Neurology

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Table Of Contents
1 Vitamin B12 Deficiency
2 Tremors

Vitamin B12 Deficiency

Symptoms
– Lower Energy/Fatigue
– Depression/Anxiety
– Muscle pain
– Irritability
– Hearing and Vision problems
– Mood disorders
– Memory loss
– Sexual problems/infertility

Tremors

  • Psychogenic tremor:
    • an abrupt onset, spontaneous remission, changing characteristics, and extinction with distraction.
  • Cerebellar tremor:
    • an intention tremor with ipsilateral involvement on the side of the lesion.
    • Neurologic testing will reveal past-pointing on finger-to-nose testing.
    • CT or MRI of the head is the diagnostic test of choice.
  • Parkinsonian tremor:
    • noted at rest, is asymmetric, and decreases with voluntary movement.
    • Bradykinesia, rigidity, and postural instability are generally noted.
    • For atypical presentations, a single-photon emission CT or positron emission tomography may help with
      the diagnosis.
    • One of the treatment options is carbidopa/levodopa.
  • Essential tremor:
    • have symmetric, fine tremors that may involve the hands, wrists, head, voice, or lower extremities.
    • Improve with the ingestion of small amounts of alcohol.
    • No specific diagnostic test but the tremor
    • Treated with propranolol or primidone.
  • Enhanced physiologic tremor:
    • a postural tremor of low amplitude exacerbated by medication.
    • History of caffeine use or anxiety.