Dr. Shahab
3 ASMs safe in pregnancy
Lamotrigine
Keppra
Oxcarbazapine
True or False:
Many children who present with initial stroke have significant medical history and were previously unwell.
FALSE
What is alexia without agraphia?
Explain RAPD and where it localizes
Relative afferent pupillary defect
Optic Nerve (CNII)
Most common comorbidity with ALS affecting cognition
What is frontotemporal dementia?
15%, higher risk genetic variation
0.4mg daily
Question of increased cancer in children with high doses of folic acid
Stuttering presentation rather than abrupt
Headache
Seizure
What is Charles Bonnet Syndrome?
5 ways to test the optic nerve
1. Visual fields
2. Acuity
3. Color
4. Pupillary reflex
5. Fundoscopy
Mode of inheritance for Kennedy's Disease, name 3 unique clinical findings compared to ALS.
X-linked, CAG trinucleotide expansion on androgen receptor gene
Sensory involvement, endocrine dysfunction, tremor, perioral fasciculations, gynecomastia, testicular atrophy, reduced fertility
What sequence can you see open ring sign and what diagnosis does it make you think of?
T1 post contrast
Tumefactive MS
What is the acute management of stroke secondary to sickle cell disease?
Emergent blood transfusion with goal to reduce percentage of hemoglobin S to under 30% and increase hematocrit to 30%
IVF
Oxygen
Loss of primary vision often with denial and confabulation
Clinical features characteristic of optic neuritis (3)
Monocular, Painful eye movements, RAPD, subacute, reduced contrast and color vision.
Rule of 2's - onset 2h to 2 days, nadir within 2 weeks, improvement over next 2 months
Isolated UMN syndrome for 5 years with limb spasticity and dysarthria
What is Primary lateral sclerosis?
For which MS medication is genetic testing required prior to starting?
Siponimod
CYP2C9 gene
Most common cause of stroke in otherwise previously healthy children (2)
Cervicocephalic dissection
Inflammatory intracranial focal cerebral arteriopathy
Disorder of shapes and sizes, often seen with migraine
What is metamorphopsia?
Alice in Wonderland syndrome
Room inversion syndrome
Sudden, unilateral, painless and progressive vision loss after TLIF surgery
Posterior ischemic optic neuropathy
Two most common genes associated with hereditary ALS
SOD1
C9orf72
Types of catamenial epilepsy and pathophysiology behind this
C1 - perimenstrual, drop in progesterone
C2 - Periovulatory, rise in estrogen
C3 - Inadequate luteal phase, second half of menstrual cycle. Inadequate progesterone secretion.
The STOP trial identified screening patients with sickle cell disease with this modality identified those most at risk for stroke
Transcranial Doppler
elevated velocities of TCD in MCA patients got regular transfusions for at least one year and reduced risk of initial stroke by 92%
Lesion location for Kluver-Bucy Syndrome
Treatment regimen for AAION
Pulse steroids --> high dose steroid with taper
Tocilizumab or methotrexate
ALS mimic with conduction block on NCS and stabilizes with IVIG. Spares bulbar and respiratory muscles
What is multifocal motor neuropathy.