NEUROLOGY LAST MIN PASSMEDICINE (II)

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NEUROLOGY
Horner's syndrome - anhydrosis determines site of lesion:
 head, arm, trunk = central lesion: stroke, syringomyelia
 just face = pre-ganglionic lesion: Pancoast's, cervical rib
 absent = post-ganglionic lesion: carotid artery
Hypertension should not be treated in the initial period following a stroke
Kearns-Sayre syndrome
 mitochondrial inheritance
 onset < 20-years-old
 external ophthalmoplegia
 retinitis pigmentosa
Lateral medullary syndrome - PICA lesion - cerebellar signs, contralateral sensory loss & ipsilateral
Horner's
Loss of corneal reflex - think acoustic neuroma
Medication overuse headache
 simple analgesia + triptans: stop abruptly
 opioid analgesia: withdraw gradually
Migraine
 acute: triptan + NSAID or triptan + paracetamol
 prophylaxis: topiramate or propranolol
Miller Fisher syndrome - areflexia, ataxia, ophthalmoplegia
Motor neuron disease - riluzole

Motor neuron disease - treatment: NIV is better than riluzole

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