Category Archives: Neurology

Parkinson’s disease

Features of Parkinson’s disease: Bradykinesia Hypokinesia (paucity of movement) Resting tremor Rigidity Postural instability (usually the last of the cardinal signs) Those are the cardinal signs.Tremor is typically made worse by stress, tiredness, or the feeling that other people are … Continue reading

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Huntington’s disease

(BMJ module; information from Dr David Crawford, consultant in neuropsychiatric genetics at St Mary’s, Manchester. Module chosen as I have a patient with Huntington’s who is developing increasing problems.) Huntington’s causes a combination of progressive motor, cognitive, and psychiatric symptoms. … Continue reading

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Restless legs syndrome

The latest BMJ has an article on restless legs syndrome. Diagnostic criteria 5 criteria need to be fulfilled for diagnosis (I’ve slightly rephrased these for myself, but the meaning should be the same): Urge to move the legs. Usually accompanied … Continue reading

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Headaches – red flags and orange flags

Red flags Probability of underlying tumour >1%. Investigate urgently. Focal neurology Significant alterations in consciousness Memory loss or confusion Co-ordination problems Seizures Known cancer Orange flags Probability of underlying tumour: 0.1 – 1%. Monitor carefully and have low threshold for … Continue reading

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Triptans

These divide into two groups: Sumatriptan, Rizatriptan, Zolmitriptan, Eletriptan and Almotriptan have a higher speed of onset. Naratriptan & Frovatriptan have a lower side-effect profile, and also possibly less chance of headache recurrence. Interestingly, someone who hasn’t responded to one … Continue reading

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Metastatic spinal cord compression

Presentation Pain The most common first symptom – 95% of patients will present initially with pain. May be present for up to two months before signs appear. May be localised in/around spinal column, or may be radicular (unilateral or bilateral) … Continue reading

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Bell’s Palsy

Comes on over a period of 12 – 36 hours. Prodromes can happen – facial numbness, altered taste, or pain around the ear. Initially progressive, but progression should have halted by 3/52 and if it continues to progress after that … Continue reading

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