IL1B eso4@a,ea; d*so+i;i+*B Ra*na2ds 4@enoenon 9 4o;*ar+@ri+is.. "KIN !IN1ING" (Go++rons 4a42;es 9 He;io+ro4e ras@.

. N.#. "TEROI1 IN1UCE1 MYOPATHY$________________________________. 12e +o +++ i+@ HIGH doses o' s+eroids o6er a 4ro;on,ed 4eriod o' +ie.

. e:$ +++ o' Te4ora; ar+eri+is i+@ @i,@ dose s+eroids.. Pro:ia; 2s;e ea&ness (LL )e'ore UL.. No 4ain.. 1i2;+* ,e++in, 24 'ro a @air - ;i)in, s+airs or )r2s@in, @air.. M2s;e 4oer i4ro6es a'+er dison+in2a+ion o' +@e dr2,.

. "U#-ARACHNOI1 HEMORRHAGE$___________________________. Ca2sed )* r24+2re o' ar+eria; sa2;ar #err* ane*r*s.. "2dden se6ere @eada@e (WOR"T HEA1ACHE EFER.. Menin,ea; irri+a+ion a* o2r (Ne& s+i8ness.. 1: -> NON CONTRA"T HEA1 CT.

. 1: -> is i4. +o r2;e o2+ "AH.. 1: -> ?an+@o@roia in C"! onrs +@e dia,nosis.. 1: -> CT ere)ra; An,io,ra4@* is i4. +o iden+i'* +@e );eedin, so2re.. T: -> Coi;in, or res+en+in, (Endo6as2;ar +@era4*.. T: -> Niodi4ine (CC# +o -- +@e 6asos4as.. Co4;ia+ions$. ______________

. % - Re-);eedin, (%s+ 0< @o2rs.. 0 - Fasos4as (a'+er 7 da*s.. 7 - H*droe4@a;2s (55 ICT.. < - "ei2res.. = - HYPO-NATREMIA (--Na d2e +o "IA1H.. NEURO-!I#ROMATO"I" TYPE 0$

____________________________. YOUNG 4+.. ".C. ne2ro)roas 5 Ca'e a2 ;ai+ s4o+s 5 #i;a+era; ao2s+i ne2roas (1ea'ness.. !ai;* HVO.. A2+osoa; doinan+ dis. a2sed )* a 2+a+ion in @roosoe 00.. NON-"EN"E or 'rae s@i'+ 2+a+ions are +@e a2se.. N.#. "i;en+ ("ae sense 2+a+ions don+ a8e+ +@e s+r2+2re o' +@e 4ro+ein.. 1:$ MRI i+@ GA1OLINIUM.

. PRONATOR 1RI!T$_________________. I+ deno+es UMNL.. W@en +@e 4+. ;oses @is e*es 9 e:+ends @is ars i+@ +@e 4a;s 24B. T@e a8e+ed ar i;; +end +o 4rona+e.. #e. UMNL a2ses ea&ness in s24ina+ion i+@ doinane o' +@e 4rona+or2s;es.

. E""ENTIAL TREMOR$


6/29

___________________. ACTION +reor.. A)sene o' o+@er ne2ro;o,ia; si,ns.. "244ressed a+ res+ ( 4ar&insonis.. No+ied @en +@e 4+. a++e4+s a +as& +@a+ re2ires ne o+or o6een+ Q. T:$ ## (Pro4rano;o; is +@e %s+ ;ine o' +++.

. Priidone a* )e 2sed (An+i-on62;san+ @i@ a* 44+ a2+e in+eri++en+Por4@*riaB. ani'es+ed as a)doina; 4ainB ne2ro;o,i 9 4s*@ia+ri a)nora;i+ies.

. MULTIPLE "CLERO"I"$_____________________. A8e+s oen in @i;d )earin, 4eiod (%=-=J *s.. M2;+i4;e ne2ro;o,ia; dei+s +@a+ an+ )e e:4;ained )* sin,;e ;esion.. PATCHY ne2ro;o,ia; ani'es+a+ions.. O4+i ne2ri+is (4ain'2; ;oss o' 6ision 9 di4;o4ia.. "ensor* s*4+os -> N2)ness 9 4ares+@esia.. Mo+or s*4+os -> Para4aresis 9 s4as+ii+*.

. #oe;V);adder d*s'2n+ion.. UHTHO!! 4@enoenon E:aer)a+ed )* @o+ ea+@er or e:erise Q. LHERMITTEs si,n E;e+ri s@o&-;i&e sensa+ion don +@e s4ine on e:ion o' +@ene&.. INTER-NUCLEAR OPHTHALMOPLEGIA (INO is @ara+eris+i$ _______________________________________________________ On a++e4+ed ;e'+ ,aeB +@e ;e'+ e*e a)d2+s 9 e:@i)i+s @orion+a; Der& n*s+a,2sB )2+ +@e ri,@+ e*e reains s+a+ionar*. On a++e4+ed ri,@+ ,aeB +@e ri,@+ e*e a)d2+s 9 e:@i)i+s @orion+a; Der&n*s+a,2sB )2+ +@e ;e'+ e*e reains s+a+ionar*. a2sed )* de*e;ina+ion o' +@e ME1IAL LONGITU1INAL !A"CICULU".. 1:$ #RAIN MRI i+@ 9 i+@o2+ GA1OLINIUM.. MRI$M2;+i4;e )i;a+rea; as*e+ri @*4erin+ense ;esions in 4eri6en+ri2;ar @i+ea++er.. C"! ana;*sis$ OLIGOCLONAL I,G )ands - Nora; 4ress2re.. T: o' a2+e e:aer)a+ion -----> HIGH 1O"E IF GLUCOCORTICOI1".. T: +o 4re6en+ '2+2re a++a&s -> #-in+er'eron or G;a+iraer ae+a+e.. N.#. YOUNG !EMALE i+@ #ILATERAL TRIGEMINAL NEURALGIA / M".

. AMYOTROPHIC LATERAL "CLERO"I"$________________________________. UPPER 5 LOWER o+or ne2ron ;esions.. UMNL ("4as+ii+* - )2;)ar s*4+os - e:a,erra+ed dee4 +endon ree:es.. LMNL (!asi2;a+ionsB as+in,.. T:$ RILUOLE (G;2+aa+e in@i)i+or - "+eroids are WRONGGGGGGGGGGGGGGG Q

. CARPAL TUNNEL 3YN1ROME / ME1IAN NERFE ENTRAPPMENT 3YN1ROME$_____________________________________________________________. A+ WRI"T Q. N2)ness 9 4ain in +@e 4a;.. T@enar einene a+ro4@*.


7/29

. Pares+@esia o' +@e %s+ +@ree 9 a @a;' di,i+s

. ULNAR NERFE ENTRAPMENT 3YN1ROME$___________________________________. -- sensa+ion o6er +@e


8/29

MAIN CAU"E" O! "TROKE$_________________________

. % . I"CHEMIC THROM#OTIC$__________________________

-> HVO o' 4re6io2s TIAs (Transien+ is@ei a++a&s.-> A+@eros;ero+i ris& 'a+ors (Uno+ro;;ed HTN 9 1M.-> Loa; in-si+2 o)s+r2+ion o' an ar+er*.-> "*4+os a* 4ro,ress or re,ress i+@ +ie.

