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ALS (Amyotrophic Lateral Sclerosis) Symptoms : "ALS"
A - Anterior horn neuron loss
L - Lower motor dominant effects
S - Spino-cortical tract (cortico-spinal tract)

Alzheimer's Disease Common Characteristics : "ALZHEIMERS"
A - Anterograde amnesia is usually first sign
L - Life expectancy increase shows more cases in recent years
Z - Zapped (loss of) acetylcholinergic neurons
H - Hereditary disease
E - Entire hippocampus becomes affected
I - Identified by neurofibrillary tangles
M - Mutation in amyloid genes associated w/disease
E - Entorhinal areas degenerate first
R - Retrograde amnesia ultimaltely develops
S - Senile plaques are formed at synapse

Alzheimer's disease progressive phases : "ABCD"
A - Amnesic phase (forgetting keys, leaving cooker on)
B - Behavioural problems (antisocial, wandering)
C - Cortical phase (incontinence, falls)
D - Decerebrate phase (return of primitive reflexes)

Auditory pathway mandatory stops : "Chidera Is My Brother"
Cochlear nucleus
Inferior colliculus
Medial geniculate nucleus
Brodmanns 41 (cortex)

Babinski and LMN signs conditions exhibiting them : "D MASTS"
D - Diabetes
M - Motor neuron disease
A - Ataxia (friedrichs)
S - Subacute combined degeneration of cord
T - Tabo paresis
S - Syringobulbia

Balint's Syndrome : "SOOT"
S - Simultagnosia
O - Optic ataxia
O - Ocular apraxia
T - Tunnel vision

Benidict's Syndrome:

Site affected Benidict's test for sugar gives Red Precipitate.

Similarly, Benidict's syndrome affects Red nucleus.

Cerebellar Damage Signs : "DANISH"
D - Dysdiadochokinesis
A - Ataxia
N - Nystagmus
I - Intention tremor
S - Slurred speech
H - Hypotonia

Cerebellar damage symptoms : "VANISHED"
V - Vertigo
A - Ataxia
N - Nystagmus
I - Intention tremor
S - Slurred (or Staccato) speech
E - Exagerrated broad based gait
H - Hypotonic reflexes
D - Dysdiadochokinesia

Cerebellar signs : "PD NISAR"
P - Past pointing
D - Dysdiadokinesia
N - Nystagmus
I - Intention tremor
S - Slurred speech
A - Ataxia
R - Rebound

Chorea Commons Causes : "St. VITUS'S DANCE"
S - Sydenhams
V - Vascular
I - Increased RBCs (polycythemia)
T - Toxins: CO, Mg, Hg
U - Uremia
S - SLE
S - Senile chorea
D - Drugs
A - APLA syndrome
N - Neurodegenerative conditions: HD, neuroacanthocytosis, DRPLA
Conception related: pregnancy, OCPs
E - Endocrine: hyperthyroidism, hypo-, hyperglycemia

Congenital myopathy features : "DREAM"
D - Dominantly inherited, mostly
R - Reflexes decreased
E - Enzymes normal
A - Apathetic floppy baby
M - Milestones delayed

Conscious change Causes : "AEIOU TIPS"
A - Alcohol
E - Encephalopathy
I - Infection
O - Opioid
U - Uremia
T - Trauma
I - Insulin
P - Psychosis
S - Syncope

Decreased level of Consciousness Metabolic Causes: "METABOLIC"
M - Major end organs (liver, kidney)
E - Endocrine/Electrolytes
T - Toxins
A - Acid
B - Base disorders
O - Oxygenation
L - Lung (PE, pneumonia)
I - Infection/Inflammatory/Iatrogenic
C - Calcium

Dementia treatable causes : "DEMENTIA"
D - Drug toxicity
E - Emotional (depression, anxiety, OCD, etc.)
M - Metabolic (electrolytes, liver dz, kidney dz, COPD)
E - Eyes/ Ears (peripheral sensory restrictions)
N - Nutrition (vitamin, iron deficiencies/NPH [Normal Pressure Hydrocephalus)
T - Tumors/Trauma (including chronic subdural hematoma)
I - Infection (meningitis, encephalitis, pneumonia, syphilis)
A - Arteriosclerosis and other vascular disease.

Dementia ; Some Common Causes : "DEMENTIA"
D - Diabetes
E - Ethanol
M - Medication
E - Environmental (eg CO poisoning)
N - Nutritional
T - Trauma
I - Infection
A - Alzheimers

Encephalitis Differential : "HE iS LATIN AMERICAN"
H - Herpesviridae
E - Enteroviridae (esp. Polio)
S - Slow viruses (esp. JC, prions) Syphilis
L - Legionella/Lyme disease/Lymphocytic meningoencephalitis
A - Aspergillus
T - Toxoplasmosis
I - Intracranial pressure
N - Neisseria meningitidis
A - Arboviridae
M - Measles/Mumps/Mycobacterium tuberculosis/Mucor
E - E. coli
R - Rabies/Rubella
I - Idiopathic
C - Cryptococcus/Candida
A - Abscess
N - Neoplasm/Neurocysticercosis

Neurocysticercosis should be assumed with recent Latin American immigrant patient unless proven otherwise.

