Neurology Review

Myoclonic epilepsy with ragged red fibers (MERRF) and also:

• Blindness: Leber (optic neuropathy)
• Stroke like episodes: Mito encephalopathy
• lactic acidosis

Subtance P: Neuroopathic Pain; polypeptide neurotransmitter. Inhibited by Capsaicin Cream (topical) –> used in shingles

• Capsaicin –> blocks TRPV1 channel –> Intracellular Ca+ accumulation –> longlasting dysfunction of nocicpetive fibres –> Initial release and subsequent depletion of Substance P

Developmental Delay & Progressive Skull enlargement –> Dandy Walker Formation

• Posterior fossa enlargement, block at luscka and magendi

Arnold Chiari (II) associated with Spinal Myelomeningocele

Preaqueductal gray matter & mamillary bodies hemorrhage and necrosis –> WERNIKE ENCEPHALOPATHHY

THIAMINE Deficiency diagnosed by “erythrocyte transketolase activity”

• increase in levels after addition of thaimine pyrophosphate

Headache –> Subarachnoid hemorrhage –> (3-14 days) –> focal neurlogical (weakness in rt arm/leg) –> Cerebral Vasospasm;;;

• CCB (nimodipine) –> Inc cerebral vasodilation, Dec cal-dependent toxicity

Donapezil (AchEsterase Inhibitors) –> can cause bradycardia and AV block in the elderly.

Orthostatic Htn –> Lisnorpil

BZD –> avoid in elderly –> falls,fractures,cognitive impairement, delirium; give ramelteon for sleep

• also avoid TCAs, antihistamines due to strong anticholinergic effect, sedation, falls

Kid with both Absense and Tonic-clonic seizure: Drug of choice –> Valproic acid. If only absence, then Ethosuccimide

Focal onset seizures –> CBZ, phenytoin, gabapentin (narrow spectrum antiepileps).

Tetanus –> CLinical diagnosis only!; no freakin toxin assay!

• toxin mediated blockade of inhibitory interneurons at the level of anterior horn cells

Nucleous Cerelus –> panic attacks