. 0 . I"CHEMIC EM#OLIC$_______________________-> HVO o' ardia disease (A'B endoardi+is or aro+id a+@eros;erosis #r2i+.-> Onse+ o' s*4+os is A#RUPT 9 2s2a;;* MA?IMAL a+ +@e s+ar+.-> M2;+i4;e in'ar+s i+@in di8eren+ +erri+iories.-> NO @eada@e or i4aired onsio2sness.

. 7 . HEMORRHAGIC$__________________-> HVO o' 2non+ro;;ed HTNB o-a,2;o4a+@*B i;;ii+ dr2, 2se e., a4@e+aines 9oaine.-> "2dden de6e;o4en+ o' 'oa; ne2ro;o,ia; si,ns.-> !o;;oed )* 55 ICT s*4+os (6oi+in, 9 @[email protected]> Worsens ,rad2a;;* o6er ins +o @o2rs.-> "*4+os a* s+ar+ i+@ nora; a+i6i+*.-> H*4er+ension is +@e os+ i4. ris& 'a+or.

. < . "PONTANEOU" "U#-ARCHNOI1 HEMORRHAGE$__________________________________________-> R24+2re o' an ar+eria; sa2;ar )err* ane2r*s or AF a;'ora+ion.-> "2dden draa+i onse+ o' se6ere @eada@e (WOR"T HEA1ACHE EFER.-> Menin,ea; irri+a+ion e.,. ne& s+i8ness.-> !oa; dei+s are 2noon.

T@e %s+ s+e4 in "TROKE ana,een+ is NON CONTRA"T HEA1 CT._____________________________________________________________

TOPOGRAPHY o' +@e ;esions in s+ro&e 4+s (ACCOR1ING TO THE A!!ECTE1ARTERY$

______________________________________________________________________________

PO"TERIOR LIM# O! INTERNAL CAP"ULE (LACUNAR IN!ARCT$________________________________________________________. Mo+or i4airen+ i+@o2+ an* @i,@er or+ia; d*s'2n+ion.. No 6is2a; e;d a)nora;i+ies. MI11LE CERE#RAL ARTERY OCCLU"ION$

____________________________________. Con+ra;a+era; @ei4;e,ia.


9/29

. Con+ra;a+era; @eianes+@esia.. ConD2,a+e e*e de6ia+ion +oard +@e side o' s+ro&e.. Hoon*o2s @eiano4ia.. A4@asia (doinan+ @eis4@ere.. Hei-ne,;e+ (Non doinan+ @eis4@ere.

ANTRIOR CERE#RAL ARTERY OCCLU"ION$_____________________________________. Con+ra;a+era; ea&ness +@a+ 4redoinan+;* a8e+s +@e LLs.. A)2;ia (;oss o' i;;in,.. A&ine+i 2+is.. Eo+iona; dis+2r)anes.. 1e6ia+ion o' @ead 9 e*es +oards +@e side o' +@e ;esion.. "4@in+er inon+inene. FERTE#RO-#A"ILAR "Y"TEM LE"ION (#RAIN "TEM$

_______________________________________________. A;+erna+e 3 i+@ on+ra;a+era; @ei4;e,ia 9 i4si;a+era; CN in6o;6een+.

Presen+a+ions aordin, +o +@e A!!ECTE1 LO#E$________________________________________________

. 1OMINANT !RONTAL LO#E "TROKE$_______________________________. E:4ressi6e (#ROCAs a4@asia.. Con+ra;a+era; @ei4aresis (d2e +o in6o;6een+ o' +@e 4riar* o+or or+e:.. Con+ra;a+era; a4ra:ia (d2e +o in6o;6een+ o' +@e s244;een+ar* o+or or+e:.

. 1OMINANT PARIETAL LO#E "TROKE$________________________________. Con+ra;a+era; sensor* ;oss (4ainB 6i)ra+ionB a,ra4@es+@esia 9 as+ereo,nosis.. Con+ra;a+era; in'erior @oon*o2s 2adran+ano4sia ("24erior o4+i radia+ion;esion.. 1OMINANT TEMPORAL LO#E "TROKE$

________________________________. APHA"IA" d2e +o ARCUATE !A"CICULU" in6o;6een+.. Ree4+ion a4@asia (A8e+ o4re@ension.. Anoi a4@asia (ina)i;i+* +o s4ea& no2ns.. Cond2+i6e a4@asia (Re4i+i+ion. Con+ra;a+era; in'erior @oon*o2s 2adran+ano4sia ("24erior o4+i radia+ion;esion.

PRE"ENTATION ACCOR1ING TO TEH A!!ECTE1 PART O! THE #RAIN$____________________________________________________________

.%. #RAIN "TEM LE"ION"$________________________. in6o;6e +@e rania; ner6es.. sensor* ;oss o' one @a;' o' +@e 'ae 9 on+ra;a+era; @a;' o' +@e )od*.


10/29

.0. THALAMU" LE"ION"$

______________________ . Hei-sensor* ;oss i+@ se6ere d*ses+@esia (THALAMIC PAIN PHENOMENON.

.7. CORTICAL LE"ION"$

______________________ . sensor* ;oss o' one @a;' o' +@e 'ae 9 i4si;a+era; @a;' o' +@e )od*. . A4@asia - Ne,;e+ - A)nora; ,ra4@es+@esia or s+ereo,nosis.

.


11/29

An+i-4;a+e;e+VAn+i-+@ro)o+i+@era4*$

________________________________________________________________________________________

. Presen+in, i+@in 7 - LONG TERM ANTICOAGULATION e.,.WAR!ARIN.

THROM#OLYTIC" / TI""UE PLA"MINOGEN ACTIFATOR (+-PA / ALTEPLA"E$___________________________________________________________________

THROM#OLYTIC" IN1ICATION" 9 CONTRAIN1ICATION"$_________________________________________________ THROM#OLYTIC" IN1ICATION"$

_____________________________.%. Non @eorr@a,i is@ei s+ro&e..0. "*4+os onse+ 7 - %%J H,... P;a+e;e+s %JJJJJV7 B G;2ose =J ,Vd; B INR > %..

__________________________________________________________________________________________


12/29

__________________________________________________________________________________________

. HEMI-NEGLECT 3YN1ROME / LE"ION in +@e (RIGHT PARIETAL LO#E CORTE?$_____________________________________________________________________. Lesion o' +@e RIGHT (NON-doinan+ @ei-s4@ere.

. @i@ is res4onsi);e 'or s4a+ia; or,ania+ion.

. "oB In +@is diseaseB T@e 4+ i,nores +@e ;e'+ side o' a s4ae.. Res4onds on;* +o +@e s+i2;i oin, 'ro +@e RIGHT side.. P+ a* s@a6e on;* +@e Ri,@+ side o' +@eir 'ae.. Co) +@e Ri,@+ side o' @is @air.. I,nore +@e s2)De+ ;oa+ed in +@e ;e'+ side o' a s4ae.. 1:$ As& +@e 4+ +o ;; in +@e n2)ers o a ;o& Q

. E?ERTIONAL HEAT "TROKE$_________________________. "e6ere e:er+ion 2nder dire+ s2n ;i,@+.. A2+e on'2sionB @*4er+@eriaB +a@*ardia 9 4ersis+en+ e4is+a:is.

