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Neuro General


Peripheral neuropathy: axonal vs demyelinating axonal: normal conduction velocity, denervation on EMG; demyelinating: slow velocity, no EMG denervation
Tension type HA mild-mod intensity, bilateral, nonthrobbing HA w/o other assoc features; infreq <1/mo; freq 1-14 days/mo; chronic >15 days/mo; NSAIDs & TCAs
MS testing MRI, VER, BAER, SSEP, CSF oligoclonal banding, spinal fluid IgG
sudden onset of LMN d/o, asym facial paresis, often hyperacusis & impaired taste Bell palsy (prev: 30/100K)
contralateral hemiplegia, hemisensory loss, & homonymous hemianopia (& global aphasia if dominant hemisphere is affected) = MCA stroke
Essential tremor Tx often not needed; propranolol
cluster HA unilateral, orbital/temporal w/tearing; Tx O2, sumatriptan, prevent w/verapamil
HA prevalence cluster M>F, parox hemicrania F>M
HA: serious sxs meningits (fever, HA, stiff neck: LP/bld cx); SAH (sudden onset: CT); subdural
MS S/S 15-50 yo; optic neuritis; fatigue; Lhermitte sx; Uhthoff's phenomenon
MS tx methylprednisolone/ IVIg for acute; glatiramer & interferon for relapsing- remitting sx
Bell palsy DDx Lyme dz, tumor, AIDS, sarcoidosis, herpes zoster in geniculate ganglion
MCA stroke: anterior main div occlusion vs posterior anterior occlusion: expressive dysphasia; posterior: receptive/ Wernicke
posterior cerebral artery occlusion leads to: thalamic syndrome: contralateral hemisensory deficit, spont pain & hyperpathia
anterior comm artery occlusion causes: weakness & cortical sensory loss in contralateral leg, poss arm weakness
ischemic stroke tx ASA, some get thrombolytics (dipyridamole, heparin for cardioembolic)
hemorrhagic stroke tx supportive; poss surg (stroke/AVM); aneurysm clipping/coil embolization
Light touch: Side of Neck: C2-3
Light touch: Tip of Shoulder: C4
Light touch: Lateral Deltoid: C5
Light touch: Thumb: C6
Light touch: Middle Finger: C7
Light touch: Pinky Finger: C8
Light touch: Medial Forearm at elbow: T1
Light touch: 1st Dorsal web: Radial nerve
Light touch: Palmar middle pad: Median
Light touch: Palmar small pad: Ulna
Light touch: Groin: L1
Light touch: Upper thigh: L2
Light touch: Outer thigh at knee: L3
Light touch: Medial ankle: L4
Light touch: Dorsal 1st web space: L5
Light touch: Lateral ankle: S1
Light touch: Buttock: L2-3
Light touch: Perianal: L4
DTR: Biceps: C5
DTR: Brachioradialis: C6
DTR: Triceps: C7
DTR: Knee: L 3,4
DTR: Ankle: S1
DTR: 0: absent
DTR: 1: diminished
DTR: 2: average
DTR: 3: exaggerated
DTR: 4: clonus
Created by: Adam Barnard Adam Barnard