neuro

• Cluster headaches are typically painful attacks focused on one side of the face, with accompanying symptoms such as watery eyes or nose 
• Migraines would present with other typical symptoms such as throbbing pain, sensitivity to light and nausea
• The combination of confusion, ataxia, nystagmus, and ophthalmoplegia (conjugate gaze palsy), set against a backdrop of heavy alcohol consumption, is indicative of Wernicke's encephalopathy. This condition arises from thiamine deficiency (vitamin B1), which can be precipitated by excessive alcohol intake leading to impaired intestinal absorption of various nutrients including vitamin B1.
• Haloperidol may be employed to control agitation and hallucinations associated with alcohol withdrawal syndrome but has no therapeutic role in managing Wernicke's encephalopathy.
• Lorazepam, is a benzodiazepine commonly used to treat symptoms associated with alcohol withdrawal syndrome. On rare occasions, it might be indicated for seizures secondary to Wernicke's encephalopathy
• Naloxone is an opioid antagonist used to counteract the effects of opioid overdose
• Wernicke-Korsakoff syndrome and is characterised by the addition of antero- and retrograde amnesia and confabulation.
• Anti-AChR antibodies are antibodies to the acetylcholine receptor and are found in myasthenia gravis. This typically presents with fatiguable muscle weakness that gets worse during the day, commonly presenting in the extraocular muscles initially. It does not cause sensory signs.
• Guillain-Barre syndrome describes an immune-mediated demyelination of the peripheral nervous system often triggered by an infection (classically Campylobacter jejuni).
• Posterior circulation infarcts (POCI, c. 25%)

  • involves vertebrobasilar arteries
  • presents with 1 of the following:
  • cerebellar or brainstem syndromes
  • loss of consciousness
  • isolated homonymous hemianopia
• Lacunar infarcts (LACI, c. 25%)

  • involves perforating arteries around the internal capsule, thalamus and basal ganglia
  • presents with 1 of the following:
  • unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
  • pure sensory stroke.
  • ataxic hemiparesis
• On CT imaging, acute haematomas appear bright (hyperdense) whereas chronic haematomas appear dark (hypodense). Extradural haematomas are limited by suture lines whereas subdural haematomas are not. Intraparenchymal haematomas arise within the brain substance. Subarachnoid haemorrhage are typically seen as hyperdensity within the basal cisterns and sulci of the subarachnoid space.
• Drugs that increase the risk of idiopathic intracranial hypertension (IIH). COMAAR - ciclosporin, oral contraceptives, mineralocorticoids, amiodarone, antibiotics (tetracyclines, sulphonamides), retinoic acid.
• Wernicke's encephalopathy - CAN OPENConfusionAtaxiaNystagmusOphthamoplegiaPEripheral Neuropathy
• Cerebellar hemisphere - finger-nose ataxia
• Basal ganglia - Hypokinetic (e.g. Parkinsonism) or hyperkinetic (e.g. Huntington's) 
• Parietal lobe - sensory symptoms, dyslexia, dysgraphia 
• Frontal lobe - motor symptoms, expressive aphasia, disinhibition