. 12e +o !AILURE O! THERMO-REGULATORY CENTER +o ain+ain a e2+@eri s+a+e.. Core +e4era+2re >


13/29

. T: $ 1o4ainer,i a,onis+s e.,. L-do4a.

. WERNICKEs ENCEPHALOPATHY$____________________________. A;o@o;i 4+.. A;+ered en+a; s+a+2s 5 Gai+ ins+a)i;i+* 5 N*s+a,2s 5 ConD2,a+e ,ae 4a;s*.

. 12e +o Fi+. # % de'eien* 0r* +o ;on, +er a;o@o; 2se.. Triad o' ee4@a;o4a+@*B o2;oo+or d*s'2n+ion 9 ,ai+ a+a:ia is dia,nos+i.. 1ECU#ITU" ULCER$

__________________. HVO o' o;d 4+ in a are ,i6er 'ai;i+*.. Con+in2ed 4ress2re on a )on* 4roinene 'or a ;on, 4eriod.. Is@ei nerosis o' +@e o6er;*in, sB ".C. +iss2e 9 s&in.. Pre6e+ed )* re4osi+ionin, o' +@e 4+ e6er* 0-< @o2rs.

. LEFO-1OPA V CAR#I-1OPA "ide e8e+s$_____________________________________

. 1o4aine 4re2rsors.. Mos+ oon side e8e+ is HALLUCINATION".. O+@ers$ 1iinessB Heada@es 9 a,i+a+ion.. In6o;2n+ar* o6een+s a* o2r.

. TRI-HE?Y-PHENI1YL side e8e+s ( FERY IMPORTANT .. A"KE1 TWICE in UW$________________________________________________________________________. I+ is an An+i-@o;iner,i dr2,s 2sed 'or +++ o' Par&insonis.. Red as )ee+B dr* as )oneB @o+ as @areB );ind as )a+B ad as @a++er 9 '2;; as a as&.. Red as )ee+ $ !;2s@in,.. 1r* as )one $ An@*drosis - dr* o2+@.. Ho+ as @are $ H*4er+@eria.. #;ind as )a+ $ M*driasis - 6ision @an,es.. Mad as @a++er $ 1e;iri2 - o'2sion.. !2;; as a as& $ Urine re+en+ion - ons+i4a+ion.

1EMENTIA"$_____________

.%. !RONTO-TEMPORAL 1EMENTIA (Pi&s disease$______________________________________________. Persona;i+* @an,es (e24@oria - disin@i)i+ion - a4a+@*.. Co42;si6e )e@a6ior (4e2;iar ea+in, @a)i+s - @*4erora;i+*.. I4aired eor*.. !ai;* HVO o' +@e disease is oon.

.0. LEWY #O1IE" 1EMENTIA$_______________________. !;2+2a+in, o,ni+i6e i4airen+.. #iarre 6is2a; @a;;2ina+ions..7. ALHEIMERs 1I"EA"E$


14/29

______________________. Pro,ressi6e deen+ia.. A,eB 'ea;e ,enderB 56e 'ai;* HVOB @ead +ra2a are oon ris& 'a+ors.. "2)+;e eor* ;ossB ;an,2a,e di2;+ies 9 a4ra:ia.. I4aired D2d,een+ 9 4ersona;i+* @an,es.

. N.#. HYPOTHYROI1I"M is an i4. a2se o' re6ersi);e @an,es in eor* 9en+a+ion$

___________________________________________________________________________________. Ao4anied )* s*s+ei @an,es e.,. ei,@+ ,ainB 'a+i,2eB @oarseness 9ons+i4a+ion.

.


15/29

.N.#. NORMAL AGING$___________________. Tiredness.. oasiona; 'or,e+'2;ness.. oasiona; ord ndin, di2;+*

. Tro2);e 'a;;in, as;ee4.. A)sene o' '2n+iona; i4airen+s.. Nora; 4er'orane on en+a; s+a+2s e:aina+ion.

. #RAIN 1EATH$_______________

. Irre6ersi);e essa+ion o' +@e )rain a+i6i+ies.

. A)sen+ or+ia; 9 )rain s+e '2n+ions.. A)sen+ ornea; ree:.. A)sen+ ,a, ree:.. A)sen+ o2;o6es+i)2;ar re:.. !I?E1 1ILATE1 PUPIL".

. No s4on+aneo2s )rea+@in, @en +@e 6en+i;;a+or is o8 'or %J ins.. "4ina; ord a* )e s+i;; '2n+ionin,B soB 1EEP TEN1ON RE!LE?E" a* )e "TILLPRE"ENT.. MU"T #E CON!IRME1 #Y TWO PHY"ICIAN".

. "HY 1RAGER 3YN1ROME$______________________. MULTIPLE "Y"TEM ATROPHY.. PARKIN"ONI"M 4+.5 A2+onoi d*s'2n+ion (4os+2ra; @*4o+ension - )oe;9);adder ;oss o' on+ro;-i4o+ene.5 Wides4read ne2ro;o,ia; si,ns (ere)e;;arB 4*raida; or ;oer o+or ne2ron.

. C@roni a;o@o; a)2se -> Cere)e;;ar daa,e$_____________________________________________. ;oss o' o-ordia+ed o6een+.. A+a:ia.. #road )ased ,ai+.. 1*se+ria.. In+en+ion +reors.. 1*sdiado&o&inesia.. N*s+a,2s.. Ms @*4o+onia (4end2;ar &nee ree:.

. #ELLs PAL"Y$_______________. !aia; +@ rania; ner6e 4eri4@era; ne2ro4a+@*.. "2dden onse+ o' 2ni;a+era; 'aia; 4ara;*sis.. Ina)i;i+* +o ;ose +@e e*e on +@e a8e+ed side.. Ina)i;i+* +o raise +@e e*e )ro on +@e a8e+ed side.. 1roo4in, o' +@e o2+@ orner i+@ disa44earne o' +@e naso;a)ia; 'o;dB. soB +@e o2+@ is dran +o +@e s4ared side.


16/29

. 1iinis@ed +earin,.. H*4era2sis.. Loss o' +as+e sensa+ion o6er +@e an+erior 0V7s o' +@e +on,2e.. I' +@e ;esion in +@e CN" o2rin, a)o6e +@e 'aia; n2;e2sB. i+ i;; +*4ia;;* CONTRALATERAL LOWER !ACIAL WEAKNE"" "PARING THE!OREHEA1.

. AMAURO"I" !UGA?$__________________. Pain;ess ;oss o' 6ision.. C@o;es+ero; 4ar+i;es a* )e seen in +@e e*e.. I+ is a arnin, si,n o' i4endin, s+ro&e.. An 2nder;*in, e)o;i disease is os+ a;a*s 4resen+.. E)o;i o2r a+ +@e aro+id )i'2ra+ion.. 1:$ NECK 1UPLE? ULTRA3OUN1.

