Nuero Review 2

• Fever
• Headache
• Stiff neck
• Nausea
• Vomiting
• Seizures
• Signs of Meningeal irritation- postive kernig's and Budzinski signs

Little GooGoo GaaGaa

• Listera
• GNR
• Group B strep

• HENS
• 1. H. influenzae type B
• 2. Enteroviruses
• 3. N. Meningitidis
• 4. S.pnemoniae

• Hens
• 1.HSV
• 2.Enteroviruses
• 3.N.Meningitidis
• 4.S.pneumoniae

• Grandies Need Some Love
• 1.GNR
• 2. N. Mingingitidis
• 3. S. Pneumoniae
• 4. Listera

•  1.Caused by Mycobacterium tuberculosis
•  2. Seen in malnourished, debilitated or immunosuppressed people
•  

Common malnourished, immunosuppressed or debitated

• Common Pathogens:
• 1. Cryptococcus
• 2. Candida
• 3. Fusarium

• Rare Pathogens:infections in healthy people
• 1. Histoplasma
• 2. Coccidioides
• 3. Paracoccidiodes

• CSF
• 1.Protein and Glucose
• 2.Cell count
• 3.PCR for HSV

Blood Culture

• Latex Agglutination for -H.influ, S.pneumo
• N. Meningitis

CT/MRI- prior to LP if focal signs

• Papilledema
• Focal Neurologic Sign
• Coagulopathy

• Increased -opening pressure
• Increased WBC 50-10,000 mostly polys
• Increased protein
• Decreased Glucose

• increased opening pressure
• whites count increased bwt 50-10,000 both polys and lymphs
• Increased protein
• decreased glucose

• Normal to slightly increased opening pressure
• WBC 20- 1,000 mostly lymphs
• Slightly Increased protein
• Normal glucose

Hospitalization for observation and  IV antifungal medications.

• Medications include
• 1. Amphortericin B
• 2. Flucytosine and be used in addition to increase efficacy

mortality rate 20-50 %

mostly supportive care

• Hospitalization
• Empirial antibotics
• -Vancomyacin and Ciprofloxacin or
• -Ampicillin
• -Consider giving steroid dexamethasone before antibiotic
• -treat close contacts with rifampin, ciprofloxacin or ceftriaxone

"RIPE"

• R- rifampin
• I- Isoniazid
• P-pyrazidamide
• E-ethambutal

For 18-24 Months

Autoimmune disease that targets gangliosides and leads to rapidly progressing, ascending, areflexic motor paralyses with or without sensory distrubances.

• Males > than Females
• Adults > Children
• 85%  Recovery Rate
• 5% Death Rate
• 60-70% of patients have a acute  GI/Respiratory infection proir to neurologic symptoms.
• Organsims assocated with disease include
• 1. Campylobactor Jejuni
• 2. CMV
• 3. EBV

Ascending weakness that evoles over days to reach a peak at 14-30 days

Loss of DTR at about day 3

Bulbar weakness and respiratory muscle paralysis may occur

50%  of pat ients havefacial weakness

pains and tingling sensations

• IV IGG
• Plasma Exchange
• Rehab
• No steroids -not helpful
• monitor FVC FVC< 15 indication for ICU and Intubation

• Orthostatic Hypotension
• Diarrhea
• Constipation
• Early Satiety
• Tachycardia/Palpitation
• Blurred Vision
• Urinary Retention
• Erectile Dysfunction

CSF shows increased protein greater than55mg/dl with few or no cells called albulminocytologic

May have positive antibodies

May spontaneously regress untill next episode

• inhalation of 100% O₂ for 20 mins while
• sitting upright
• Triptans
• Prednisone, veraparmil, methylsergide

trigeminal nerve resecion or injection

Simple Dugs-OTC pain medication taken at 1st onset

Drugs that induce Sleep

Ergotamine, s=- all constrict cerebral and systemic blood vessels and prevents release of inflammatory mediators from trigeminal nerve

N/V may make oral medications ineefective

Triptans

Indicated for patient who have  for or more mirgraines a month

• regular excerise
• regular sleep schedule
• avoid  alcohol, caffeine or other triggers

Medications- reduce migraines by 50%when taken dailly

• amitriptyline
• olivaloproex sodium
• propanolol
• timolol

• Relaxation techniqques- Hot/Cold paxks
• bths/showers, massage, meditation

OTC analgesics- high doses may cause rebound HAs

Sleep medication