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Glossary of FA Wards - Neuro

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Reflexes - grading scale
0 = areflexia
1 = weak reflex (hypoactive)
2 = normal
3 = hyperactive with spread across joint. "spread" of reflex to other muscle groups
4 = hyperactive with clonus
Strength - grading scale
0 = no movement
1 = flicker of contraction
2 = full range of motion with gravity eliminated
3 = full range of motion against gravity
4 = full range of motion against gravity and some resistance
5 = full power
"inability to recognize object by feeling"
graphesthesia
"ability to localize sensory input"
point localization
"inability to recognize dual, bilateral stimuli"
extinction
When is a CT better than an MRI
skull fracture - (bone cannot be imaged by MRI)

Intracranial bleeds - Acute bleeds appear white on CT within 20 minutes of onset.
Blood takes hours to appear on MRI

Trauma - CT is safer than MRI in trauma setting b/c pt may have metallic implants, fragments, or pacemakers. It's also faster when time is of the essence.

Monitoring hydrocephalus - CT is cheaper and large ventricles are easier to image.
increased WBC in CSF think:
Bacterial meningitis (inc PMNs)

Viral meningitis (inc leukocytes)

Subarachnoid hemorrhage
Bacterial meningitis labs:
inc WBCs (PMNs)
dec glucose
inc PROTEIN
inc Opening Pressure
Viral Meningitis labs;
inc WBCs (leukocytes)
normal glucose
RBCs in CSF think
Subarachnoid Hemorrhage
Increased protein in CSF but normal WBCs
Guillain Barre GBS
Significantly Increased gamma globulin (% protein) in CSF
Multiple Sclerosis
clear or yellow CSF
GBS (high protein)
Significantly increased Opening Pressure
Pseudotumor Cerebri (all other levels are normal)
decreased glucuse
bacterial meningitis

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