. "U#-1URAL HEMATOMA$_____________________

. 12e +o #LUNT or s@earin, +ra2a +earin, +@e #RI1GING FEIN".. a2sin, +@e +o s;o;* );eed in+o +@e s2)d2ra; s4ae.. Heada@e 9 ,rad2a; ;oss o' onsio2sness o2r ,rad2a;;*.. More oon in o;der 4+s 9 a;o@o;is d2e +o )rain a+ro4@* 9 6esse; 'ra,i;i+*.. NON on+ras+ @ead CT -> WHITE CRE"CENT... Mass e8e+ i+@ id ;ine s@i'+ a* )e seen.. Eer,en+ ne2ros2r,ia; ons2;+a+ion 'or @ea+oa e6a2a+ion is neessar*.

. EPI-1URAL HEMATOMA$_____________________. Tra2a +o +@e TEPORAL )one.. InD2r* +o +@e MI11LE MENINGEAL ARTERY.. Non on+ras+ @ead CT -> #ICONFE? HEMATOMA.. "YRINGOMYELIA / COR1 CAFITATION$

__________________________________. Idio4a+@i Ca6i+ar* e:4ansion o' +@e s4ina; ord.. A8e+s +@e 244er ;i)s in a CAPE ;i&e dis+ri)2+ion.. Aree:i ea&ness in +@e 244er e:+ree+ies.. 1issoia+ed anes+@esia (Loss o' 4ain 9 +e4era+2re i+@ in+a+ 4osi+ion 96i)ra+ion.. A ord a6i+* is 4resen+ Q. Loer er6ia; or 244er +@orai are +@e os+ oon a8e+ed si+es.. 1IA#ETIC NEUROPATHY$

______________________. "*e+ri 4eri4@era; 4o;*ne2ro4a+@*B onone2ro4a+@* or a2+onoi ne2ro4a+@*.. Monone2ro4a+@ies ei+@er rania; or soa+i.. CN 7 (O2;oo+or is +@e os+ oon a8e+ed.. T@e a2se o' ne2ro4a+@* is I"CHEMIC.. "oa+i 9 4aras*4a+@e+i )ers in CN 7 @a6e se4ara+e );ood s244;ies.. "o .. On;* soa+i )ers are a8e+ed @i;e +@e 4aras*4a+@e+i )ers are in+a+.


17/29

. Mani'es+ed )* PTO"I" 9 1OWN 9 OUT GAE.. Aooda+ion 9 ;i,@+ ree: are in+a+.. "PINAL COR1 COMPRE""ION$

__________________________. iso;a+edB s*e+riB ;oer e:+rei+* s*4+os.

. Loss o' sensa+ions 9 si,ns o' 244er o+or ne2ron ;esion.. Wea&ness i+@o2+ 'asi2;a+ionsB @*4erree:ia 9 56e #a)ins&i si,n.. Possi);e e+io;o,ies$ (1is& @ernia+ion - E4id2ra; a)sess 9 a;i,nan*.. I+ is a edia; eer,en* Q. 1:$ MRI "4ine .. NOT CT QQ

. ALHEIMERs 1I"EA"E$______________________ I+ is +@e os+ oon a2se o' deen+ia. NO dis+2r)ane in onsio2sness. A,e ,ro24 > J.

EARLY !IN1ING"$__________________. An+ero,rade eor* ;oss (iedia+e rea;; a8e+edB dis+an+ eor* 4reser6ed.. Fis2os4a+ia; dei+s (;os+ in on nei,@)or@ood.. Lan,2a,e di2;+ies (di2;+* ndin, ords.. Co,ni+i6e i4airen+ i+@ 4ro,ressi6e de;ine. LATE !IN1ING"$

_________________. Ne2ro4s*@ia+ri (@a;;2ina+ions 9 anderin,.. 1*s4ra:ia (di2;+* 4er'orin, ;earned o+or +as&s.. La& o' insi,@+ re,ardin, dei+s.. Non-o,ni+i6e ne2ro;o,ia; dei+s (4*raida; 9 e:+ra-4*raida; o+orB*o;on2s.. Urinar* inon+inene. 1:$ CT -> 1i82se or+ia; 9 s2)or+ia; a+ro4@*B

@i@ is disa44ro4ria+e;* ,rea+er in +@e +e4ora; 9 4arie+a; ;o)es.

. GLIO#LA"TOMA MULTI!ORME (G#M / HIGH GRA1E A"TROCYTOMA$_________________________________________________________. "*4+os o' 55 ICT (Na2sea-6oi+in,-@eada@e orsenin, i+@ @an,e in4osi+ion.. 55 ICT / "4ae o24*in, ;esion.. Persona;i+* @an,es 9 s+ran,e )e@a6ior (12e +o in6o;6een+ o' +@e 'ron+a; ;o)e.. 1:$ CT or MRI -> #UTTER!LY a44earane i+@ en+ra; nerosisB. i+@ HETEROGENOU" "ERPIGINOU" CONTRA"T ENHANCEMENT.

. CRANIOPHARYNGIOMA / H*4o4i+2i+aris si,ns 5 Heada@es 5 #i+e4ora;);indness$

_______________________________________________________________________________. #eni,n +2ors arisin, 'ro Ra+@&es 4o2@.


18/29

. #ioda; a,e dis+ri)2+ion i.e. @i;dren 9 ==-= *s a,e ,ro24.. I+ is ;oa+ed a)o6e se;;a +2ria.. Consis+s o' 2;+i4;e *s+s ;;ed i+@ oi;* 2id.. Presen+s i+@ s*4+os o' @*4o+@*roidis.. In @i;dren (Re+arded ,ro+@ d2e +o -- GH 9 T"H.. In ad2;+s ("e:2a; d*s'2n+ion.

. Woen a* 4resen+ i+@ aenorr@ea.. I+ o4resses +@e o4+i @iasa -> #ITEMPORAL #LIN1NE"".. Heada@es o2r d2e +o 55 ICT.. 1:$ MRI or CT.. T:$ "2r,er* or radio+@era4*.

. CAU1A EUINA 3YN1ROME$________________________. Co4ression o' +@e s4ina; ner6e roo+s.. Ca2ses (T2or - Hernia+ed dis& - A)sess - Tra2a.. Lo )& 4ain.. #oe; 9 );adder d*s'2n+ion.

. "add;e anes+@esia.. "ia+ia.. Loer e:+rei+* sensor* 9 o+or ;oss.. 1:$ Eer,en+ MRI.

HIF assoia+ed ;esions on MRI$________________________________.%. PRIMARY CN" LYMPHOMA$

_________________________. "o;i+ar*.. WEAKLY rin, en@anin, 4eri-6en+ri2;ar ass.. A;+ered en+a; s+a+2s.. Assoia+ed E#F 1NA in +@e C"!.

.0. TO?OPLA"MO"I"$__________________. M2;+i4;e.. Rin, - en@anin, s4@eria; ;esions in +@e )asa; ,an,;ia.. 56e sero;o,* is no+ s4ei Q. TMP-"M? is 4re6en+i6e.

