neuro

• A woman of childbearing age who presents with generalised tonic-clonic seizures should be offered lamotrigine or levetiracetam
• A rare but recognised adverse effect of lamotrigine therapy is Stevens-Johnson syndrome
• Common peroneal nerve lesion can cause weakness of foot dorsiflexion and foot eversion
• A combination of thrombolysis AND thrombectomy is recommend for patients with an acute ischaemic stroke who present within 4.5 hours
• Acoustic neuromas are best visualized by MRI of the cerebellopontine angle
• The most common secondary brain tumours are lung, breast, kidney, melanoma and colorectal cancers metastases
• Management of myasthenic crisis - intravenous immunoglobulin, plasmapheresis
• Anterior cerebral artery stroke causes leg weakness but not face weakness or speech impairment
• Temporal lobe seizures typically feature epigastric aura and automatisms 
• A man suddenly stares into space and is non-responsive. He then repeatedly smacks his lip and appears to be chewing. This lasts for around 1 minute - focal impaired awareness seizure
• Levodopa and other antiparkinsons drugs are 'critical' medicines which should not be stopped on acute admissions and must be delivered on time
• Cluster headache - acute treatment: subcutaneous sumatriptan + 100% O2
• Guillain-Barre syndrome is classically triggered by  Campylobacter jejuni infection
• Focal seizures: lamotrigine or levetiracetam are first-line
• Bell's palsy is a lower motor neuron condition. Unlike UMN conditions of the face, in LMN conditions the entire side of the patients face is affected
• IV lorazepam is the first-line treatment in patients with early status epilepticus
• Propranolol is preferable to topiramate in women of childbearing age (i.e. the majority of women with migraine)
• Fluctuating consciousness = subdural haemorrhage
• Headache linked to Valsalva manoeuvres = raised ICP until proven otherwise so LP is contraindicated
• A maximum of two doses of IV benzodiazepines can be administered during convulsive status epilepticus
• A woman suddenly has the sensation of smelling roses whilst at work. She is conscious throughout - focal aware seizure
• Stroke: aspirin 300mg should be given once a haemorrhagic stroke has been excluded by a CT scan
• All patients with a Bell's palsy should be given oral prednisolone within 72 hours of onset
• MRI with contrast should be used to view demyelinating lesions
• Worsening lower limb weakness following gastroenteritis - think Guillain-Barre
• The most common pattern for progression of multiple sclerosis is relapsing-remitting
• Fourth nerve palsy - when looking straight ahead, the affected eye appears to deviate upwards and is rotated outwards
• Broca's dysphasia: speech non-fluent, comprehension normal, repetition impaired
• Clopidogrel is the preferred antiplatelet for secondary prevention following stroke
• Sensorineural hearing loss is the most common complication following meningitis 
• Absence seizures: ethosuximide is first-line
• Lung primary tumours are the most common cause of brain metastases
• Migraine

  • acute: triptan + NSAID or triptan + paracetamol
  • prophylaxis: topiramate or propranolol
• Verapamil is used for long-term prophylaxis of cluster headaches
• Tonic or atonic seizures: lamotrigine is first-line for females 
• Defective eye abduction and horizontal diplopia - CN VI
• Myasthenia gravis - antibodies against acetylcholine receptors
• On CT imaging, a chronic subdural haematoma will appear as a hypodense (dark), crescentic collection around the convexity of the brain
• Extradural haemorrhage appears as a biconvex on imaging
• CT head showing temporal lobe changes - think herpes simplex encephalitis