NEUROLOGYDR SHARJEEL

CNS EXAMINATION HIGHER MENTAL FUNCTIONS

CONSCIOUS LEVEL GCSORIENTATION IN TIME SPACE & PERSONMEMORY

RECENT PAST

MOODSLEEPBEHAVIOUR

SPEECHCOMPREHENSIVEARTICULATIONFLUENCYREPETITIONNOMINATIONCALCULATIONREADINGWRITING

CRANIAL NERVE EXAMINATIONOLFACTORY NERVEOPTIC NERVE

VACOLORVFFUNDUS

CN 3,4,6EXTRAOCULAR MOVEMENTS

TRIGEMINAL CORNEAL REFLEXMUSCLES OF MASTICATIONJAW JERKSENSORY SENSATION

FACIALFOREHEAD WRINKLES& EYE CLOSURENASOLABIAL FOLDSTASTE OF ANT PART OF TONGUE

VESTIBULOCOCHLEARHEARINGVESTIBULAR

GLOSSOPHARYNGEALGAG REFLEX

VAGUSUVULA & PALATE LIFTING

ACCESSORYSHRUGGING OF SHOULDERS AND TURNING

OF HEADHYPOGLOSSAL

TONGUE MOVEMENT

MOTOR SYSTEMUPPER LIMB & LOWER LIMB

BULKTONE POWERFASCICULATIONS

TENDON REFLEXESBICEPS,TRICEPS,SUPINATOR,KNEE,ANKLE.

SUPERFICIAL REFLEXESPLANTARS

SENSORY SYSTEM

CEREBELLAR SIGNS

MENINGEAL SIGNSSKULL & SPINECAROTID BRUIT & PULSATIONSGAIT.

Important points regarding neurological diseasesDiagnostic criteria of Optic Neuritis

Acute or subacute loss of vision plus one of following RAPD VF defects Color vision defect Papillitis

CRION(chronic relapsing inflammatory optic neuropathy)Pain persists for 24-48 hrs beyond visual lossHighly steroid sensitive and need lifelong steroidsNo evidence of demyelinating diseaseT cell granulomatous response

Devic disease(NMO)Bil ateral opti neuritis Demyelination of spinal cord(transverse myelitis)Also called neuromyelitis opticaB cell humoral immunity Iv steroids

Polio Absent /decreased reflexesMuscle wastingLMN disease

Guillan Barre (GBS)Neurology wards ICU s are filled with GBS

patients because it has got two life threatening complications Respiratory failure Cardiac arrhythmias

Motor Neuron Disease (MND)It is the only neurological disease having both

upper and motor neuron signs It spares extraocular muscles

Name 2 conditions in which we give heparin despite haemarrhagePulmonary embolism

Patient comes with massive haemoptsisCerebral venous thrombosis

Patient with intracranial bleed There is no circle of willis in venous circulation so you

have to open the blockage to re establish the venous flow.Doppler of brain circulation

Significant role of doppler is in pathology of anterior circulation . Posterior circulation is nt much better appreciated.

Millard gubler SyndromePatient with

abducens paresis and contralateral hemiparesis

MucormycosisFungal life

threatening and visual threatening condition usually occur in diabetic patients

Patient presented with unilateral ptosis and ophthalmoplegia with severe headache

Within few days become NPL

MRI brain with contrast shows fungal abscess involving left sphenoid fossa.

Tuberculous meningitis

Wilson dx

Stroke This is CT scan of 40

yr old male who presented with Rt homonymous heminopia and rt side hemiparesis . CT shows left PCA infarcts.

Stroke

MSWe have seen lot of

MS patients mostly presented wit INO .

Thanks