Head trauma rapid neuro exam : "12 Ps"
Psychological (mental) status
Pupils: size, symmetry, reaction
Paired ocular movememts
Papilloedema
Pressure (BP, increased ICP)
Pulse and rate
Paralysis, Paresis
Pyramidal signs
Pin prick sensory response
Pee (incontinent)
Patellar relex (and others)
Ptosis
Reevaluate patient every 8 hours

Huntington's : Chromosome, Involvement : "HUNT 4 DATE"
HUNTington's on chromosome 4
With cauDATE nucleus involvement.

Hydrocephalus, Normal pressure hydrocephalus DDx : "3 Ws"
Wet : urinary incontinence
Wobbly : gait abnormality
Wacky : dementia, memory problems

Meningitis : Site of TB Meningitis Attack : TB meningitis attacks The Base of the Brain.

Multiple Sclerosis Signs and Symptoms : "INSULAR"
I - Intention tremor
N - Nystagmus
S - Slurred speech
U - Uthoff's phenomenon
L - Lhermitte's sign
A - Ataxia
R - Rebound

Neurofibromatosis Diagnostic Criteria : "ROLANDO"
R - Relative (1st degree)
O - Osseous fibromas
L - Lisch nodules in eyes
A - Axillary freckling
N - Neurofibromas
D - Dime size cafe au lait spots
O - Optic gliomas

Neuropathy diagnosis confirmation NEuropathy: "NEuropathy"
Nerve conduction velocity
Electromyography

Ocular bobbing vs. dipping : "Breakfast is fast, Dinner is slow, both go down"
Bobbing is fast.
Dipping is slow.
In both, the initial movement is down.

Parkinson's Disease Signs and Symptoms : "SMART"
S - Shuffling gait
M - Mask-like facies
A - Akinesia
R - Rigidity
T - Tremor

Perinaud's Syndrome Clinical Features: "PERINAUDS"
P - Pseudo 6th nerve palsy/Penial region
E - Eyelid Retraction
I - Internuclear ophthalmoplegia
N - Nystagmus
A - Accomodation reflex present
U - Upward gaze palsy
D - Defective convergence/Decerebrate rigidity
S - Skew deviation

Peripheral nervous examination : "To Please Rooster, Save Chickens"
Tone
Power
Reflexes
Sensation
Co-ordination/Clonus

Peripheral neuropathies Differential : "DANG THERAPIST"
D - Diabetes
A - Amyloid
N - Nutritional (eg B12 deficiency)
G - Guillain-Barre
T - Toxic (eg amiodarone)
H - Heriditary
E - Endocrine
R - Recurring (10% of G-B) Alcohol
P - Pb (lead)
I - Idiopathic
S - Sarcoid
T - Thyroid

Peripheral neuropathy differential : "STAND LAG"
S - Sarcoid
T - Thyroid
A - Amyloid
N - Nutritional
D - Drugs/Diabetes
L - Lead
A - Alcohol
G - Guillian-Barre

Proximal myopathy differential : "PEACH PODS"
P - Polymyositis
E - Endocrine : hyper, hypothyroidism, Cushing's syndrome, acromegaly
A - Alcohol
C - Carcinoma
H - HIV infection
P - Periodic hypokalemic paralysis
O - Osteomalacia
D - Drugs : steroids, statins
S - Sarcoidosis

Pupillary dilatation (persistent) causes : "3AM"

3 - 3rd nerve palsy

A - Anti-muscarinic eye drops (eg to facilitate fundoscopy).

M - Myotonic pupil (Holmes Adie pupil): most commonly in young women, with absent/delayed reaction to light and convergence, and of no pathological significance.

Status Epilepticus treatment : "Thanks God All Dogs Cannot Bite"
Thiamine
Glucose
Ativan
Diprivan
Cerebyx
Barbiturate

Stroke risk factors : "HEADS"
H - Hypertension/Hyperlipidemia
E - Elderly
A - Atrial fibrillation
D - Diabetes mellitus/Drugs (cocaine)
S - Smoking/Sex (male)

Stroke ; Causes of Stroke in young patients : "7 Cs"
Cocaine
Consanguinity [familial such as neurofibromatosis and von Hippel-Lindau]
Cancer
Cardiogenic embol
hyperCoagulation
CNS infection [eg: HIV conditions]
Congenital arterial lesion

Stroke: basic work up : "3 Ps"
Pump
Pipes
Plasma

Vertigo differential : "VOMITS"
V - Vestibulitis
O - Ototoxic drugs
M - Menieres disease
I - Injury
T - Tumor
S - Spin (benign positional vertigo)

Visual loss persistent bilateral sudden onset visual loss differential : "FLOP"
F - Functional
L - Leber's hereditary neuropathy
O - Occipital infarctions
P - Pituitary apoplexy

Whipple's disease: features : "A WHIPPLES DOOM"
A - Arthralgias
W - Whipplei (organism)
H - Hypothalamic involvement
I - Intestinal involvement/Intestinal biopsy required
P - PAS positive macrophages
P - PCR positivity
L - Lymphadenopathy
E - Extrapyramidal involvement
S - Septran treat with
D - Dementia
O - Ocular abnormalities (vertical gaze palsy)
O - Oculomasticatory myorhythmia
M - Myoclonus

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