Discover and read the best of Twitter Threads about #neurologist

Most recents (8)

1) Migraine Premonitory(Prodromal) Phase::
Presences of non-painful Symptoms, which can start hours to days before the onset of migraine pain and can be predictive of an impending headache.
2) Three Separate Groups of Symptoms::
1::Fatigue & Cognitive changes...
Concentration difficulty, Irritability, depression, fatigue, memory impairment.
2::Homeostatic Changes...
Food craving, Thirst, Yawning, Increased Urination, Sleep disturbance.
3) 3::Sensory Changes...
Photo, phono, osmo, Phobia, nause, neckstiffness.
Read 7 tweets
1) Migraine with AURA::
Recurrent attacks of unilateral fully reversible visual, sensory, or other CNS symptoms that develops gradually over minutes and usually followed by Headache and associated Migraine Symptoms.
2) Total 20-40% prevalent,Increased risk in 1st degree Relative + twins + Heritibility. Onset::
Gradual and progressive, unlike abrupt in Stroke.
AURA consists of Positive symptoms like flashing lights, and paresthesia while stroke dominates Negative symptoms like weakness.
3) Duration::
Typically 30 minutes but may be Prolong upto 4 hours. Symptoms::
Visual(90%,most common) > Sensory, language, motor.
Scintillating scotoma, Flashing lights, Blurry Visions.
Read 12 tweets
1) Absence Seizures::
Age 5 years to 10 years, history of febrile seizures in only significant.

Simple TAS:
Sudden onset of impaired Consciousness with blank facial stare without other motor, behavioral phenomenon.
Complex TAS:
Accompanied by motor, behavioral or Autonomic
2) phenomenon.
Clonic... May be subtle, like eye-blinking, Nystagmus, jerk of arms.
Tone... Extension or flexion of trunk in case of contractions(increase tone) , head nodding or dropping objects in case decrease Tone.
Automatism... Rubbing face or hand, licking lip, chewing,
3) grimacing, scratching.
Autonomic...Pallor, Flushing, salivation, sweating.

Atypical Absences::
Less abrupt onset or cessation, more changes in tone, long duration than TAS, associated with other seizures types & mental Retardation, usually begin before age 5 years,
Read 12 tweets
1) GEFS plus (Genetic Epilepsy with Febrile Seizures plus)
Mildest Benign Form: Normal EEG + IMAGING
1:Simple Febrile Seizures
2:Febrile Seizures Plus
Severe Form: Abnormal EEG + IMAGING
3:Dravet Syndrome
4:Doose Syndrome
2) GEFS plus is a genetic syndrome, Defect in 4 Genes, SCN1A, SCN1B, GABRG2, GABRD. Other seizures with FS Or FS-plus are Absence, atonic, myoclonic, and partial.
Typical convulsive seizures, 6month-6years, with fever 38c' or greater.
3) FS-plus:
Mild form of generalized epilepsy, different presentations.
1:Febrile Seizures continues past 6 years which is upper limit of FS, than decrease gradually.
2:Febrile Seizures and Afebrile seizures upto typical age for Febrile Seizures.(6 months to 6 years).
Read 10 tweets
#NeurologyMorningReport #NMR Case 65 #MedTwitter #NeuroTwitter Updates & Answers posted later today. Asking your help #MedEd #neurology #neurologyresident #neurologist #medstudent #NeurologyProud #MedStudentTwitter Join me in educating. Share your questions and knowledge.

1/ Image
Page - 25yo man, hx B cell ALL, ?seizure, now w/ AMS Please come to bedside
Admitted w/diarrhea & GI graft vs host disease
h/o ALL, multiple relapses including leptomeninges now in remission

What further information do you need? What are your 1st thoughts about what's going on?
See image for details of event and vital signs

Medications: tacrolimus, infliximab, remicade

3/ Image
Read 15 tweets
(1/7) Lipid Myopathy
1:Carnitine Palmitoyltransferase 2 deficiency
2:VLC acyl-CoA-Dehydrogenase deficiency
3:Trifunctional Deficiency
(2/7) Metabolism of fats,Beta-Oxidation, Carnitine.
Excessive accumulation of fatty acids,fatty liver, cardiomyopathy.
Exercise induced weakness, static myopathy, Fasting non-ketotic hypoglycemia, Rhabdomyolysis.
(3/7) Labs:
EMG-Myopathic patterns,
BLOOD: lncreased CK, low free carnitine, increased Acylcarnitine, lactate, urinary organic acids,
During Crises ⬆️ CK, Acylcarnitine, myoglobunuria, hypoglycemia, absent ketone formations.
Read 9 tweets
1/10 Mitochondrial Myopathy

Symmetric,proximal, ⬆️ CK + Growth Differentiating Factor-15, EMG-Myopathic finding
Biopsy - Cox negative Fibre, Red + Blue ragged Fibres.
2/10 B=Brain:
Ataxia,Dementia,Strokes,Migraine, Dystonia, Mood issues, seizures, Epilepsia partialis (1)
3/10 continue(MELAS+POLG) .
MRI Brain,CSF lactat,EEG.
Leigh-Central gray matter,Putamen, caudate, thalamus, cerebellum, midbrain, pons, Medulla, longtracts.
MELAS- Parital +Occipital lobes.(2)
Read 13 tweets
.@BethDarnall designed the questionnaire widely used to diagnose Pain Catastrophizing (PC). She pinned a survey to her twitter pg, asking people in #ChronicPain what they think of the term. Research on PC & rx #opioids is +75 times higher now than in '00-02.

What's PC? / thread
The Pain Catastrophizing Scale measures "rumination (eg, 'I can't stop thinking about how much it hurts'), magnification (eg, 'I worry that something serious may happen'), and helplessness (eg, There is nothing I can do to reduce the intensity of the pain')." [Darnall note 1]
"Psycho-pathology is both an antecedent & a consequence of persistent pain." [note 2]

Pain catastrophizing is "a mental set related to pain that is characterized by feelings of helplessness and persistent and unrealistic beliefs about pain and its consequences." [note 3]
Read 12 tweets

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