.7. PROGRE""IFE MULTI!OCAL LEUKOENCEPHALOPATHY$_______________________________________________. Non - en@anin,.. No ass e8e+s.. O44or+2nis+i 6ira; in'e+ion (SC 6ir2s.

.


19/29

.=. A#"CE""$____________. "o;i+ar*.. Rin, en@anin,.. Iso;a+edB ro2nd i+@ soo+@ )orders.

. HVO o' &non e:+ra-rania; in'e+ions.. !;2id o;;e+ion in +@e a:i;;ar* sin2s.. T@e os+ oon a2sa+i6e or,aniss are AERO#IC 9 ANAERO#IC"TREPTOCOCCI 9 #ACTEROI1E".

CAROTI1 ARTERY "TENO"I"$__________________________. Ma* 4ro,ress +o e)o;i s+ro&e or TIAs.. Ma* )e si;en+ i+@ no s*4+os.. "*4+oa+i -> s2dden onse+ o' 'oa; ne2ro. s*s i4si;a+era; +o +@e );o&edar+er*.. 1:$ NECK 1UPLE? UV3.

. T:$ CEA or CA".. CAROTI1 EN1 ARTERECTOMY (CEA is reoended i'$ _________________________________________________. "*4+oa+i 4+s i+@ aro+id s+enosis J - ZZ .. Lo s2r,ia; ris&.. Good = *ear 4redi+ed s2r6i6a;.. "2r,ia;;* aessi);e aro+id ;esion.. CAROTI1 ANGIOPLA"TY WITH "TENTING (CA" is reoended i'$

___________________________________________________________. Hi,@ s2r,ia; ris&.. Poor = *ear 4redi+ed s2r6i6a;.. Lesion no+ aena);e +o s2r,er*.

IMPORTANT CRANIAL NERFE" 9 THEIR !UNCTION"$_____________________________________________ OPTIC NERFE (CN 0$

_____________________. FI"ION. OCULOMOTOR (CN 7$

____________________. E*e o6een+ (Mos+.. Add2+ion i+@ edia; re+2s.. E;e6a+ion i+@ s24erior re+2s.. 1e4ression i+@ in'erior re+2s.. E*e ;id o4enin,.. P24i; ons+ri+ion.

TRIGEMINAL (CN =$____________________. T@ree )ran@es i+@ )o+@ o+or 9 sensor* )ers.


20/29

. T@e %s+ )ran@ is a;;ed +@e O4@+@a;i ner6eB. I+ arries sensor* )ers +o +@e sa;4B 'ore@eadB 244er e*e;idB ornea 9 nose. !ACIAL (CN $

________________. !aia; o6een+.

. Tas+e in +@e an+erior 0V7s o' +@e +on,2e.. Laria+ion.. "a;i6a+ion.. E*e ;osin,. FAGU" (CN %J$

________________. "a;;oin,.. Pa;a+e e;e6a+ion.. Moni+orin, )aro 9 @eo ree4+ors o' +@e aor+i ar@.

. IMPAIRE1 1AILY !UNCTIONING$

_____________________________. is essen+ia; +o dis+in,2is@ )e+een deen+ia 9 nora; a,in,.. P+s i+@ deen+ia @a6e '2n+iona; i4airen+.. Nora; a,in, is no+ ass. i+@ i4airen+.

. ACUTE GLAUCOMA$_________________. O2rs @en a 4re-e:is+in, narro an+erior @a)er an,;e is ;osedB. in res4onse +o 424i;;ar* di;a+a+ion 'ro edia+ions or ano+@er s+ii2;2s.. PP+ )* dire+ )ri,@+ ;i,@+ e.,. a+@in, TF.. 55 IOP a* ;ead +o na2sea 9 6oi+in, 9 +earin, 4ain.. Co4;ain o' seein, @a;os aro2nd ;i,@+.. 1aa,e o' +@e o4+i ner6e is oon 9 a* ;ead +o 6is2a; ;oss.. "2dden onse+ o' 4@o+o4@o)iaB e*e 4ainB @eada@e 9 na2sea.. Pa;4a+ion -> 6er* @ard e*e.. NON REACTIFE MI1 1ILATE1 PUPIL.. 1:$ TONOMETRY.

HEA1ACHE"$____________

.%. MIGRAINE HEA1ACHE$_______________________. Uni;a+era;.. P2;sa+in, 2a;i+*.. A++a&s ;as+ 'ro < - 0 @s.. P@o+o4@o)ia.. Coon in *o2n,er 'ea;es.. AURA o' ne2ro;o,ia; s*s 4reeidin, @eada@e.. T:$ TRIPTAN" (Eien+ on;* )e'ore +@e s+ar+ o' +@e a++a& 5 N"AI1s.. I.F. An+i-ee+is e.,. (PRO-CHLOR-PERAINE or Me+o;o4raide "EFEREFOMITING CA"E".


21/29

.0. CLU"TER HEA1ACHE$______________________. In+ense 2ni;a+era; re+ro-or)i+a; 4ain.. "+ar+s s2dden;* (2s2a;;* a+ ni,@+.. More oon in en.

. Redness o' +@e i4si;a+era; e*e.. Tearin, e*e 4ain.. "+28ed or r2nn* nose.. I4si;a+era; Horners 3.. A++a&s o2r in ;2sers.. Pro4@*;a:is is +@e &e* +o ana,een+ (Fera4ai; - Li+@i2 - Er,o+aine.. T: o' a2+e a++a& -> %JJ O?YGEN 9 ".C. "2a+ri4+an.

.7. #ENIGN I1IOPATHIC INTACRANIAL HYPERTEN"ION / P"EU1OTUMOR CERE#RI$______________________________________________________________________. O6er-ei,@+ 'ea;e in +@e @i;d )earin, 4eriod.. HVO o' OCPs in+a&e or @*4er6i+ainosis A.

. Heada@e - +ransien+ ;oss o' 6ision - 42;as+ai;e +inni+2s - di4;o4ia.. E:$ 4a4i;;edea - 4eri4@era; 6is2a; de'e+s.. 1:$ MRI 9 LP (C"! o4enin, 4ress2re > 0=J H, i+@ NORMAL ana;*sis.. T:$ "+o4 +@e o8endin, edia+ionsB ei,@+ ;oss 9 Ae+ao;aide.. ACETAOLAMI1E 5V- !URO"EMI1E is +@e %s+ ;ine +@era4*.. Ae+ao;aide -> in@i)i+s @oroid 4;e:2s ar)oni an@*drase -> -- C"! 4rod2+ion.. Mos+ oon o4;ia+ion is #LIN1NE"" Q. "@2n+in, or o4+i ner6e s@ea+@ 'enes+ra+ion is done +o 4re6en+ );indness.

.


22/29

. !oo+ dro4 a* )e on,eni+a; (C@aro+ - Marie - Too+@ disease.

. HERPE" ENCEPHALITI"$______________________. Ca2sed )* H"F-%.. Main;* a8e+s +@e TEMPORAL ;o)e o' +@e )rain.

