Ou Tulsa Pa Neuro Tx

Front 1

Inhalation of 100% oxygen
Nasal Zolmitriptan
Sumatriptan (intranasal or subcutaneous)

Back 1

Cluster Headache

Front 2

Analgesics (<15 day supply)
Cafergot
Sumatriptan

Back 2

Migraine

Front 3

Simple analgesics = 1st line (ASA, Acetaminophen, NSAIDS
Tx comorbid depression/anxiety
Relaxation (massage, hot bath)

Back 3

Tension Headache

Front 4

Standard low dose tx for insomnia (Trazadone), agitation, and depression (SSRI)

Acetylcholinesterase Inhibitors trial = donepexil, rivastgmine, and galantamin

Back 4

Alzheimer Disease

Front 5

Cholinesterase inhibitors are the mainstay

Back 5

Dementia w/ lewy bodies

Front 6

Neuroleptics to treat hallucinations, but exacerbate movement disorder

Dopinergics exacerbate psychiatric symptoms

Back 6

Dementia w/ lewy bodies

Front 7

Control of hypertension and metabolic disorders may help to slow progression of symptoms

Back 7

Vascular Dementia

Front 8

Drainage of large volume of CSF results in Gait improvement

lumboperitoneal shunt is recommended, cognitive impairment is not likely to responde

Back 8

Normal Pressure Hydrocephalus

Front 9

Symptomatic only, SSRI can help behavior issue

Back 9

Frontotemporal Dementia (Pick Disease)

Front 10

60% self limiting
Oral Prednisone has been shown to improve complete recovery

Back 10

Bell Palsy

Front 11

Hospitalization with close monitoring of respiratory status
Plasmapheresis ASAP

IV immunoglobulin preferred w/ all pt w/ cardiovascular instablility
Low dose Heparin to prevent pulmonary embolism

Back 11

Guillain-Barre Syndrome

(Acute idiopathic polyneuropathy)

Front 12

Beta-interferon intramuscularly or
Glatiramer acetate subcanteously used indefinitely

symptomatic tx: amantadine and pemoline for fatigue
baclofen and diazepam for spasticity

Back 12

Multiple sclerosis

Front 13

Corticosteroids might hasten acute relapse
Immunosuppressants therapy may be effective: cyclophoshamide, azathioprine, methotrexate

Back 13

Multiple sclerosis

Front 14

Cholinesterase inhibitor: pyrdostignime = GOLD Standard

Thymectomy often improves symptoms

Back 14

Myasthenia Gravis

Front 15

Oxcarbazepine or Carbamazepine

Posterior Fossa exploration surgery

Radiofrequency Rhizotamy in elder PT

Back 15

Trigeminal Neuralgia (Tic Douloureux)

Front 16

Supportive Tx
Dextrose, Nalone, Thiamine empirically

Back 16

Stupor/Coma

Front 17

Aspirin = 1st line

IV thrombolytic TX or intra-arterial mechanical thrombolysis

Back 17

Cerebral Infarction

Front 18

Aspirin
Long term management (HTN, DM)

Back 18

Lacunar Infarction

Front 19

Aspirin
Physical Activity
Statin Tx to control lipidemia
BP reduction
smoking cessation

Back 19

Transient Ischemic Attack (TIA)

Front 20

ALL PT admitted to hospital

Definitive TX = Surgical clipping or endovascular technique w/in 2 days

Symptomatic tx for concious PT
Phenytoin to prevent seizures

Back 20

Subarachnoid Hemorrhage

Front 21

Prevent further bleeding
Surgery for unruptured aneurysm = clipping aneurysm or endovascular technique

Nimodipine helps prevent vasospasm

Back 21

Intracranial Aneurysm

Front 22

MOST MANAGED CONSERVATIVELY

Prompt surgical evacuation of hematoma in Cerebellar hemorrhage

Back 22

Intracerebral Hemorrhage

Front 23

TX for Arteriovenous Malformations with seizure only?

Back 23

anticonvulsant

Front 24

Tx for accessible Arteriovenous Malformation?

Back 24

Surgery

(if bled present or to prevent further progression of neurological deficit)

Front 25

Non-accessible:
Embolization

Injection of vascular occlusive polymer

Occlusion of vessel by ballon catheter

Back 25

Ateriovenous Malformation (non-accessible)

Front 26

Immediate Antibiotic based on age:

18-50 = vancomycin + ceftriaxone
50+ = vancomycin + ampicillin + ceftriaxone
post surgery = vancomycin + cefepim

Back 26

Bacterial Meningitis

Front 27

Tx Adults w/ pneumococcal bacterial meningitis?

Back 27

Dexamthasone

Front 28

Tx for gram positive bacterial meningitis?
And
Tx for HIV PT with bacterial meningitis?

Back 28

Corticosteroids

Front 29

Generally benign, and self limiting
No specific Tx required

Herpes simplex - Acyclovir
Headache - Acetaminophen

Back 29

Aseptic (Viral) meningitis

Front 30

IV antibiotics combined with surgical drainage

Empirical broad spec ceftriaxone, metronidazole, or vancomycin --> switch to proper abx after culture

Abx continued parenterally for 6-8 weeks followed by oral tx for 2-3 months

monitor PT w/ CT or MRI every 2 weeks

Back 30

Brain Abcess

Front 31

No tx necessary unless disability

Propanolol continued indefinitely

Back 31

Benign Essential (familial) Tremor

Front 32

Treatment is symptomatic, Physical Therapy

Levodopa + Carbidopa
Dopamine Agonist
Anticholinergic Drugs

Back 32

Parkinsonism

Front 33

Drug tx until symptom free for 3 years

Phenytoin, Carbamazepine, Valpric Acid

Back 33

Seizures

Front 34

Tx for Absence Seizure?

Back 34

Valproic Acid

Front 35

Tx for myoclonic seizure

Back 35

Valproic Acid

Front 36

Maintain airway
50% IV dextrose
IV phenytoin for seizure control
(if continued seizure use lorazepam, still present then phenobarbital)

Back 36

Status Epilepticus

Front 37

Acyclovir empirically

Back 37

Viral Encephalitis

Front 38

What is the treatment for Cerebral Palsy?

Back 38

Supportive Tx

Front 39

No Cure
Can't slow progression
Tx is symptomatic

offspring should get genetic counseling

Back 39

Huntington Disease

Front 40

Treat with movement and exercise

Treat most PT for underlying anemia

Back 40

Restless Leg Syndrome

Front 41

Symptomatic
Cognitive behavioral therapy
Adrenergic agonist (Clonidine)

Back 41

Tourette Syndrome

Front 42

No medication or hospitalization needed for majority

Seizure persist: Diazepam and ABC monitor

(Studies show Acetaminophen or Tylenol do not lower risk of seizure with fever)

Back 42

Febrile Seizure