Czech Neurology Board Examination flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Corticospinal tract decussation

Most corticospinal fibers cross in the medullary pyramids to form the lateral corticospinal tract; a smaller uncrossed portion forms the anterior corticospinal tract and crosses segmentally.

Broca's area

Located in the inferior frontal gyrus of the dominant hemisphere; lesions cause nonfluent aphasia with preserved comprehension but impaired repetition and naming.

Resting membrane potential

Approximately −70 mV in neurons, determined mainly by potassium permeability and the Na+/K+-ATPase pump, which moves three sodium ions out for two potassium ions in.

Relative afferent pupillary defect

Asymmetric pupillary constriction when light is swung from the normal to the affected eye; indicates optic nerve or severe retinal disease, not an efferent pupil defect.

Horner syndrome

Triad of ptosis, miosis, and anhidrosis caused by disruption of the sympathetic pathway anywhere from hypothalamus to internal carotid artery; anhidrosis helps localize.

Glasgow Coma Scale

Score from 3 to 15 combining eye opening (1–4), verbal response (1–5), and motor response (1–6); a score of 8 or less generally prompts consideration of airway protection.

Thrombolysis window ischemic stroke

Intravenous alteplase or tenecteplase is indicated within 4.5 hours of symptom onset after CT excludes hemorrhage and contraindications such as uncontrolled hypertension above 185/110 mmHg.

Mechanical thrombectomy indication

For large vessel occlusion (internal carotid, M1, or basilar artery) within 6 hours of onset; selected patients with salvageable penumbra may benefit up to 24 hours.

Subarachnoid hemorrhage diagnosis

Sudden severe thunderclap headache; CT is highly sensitive within 6 hours; if CT is negative and suspicion persists, lumbar puncture for xanthochromia is performed after 12 hours.

Status epilepticus treatment

Continuous seizure ≥5 minutes or recurrent seizures without recovery; first-line benzodiazepines, then intravenous antiseizure medication such as levetiracetam, valproate, or fosphenytoin.

Juvenile myoclonic epilepsy

Adolescent-onset myoclonic jerks on awakening, generalized tonic-clonic seizures, and sometimes absence seizures; EEG shows 3–4 Hz generalized spike-wave; often requires lifelong treatment.

Narcolepsy type 1

Excessive daytime sleepiness with cataplexy and low CSF hypocretin-1; multiple sleep latency test shows mean sleep latency ≤8 minutes and at least two sleep-onset REM periods.

Guillain-Barré syndrome

Acute ascending areflexic weakness with albuminocytologic dissociation in CSF (elevated protein, normal cell count); treat with IVIG or plasma exchange; monitor respiratory function.

Myasthenia gravis

Fatigable weakness, ptosis, and diplopia; anti-acetylcholine receptor antibodies in most generalized cases; repetitive nerve stimulation shows decrement; treat with acetylcholinesterase inhibitors and immunosuppression.

Lambert-Eaton myasthenic syndrome

Proximal weakness, hyporeflexia improving with exercise, and autonomic symptoms; anti-VGCC antibodies; associated with small cell lung cancer; repetitive nerve stimulation shows increment.

Amyotrophic lateral sclerosis

Progressive combined upper and lower motor neuron signs, often with bulbar involvement; riluzole and edaravone modestly slow progression; noninvasive ventilation for respiratory insufficiency.

McDonald criteria multiple sclerosis

Diagnosis requires dissemination in space and time demonstrated clinically or by MRI; CSF oligoclonal bands can substitute for dissemination in time when other criteria are met.

Neuromyelitis optica spectrum disorder

Anti-aquaporin-4 antibody disease with longitudinally extensive transverse myelitis, optic neuritis, and area postrema syndrome; acute attacks treated with steroids and plasma exchange.

Anti-NMDA receptor encephalitis

Psychiatric symptoms, memory loss, seizures, dyskinesias, and autonomic instability; associated with ovarian teratoma; treat with steroids, IVIG or plasma exchange, and tumor removal.

Parkinson's disease diagnosis

Bradykinesia plus rest tremor or rigidity; levodopa is the most effective symptomatic treatment; motor complications include wearing-off and dyskinesias.

Dementia with Lewy bodies

Fluctuating cognition, visual hallucinations, parkinsonism, and REM sleep behavior disorder; neuroleptic sensitivity; treat cognitive symptoms with cholinesterase inhibitors.

Huntington's disease

Autosomal dominant CAG repeat expansion in HTT; chorea, cognitive decline, and psychiatric symptoms; onset typically midlife; chorea treated with tetrabenazine or deutetrabenazine.

Glioblastoma treatment

Maximal safe resection followed by radiotherapy with concurrent and adjuvant temozolomide; MGMT promoter methylation predicts benefit from temozolomide.

Bacterial meningitis empiric therapy

Vancomycin plus a third-generation cephalosporin such as ceftriaxone; add ampicillin for Listeria in patients over 50 or immunocompromised; dexamethasone before or with first antibiotic dose.

Herpes simplex encephalitis

Temporal lobe involvement with fever, headache, seizures, and confusion; CSF shows lymphocytic pleocytosis and elevated protein; treat empirically with intravenous acyclovir.

Migraine with aura

Fully reversible visual, sensory, or language symptoms developing over ≥5 minutes and lasting 5–60 minutes, followed by headache; treat acute attacks with triptans or NSAIDs.

Cluster headache

Severe unilateral orbital or supraorbital pain lasting 15–180 minutes with ipsilateral autonomic symptoms; treat acute attacks with high-flow oxygen or subcutaneous sumatriptan; prevent with verapamil.

Trigeminal neuralgia

Paroxysmal electric-shock-like facial pain in the V2 or V3 distribution, triggered by touch or chewing; first-line treatment is carbamazepine or oxcarbazepine.

Giant cell arteritis

Age over 50 with new headache, jaw claudication, visual symptoms, and elevated ESR or CRP; treat immediately with high-dose corticosteroids and confirm with temporal artery biopsy.

Demyelinating versus axonal neuropathy

Demyelinating neuropathy shows slowed conduction velocity, prolonged distal latency, and conduction block; axonal neuropathy shows reduced amplitude with relatively preserved conduction velocity.

Repetitive nerve stimulation findings

A decrement greater than 10% suggests myasthenia gravis; an increment greater than 100% suggests Lambert-Eaton myasthenic syndrome.

Post-stroke rehabilitation timing

Multidisciplinary rehabilitation should begin early, within 24–48 hours once medically stable; constraint-induced movement therapy improves upper limb function in selected patients.