. A2+e onse+ % ee& d2ra+ion.. A;+ered en+a+ion - 'oa; ne2ro. dei+s - @ei4aresis - d*s4@asia - a4@asia -a+a:ia.. Ma* 4resen+ i+@ sei2res Q. !EFER is 4resen+ in ZJ o' ases.. C"! ana;*sis -> LYMPHOCYTIC PLEOCYTO"I".. .............-> 55 R#Cs (Heorr@a,i des+r2+ion o' +@e +e4ora; ;o)es.. .............-> 55 P+n ;e6e;.. .............-> -- G;2ose ;e6e;. 1: $ H"F POLYMERA"E CHAIN REACTION I" THE GOL1 "TAN1AR1.. T: $ IF ACYCLOFIR.

. ETHICAL PRO#LEM$__________________. REGAR1LE"" O! HVO O! 1RUG A#U"EBB. P+s i+@ a2+e se6ere 4ain s@d reei6e +@e sae s+andard o' 4ain ana,een+ QQ. IF MORPHINE is +@e )es+ +++ 'or a2+e se6ere 4ain.. P@*siians s@d NEFER 2nder+rea+ 4ain e6en i' +@ere is a ris& 'or a)2se.. "ITE O! THE LE"ION ----> 1E!ICIT$

___________________________________. UPPER THORACIC "PINAL COR1 ---> Para4;e,ia - #;adder 9 'ea; inon+ineneB. ............................... 5 A)sen+ sensa+ion 'ro +@e (NIPPLE donards.. LOWER THORACIC "PINAL COR1 ---> A)sen+ sensa+ion 'ro +@e (UM#ILICU"donards.

. PARKIN"ON 1I"EA"E / TREMOR" 5 RIGI1ITY 5 #RA1YKINE"IA$________________________________________________________. Ne2rode,enera+i6e disorder.. Ca2sed )* a22;a+ion o' a;4@a s*n2;ein i+@in +@e ne2rons o' "U#"TANCIANEGRA.. T@e os+ oon 4resen+in, s*4+o is as*e+ri res+in, +reor in +@e 244ere:+rei+*.

.% TREMOR$___________. A res+in, < +o H +reor i+@ a 4i;;-ro;;in, 2a;i+*.. !re2en+;* rs+ ani'es+s in one @and.. Ma* s;o;* ,enera;ie +o in6o;6e +@e o+@er side o' +@e )od* 9 +@e ;oer e:+rei+*.

.0 RIGI1ITY$______________. #ase;ine 55 resis+ane +o 4assi6e o6een+ (Lead 4i4e or o, @ee;.


23/29

.7 #RA1YKINE"IA$__________________. 1i2;+* ini+ia+in, o6een+s as @en s+ar+in, +o a;& or risin, 'ro a @air.. Narro )asedB s@2Xin, ,ai+ i+@ s@or+ s+rides i+@o2+ ar sin, (!E"TINATING.. Miro,ra4@ia ("a;; @and ri+in,.. H*4oiia (-- 'aia; e:4ression.

. H*4o4@onia (so'+ s4ee@.

.< PO"TURAL IN"TA#ILITY$__________________________. !;e:ed a:ia; 4os+2re.. Loss o' )a;ane d2rin, +2rnin, or s+o44in,.. Loss o' )a;ane @en 42s@ed s;i,@+;*.. !re2en+ 'a;;s.

. NO "PECIAL TE"T !OR E?ACT 1IAGNO"I".. ONLY PHY"ICAL E?AMINATION CAN LEA1 TO THE 1:.

. "TATU" EPILEPTICU"$_____________________. "in,;e sei2re ;as+in, > 7J ins.. HVO o' sei2re disorder i+@ no o4;iane +o an+i-on62;san+ +@era4*.. A )rain seiin, > = ins is a+ 55 ris& o' 4eranen+ inD2r* $ CORTICAL LAMINARNECRO"I".. T: -> #ENO1IAEPINE -> IF 1IAEPAM.. !ai;ed -> A11 !O"PHENOTOIN.. !ai;ed -> A11 PHENO#AR#ITAL.. !ai;ed -> A11 "UCCINYL CHOLINE.. 1ELIRIUM$

___________. A2+e on'2sion s+a+e.. Red2ed oe 2+2a+in, ;e6e; o' onsio2sness.. Ina)i;i+* +o s2s+ain a++en+ion.. An:ie+*B a,i+a+ion 9 @a;;2ina+ions.. Coon 44+ 'a+ors (in'e+ions$ UTI.. Po;*4@ara*B edia+ion side e8e+sB 6o;2e de4;e+ion 9 e;e+ro;*+e i)a;ane.. "ERUM ELECTROLYTE" 9 URINALY"I" s@d )e done +o de+e+ +@e a2se.. T:-> T*4ia; 9 a+*4ia; an+i-4s*@o+is (HALOPERI1OL.. #enodiae4ines (Lorae4a are no+ reoended in o;d a,e.

. ONCE MORE$ 1I!!ERENT CERE#RAL ARTERY OCCLU"ION" 9 THEIR E!!ECT"$__________________________________________________________________ MI11LE ere)ra; ar+er* o;2sion$

____________________________________. Con+ra;a+era; o+or 9 sensor* dei+s.. More 4rono2ned in +@e 244er ;i) +@an +@e ;oer ;i).. Hoon*o2s @eiano4ia.. I' +@e doinan+ ;o)e (LE!T is in6o;6ed ------> APHA"IA.


24/29

. I' +@e NON doinan+ ;o)e (RIGHT is in6o;6ed -> HEMI NEGLECT 3.

ANTERIOR ere)ra; ar+er* o;2sion$______________________________________. Con+ra;a+era; o+or 9 sensor* dei+s.. More 4rono2ned in +@e ;oer ;i) +@an +@e 244er ;i).

. Urinar* inon+inene.. Gai+ a4ra:ia. PO"TERIOR ere)ra; ar+er* o;2sion$

_______________________________________. Hoon*o2s @eiano4ia.. A;e:ia i+@o2+ a,ra4@ia (doinan+ @eis4@ere.. Fis2a; @a;;2ina+ions (or+e:.. "ensor* s*4+os (T@a;a2s.. INTRACRANIAL HYPERTEN"ION$

____________________________

. 55 in+ra-rania; 4ress2re > 0J H,.. Ca2ses$ Tra2a - s4ae o24*in, ;esion - @*droe4@a;2s - i4aired C"! o2+o.. "*4+os$ 1i82se @eada@e orse in +@e ornin, - Na2sea 9 6oi+in,.. Fision @an,es - 4a4i;;edea - rania; ner6e deis.. "ono;ene - o'2sion - Uns+eadiness.. C2s@in,s ree:$ H*4er+ension 9 )rad*ardia.. 1:$ CT or MRI.

