NEUROLOGICAL DISORDERS:

HEADACHE:

Types of primary headache:

1.

2.

3.

TENSION headache:

Characteristic feature:

Reason:

Treatment:
MIGRAINE:

Rule of 5 – 4 -3 – 2- 1

5 –

4 –

2 –

1 –

Treatment: Prophylaxis

Rest, avoid triggers

Cluster Headache:

Location:

Horner’s syndrome:

No triggers;

Additional features:

Treatment:

INTRACRANIAL BLEEDS

TRAUMA related Non Trauma related

SUBARACHNOID HEMORRHAGE:
BERRY ANEURYSM:

m/c site:

Risk factors for rupture:

Features of SAH:

- “Worst” Headache in life

Investigation:

Imaging:

CSF examination:
Complications:

1. Vasospasm

2. Hydrocephalus

3. Re rupture

4. Inappropriate ADH release

m/c cranial nerve involved in Berry aneurysm:

m/c cranial nerve involved in raised ICT:

Treatment:

1. Measures to decrease ICP

2. Maintain systolic BP: (range)

3.

4. Treatment of Berry aneurysm:

Extra (epi) dural haemorrhage Subdural haemorrhage

Treatment:

Scenario: A patient is admitted to ICU following a RTA. He is in a

comatose state. NCCT of head reveals no significant findings. Probable
diagnosis?

Investigation of choice:

m/c site:
Raised ICT: features:

In severe cases: CUSHING’S TRIAD:

MAP – ICT = CPP

CUSHING’S REFLEX:

Management of raised ICT:

Position:

Drug:
Hyperventilation:

Sedatives

Control of seizures:

Normal Pressure Hydrocephalus Pseudotumor cerebri

(NPH)

Treatment:

CSF pressure Ventricular size

Hydrocephalus

NPH

Pseudotumor

cerebri
NEURODEGENERATIVE BRAIN DISORDERS:
• Alzheimer’s disease
• Parkinson’s disease
• Huntington’s disease

ALZHEIMER’S DISEASE:

Risk factors:

Features:

5 ‘A’ s
Treatment:

PARKINSON’S DISEASE:

Basic pathology:

Features:

Treatment:
Huntington’s chorea:

Genetics:

Pathology:

Clinical features

Treatment:

CEREBROVASCULAR ACCIDENTS: STROKE

TIA Stroke

Duration

Brain imaging

ABCD2 score
 Etiology:

Ischemia Hemorrhage

How to quickly recognise STROKE?

Features:
Localisation based on features:

Important association with

pinpoint pupils:

4 “P”s

1.

2.

3.

4.

Speech defects – Aphasia:

Broca’ aphasia Wernicke’s aphasia

Area affected

Defect
Initial Investigation:

Treatment of ischemic stroke:

- Supportive treatment

Brainstem Stroke syndromes:

MIDBRAIN SYNDROMES: due to occlusion of:

LATERAL MEDULLARY SYNDROME (WALLENBERG SYNDROME)

Due to occlusion of:

Upper and lower motor neurons:

 UMN lesions LMN lesions

Paralysis

Muscle atrophy

Deep tendon reflexes

Fasciculation/
Fibrillation

Babinski’s sign

MOTOR UNIT:

NEUROPATHY MYOPATHY

Pattern of weakness

Fasciculation

Deep tendon reflexes

Sensory signs
Disorders involving Myelin:

Guillain Barre syndrome : AIDP:

Post infectious condition:

Characteristic feature:

AFP:

Cranial nerves:

Sensory disturbances:

Autonomic disturbances:

Which features are not usually seen?

Diagnosis:

Best investigation:

CSF analysis:

Treatment:

MULTIPLE SCLEROSIS:

Target antigens:

Characteristic feature is “Multiple neurological deficits that cannot be

explained by one lesion”

Features:

Diagnosis: T2W MRI

CSF examination:

Treatment:
Neuromuscular junction disorder:

MYASTHENIA GRAVIS

Autoimmune disorder

Association:

Muscles affected:

Most important/ CHARACTERISTIC feature:

Testing:

Screening Diagnostic

Treatment:
HEMISECTION OF SPINAL CORD:

BROWN SEQUARD SYNDROME

IPSILATERAL SIDE CONTRALATERAL SIDE

SCENARIO:

A 45-year-old man is brought to the emergency department with 1–2 days

of fever, headache, nausea, and vomiting. On physical examination he is

found to have neck stiffness and photophobia. Diagnosis?

 Meningitis Vs Encephalitis

Fever

Headache

Seizures

Cortical
involvement

Signs of meningeal
irritation

CSF analysis

Etiology:

Bacteria Virus Tuberculosis

m/c cause of meningitis in HIV infected patients:

CSF analysis:

Normal Bacterial Viral TB

CSF pressure 50 – 180 mm
H20
Appearance Clear

Cells 0 – 5 / µL
(Lymphocytes)

Protein 20 – 45 mg/ dL
Sugars 40 – 70 mg/dL

CSF/ serum 0.6

glucose

Treatment:

The most common long-term neurologic deficit from bacterial meningitis is?