. CERE#RAL HEMORRHAGE d2e +o E?CE"" ANTI-COAGULATION$_____________________________________________________. An+i-oa,2;a+ion +@era4* is +@e os+ oon );eedin, disorded a2sin, )rain@eorr@a,e.. "o .. P+s on an+i-oa,2;an+s (e.,. War'arin s@d )e oni+ored re,2;ar;* i+@ INR.. Ris& o' );eedin, 55 i+@ INR 55 Q. Corre+ion o' e:ess an+i-oa,2;a+ion is de4enden+ 24on +@e INR 6a;2e$. INR = B NO si,nian+ );eedin, -> Oi+ ne:+ War'arin dose.. INR =-Z B NO si,nian+ );eedin, -> "+o4 War'arin +e4orari;*.. INR > Z ---------------------------> "+o4 War'arinB Gi6e ora; Fi+. K.. "ERIOU" INTRA-CRANIAL #LEE1ING -> !RE"H !ROEN PLA"MA (!!P.. !!P re6erses +@e a+io o' ar'arin B or&s iedia+e;* 9 ;as+s 'or 'e @o2rs.

. HYPOKALEMIA -> WEAKNE""B !ATIGUE 9 MU"CLE CRAMP"$___________________________________________________. E;e+ro;*+e dis+2r)ane i+@ K 0.= EVL.. !;aid 4ara;*sisB @*4oree:iaB +e+an*B r@a)do*o;*sis 9 arr@*+@ia a* o2r.. ECG -> #ROA1 !LAT T-a6esB U a6es 9 4re-a+2re 6en+ri2;ar )ea+s.. A'B Torsades de 4oin+s 9 F! a* o2r.. HVO o' K as+in, di2re+i is oon (H*dro@;oro+@iaide.. O+@er a2ses -> 1iarr@ea - 6oi+in, - anore:ia - @*4era;dos+erinis.. "*4+os reso;6e i+@ K s244;een+a+ion.

. TAKE CARE$ 1i8eren+ia+e )e+ IIH 9 NPH$


25/29

_________________________________________. NORMAL PRE""URE HY1ROCEPHALU" / Triad o' Urine inon+inene 5 A)nora;,ai+ 5 1een+ia.

_________________________________________________________________________________________

. #ENIGN I1IOPATHIC INTACRANIAL HYPERTEN"ION / P"EU1OTUMOR CERE#RI$___________________________________________________________________

. O6er-ei,@+ 'ea;e in +@e @i;d )earin, 4eriod.. HVO o' OCPs in+a&e or @*4er6i+ainosis A.. Heada@e - +ransien+ ;oss o' 6ision - 42;as+ai;e +inni+2s - di4;o4ia.. 1:$ MRI 9 LP (C"! o4enin, 4ress2re > 0=J H, i+@ NORMAL ana;*sis.

/////////////////////////. KEY-WOR1" +o RE-MEM#ER$/////////////////////////

. OLIGO-CLONAL #AN1" -> M".. CYTO-AL#UMINOU" 1I""OCIATION -> G#3.

. HEMORRHAGE -> HYPER-dense areas on CT. (WHITE.. IN!ARCTION" -> HYPO-dense areas on CT. (#LACK.

. GAIT". !E"TINATING / HYPOKINETIC / "HU!!LING -> PARKIN"ONI"M.. HIGH "TEPPAGE -------------------------> TA#E" 1OR"ALI" or L= Radi2;o4a+@*.. "EMI-CIRCLE ---------------------------> "TROKE HEMIPLEGIA.. WA11LING ------------------------------> MU"CULAR 1Y"TROPHY.. WI1E #A"E1 9 "HU!!LING ----------------> NORMAL PR""URE HY1ROCEPHALU".. IP"ILATERAL ATA?IA --------------------> CERE#ELLAR ATA?IA.. "PA"TIC -------------------------------> UMNL UPPER MOTOR NEURON LE"ION$. "TAGGERING ----------------------------> FE"TI#ULAR ATA?IA.

. TREMOR". RE"TING TREMOR" (PARKIN"ON-> A+ res+Bi4. e a+i6i+*BHi,@ 're2en* +reors=- H.. E""ENTIAL TREMOR"-> Wors+ a+ +@e end o' +@e ,oa; dire+ed a+i6i+* (rea@in, a4en.. CERE#ELLAR TREMOR" -> In+ension +reors - ;o 'e2en* 7-< H - N*s+a,2s 9a+a:ia.

. TRIGEMINAL NEURALGIA$ LIGHTENING PAIN on +@e 'ae - e;e+ri s@o& - T:$CAR#AMAEPINE.

. GUILLAIN #ARRE3$ Asendin, 4ara;*sis - Pre.)* in'e+ion - CYTOAL#UMINOU"1I""OCIATION.


26/29

. TICK #ORNE PARALY"I"$ Asendin, 4ara;*si - NO 'e6er - Nora; C"! - T:$ Ti&reo6a;.

. MYA"THENIA GRAFI"$ P+osisB1i4;o4ia RE"OLUTION O! MU"CULAR WEAKNE""WITH RE"T.

. LAM#ERT EATON 3YN1ROME$ LUNG CANCER HVOB A2+o-A)s a,ains+ 6o;+a,e ,a+edCa @anne;s.

. N.#. MYA"THENIA GRAFI"$ A2+oA)s a,ains+ (4os+s*na4+i res - INTACT 1TRs.. N.#. LAM#ERT-EATON 3$ A2+oA)s a,ains+ (4res*na4+i ree4+ors - LO"T 1TRs.

. 1ERMATOMYO"ITI"$ "*. 4ro:. s ea&ness - "KIN (Go++rons 4a42;es 9He;io+ro4e ras@.

. "TEROI1 IN1UCE1 MYOPATHY$ Pro:. s ea&ness (LL )e'ore UL - No 4ain.. "U#-ARACHNOI1 HEMORRHAGE$ R24+2re o' #err* ane*r*s - WOR"T

HEA1ACHE EFER.. NEURO-!I#ROMATO"I" 0$ ".C. ne2ro)roas 5 Ca'e a2 ;ai+ s4o+s 5 ao2s+i

ne2roas.

. PRONATOR 1RI!T / UMNL.

. E""ENTIAL TREMOR$ T:$ ## Pro4rano;o;.

. MULTIPLE "CLERO"I" / O4+i ne2ri+is (4ain'2; ;oss o' 6ision 9 di4;o4ia.. MULTIPLE "CLERO"I" / INTER-NUCLEAR OPHTHALMOPLEGIA (INO.. MULTIPLE "CLERO"I" / 1:$ #RAIN MRI i+@ 9 i+@o2+ GA1OLINIUM.

. MULTIPLE "CLERO"I" / C"! ana;*sis$ OLIGOCLONAL I,G )ands - Nora; 4ress2re.. MULTIPLE "CLERO"I" / T: o' a2+e e:aer)a+ion -----> HIGH 1O"E IFGLUCOCORTICOI1".. MULTIPLE "CLERO"I" / 4re6en+ '2+2re a++a&s -> #-in+er'eron or G;a+iraerae+a+e.. MULTIPLE "CLERO"I" / YOUNG !EMALE i+@ #ILATERAL TRIGEMINAL NEURALGIA.

. AMYOTROPHIC LATERAL "CLERO"I"$ UPPER 5 LOWER o+or ne2ron ;esions.

. CT3$ ME1IAN N. - A+ WRI"T - T@enar einene a+ro4@* - Pares+@esia %s+ 7.=n,ers

. ULNAR N. ENT. 3$ 4ares+@esia o'


27/29

. UN-PROFOKE1 !IR"T "EIURE -> HEA1 CT WITHOUT CONTRA"T is +@e %s+ ini+ia;s+e4 done.

. LIM# I"CHEMIA$ = Ps (Pain - Pa;;or - Pares+@esia - P2;se;essness 9 Para;*sis.. METOCLOPRAMI1E$ "ide e8e+ 1*s+onia - Mani'es+ed )* s+i8 4ain'2; ne&.

. HEMI-NEGLECT 3YN1ROME$ RIGHT PARIETAL LO#E CORTE? ;esion - (NON-doinan+ @ei-s4@ere.

. E?ERTIONAL HEAT "TROKE$ T: -> EFAPORATION COOLING (NOT iersion in o;da+er :::.

. CAFERNOU" "INU" THROM#O"I"$ 1:$ MRI - T:$ #road s4e+r2 An+i)io+is.

. RE"TLE"" LEG 3YN1ROME$ Cra;in, sensa+ion - T: $ 1o4ainer,i a,onis+s e.,.L-do4a.

. WERNICKEs ENCEPHALOPATHY$ ee4@a;o4a+@*Bo2;oo+or d*s'. 9 ,ai+ a+a:ia.(--Fi+ #%.. 1ECU#ITU" ULCER$ Pre6e+ed )* re4osi+ionin, o' +@e 4+ e6er* 0-< @o2rs.

. LEFO-1OPA V CAR#I-1OPA "ide e8e+s$ Mos+ oon side e8e+ isHALLUCINATION".

. TRI-HE?Y-PHENI1YL$Red as )ee+B dr* as )oneB @o+ as @areB );ind as )a+B ad as @a++er 9 '2;; as a as&.

. 1EMENTIA". !RONTO-TEMPORAL $ Persona;i+* @an,es (e24@oria - disin@i)i+ion - a4a+@*.. LEWY #O1IE" 1EMENTIA$ #iarre 6is2a; @a;;2ina+ions.. ALHEIMERs 1I"EA"E$ Pro,ressi6e deen+ia - I4aired D2d,een+ 9 4ersona;i+*@an,es.. HUNTINGTONs 1I"EA"E$ Triad o' ood dis+2r)anes 5 C@orei'or o6een+s 51een+ia.. CREUT!EL1T - SAKO# 1I"EA"E$ EEG -> "HARP TRI-PHA"IC "YNCHRONOU"1I"CHARGE".. NORMAL PRE""URE HY1ROCEPHALU"$ Triad o' Urine inon+inene 5 A)nora;

,ai+ 5 1een+ia.. P"EU1O-1EMENTIA$ T: -> ""RIs.. NORMAL AGING$ A)sene o' '2n+iona; i4airen+s.

. #RAIN 1EATH$ 1TRs a* )e "TILL PRE"ENT - MU"T #E CON!IRME1 #Y TWOPHY"ICIAN".

. "HY 1RAGER 3YN1ROME$ MULTIPLE "Y"TEM ATROPHY - PARKIN"ON 4+. 5 );adder;oss o' on+ro;.

. C@roni a;o@o; a)2se -> Cere)e;;ar daa,e.


28/29

. #ELLs PAL"Y$ !aia; +@ rania; ner6e 4eri4@era; ne2ro4a+@*.

. AMAURO"I" !UGA?$ #LACK CURTAIN !ALLING - i4endin, s+ro&e - NECK 1UPLE?ULTRA3OUN1.

. "U#-1URAL HEMATOMA$ Tearin, +@e #RI1GING FEIN" .. CT -> WHITE CRE"CENT.

. EPI-1URAL HEMATOMA$ InD2r* +o +@e MI11LE MENINGEAL ARTERY .. CT ->#ICONFE? HEMATOMA.. "YRINGOMYELIA$ CAPE ;i&e - Loss o' 4ain 9 +e4era+2re i+@ in+a+ 4osi+ion 9

6i)ra+ion.. "PINAL COR1 COMPRE""ION$ I+ is a edia; eer,en* - 1:$ MRI "4ine.

. ALHEIMERs 1I"EA"E$ CT -> 1i82se or+ia; 9 s2)or+ia; a+ro4@*.

. GLIO#LA"TOMA MULTI!ORM$ #UTTER!LY a44earane i+@ en+ra; nerosis on FTor MRI.

. CRANIOPHARYNGIOMA / H*4o4i+2i+aris si,ns 5 Heada@es 5 #i+e4ora;);indness.

. CAU1A EUINA 3YN1ROME$ L#P - );adder d*s. - "add;e anes+@esia - 1:$ Eer,en+MRI.

. HIF assoia+ed ;esions on MRI$. PRIMARY CN" LYMPHOMA$ "o;i+ar* - WEAKLY rin, en@anin, - Ass. E#F 1NA.. TO?OPLA"MO"I"$ M2;+i4;e - Rin, - en@anin, s4@eria; - TMP-"M? is 4re6en+i6e.

. PROGRE""IFE MULTI!OCAL LEUKOENCEPHALOPATHY$ Non - en@anin, - Noass e8e+s.. A#"CE""$ "o;i+ar* - Rin, en@anin, - a2sed )* ANERO#E"

. CAROTI1 ARTERY "TENO"I"$ NECK 1UPLE? UV3.- CAROTI1 EN1 ARTERECTOMY i's+enosis J-ZZ .

. ACUTE GLAUCOMA$ Pa;4a+ion -> 6er* @ard e*e - NON REACTIFE MI1 1ILATE1PUPIL.. HEA1ACHE"

. MIGRAINE HEA1ACHE$ 'ea;e Uni;a+era; P2;sa+in,B AURA o' ne2ro s*s 4reeidin,@eada@e.. CLU"TER HEA1ACHE$ 2ni;a+era; =+earin, re+ro-or)i+a; 4ain .. T: -> %JJ O?YGEN.. P"EU1OTUMOR CERE#RI$ O)ese 'ea;e- Fi+ A - OCPs - Mos+ oon o4;ia+ionis #LIN1NE"". "U#-ARACHNOI1 HEMORRHAGE$ WOR"T HEA1ACHE EFER QQ


29/29

. #ROWN "EUAR1 3YN1ROME$ on+ra-;a+era; ;oss o' 4ain 9 +e4era+2resensa+ionB. #ROWN "EUAR1 3YN1ROME$ )e,innin, +o ;e6e;s )e;o +@e ;e6e; o' +@e ;esion.

. L= RA1ICULOPATHY -> !oo+ dro4 -> Co4ensa+ed )* HIGH "TEPPAGE GAIT$

. HERPE" ENCEPHALITI"$ C"! ana;*sis -> LYMPHOCYTIC PLEOCYTO"I" - T: $ IFACYCLOFIR.

. PARKIN"ON 1I"EA"E / TREMOR" 5 RIGI1ITY 5 #RA1YKINE"IA.

. 1ELIRIUM$ T: -> T*4ia; 9 a+*4ia; an+i-4s*@o+is (HALOPERI1OL.

. A#"ENCE sei2res -> ETHO"U?IMI1E.

1r. Wae; Ta Mo@aed

_________________________

Ck Neurology

Documents

Transcript of Ck Neurology