Stroke and Critical care risks NIH Stroke scale CHA2DS2VASc Stroke Risk Modified Rankin Scale ASPECTS – Alberta Stroke Program Early CT score Glasgow Coma Scale Seizure – anticonvulsant calculator Phenytoin Correction Cognitive evaluation RASS – Richmond agitation sedation scale MMSE – Mini Mental status exam MOCA – Montreal Cognitive...

When and how the epidemic will end? The outlook is not very promising. Number of new cases is stabilizing. We will need to have a vaccine, for the virus to die down and disappear. It takes a long, long time to develop a safe and effective vaccine Until then,...

If migraine frequently recurs during a specific period of the menstrual cycle, or become worse during menopause, then estrogen related migraine needs to be considered. The treatment approach is different from the regular migraine. Hormone related migraine, mechanism and treatment Decline in estrogen Beginning of menstrual cycle Postpartum Scheduled...

Epilepsy foundation excellent resource Should a first seizure in Senior be treated? Alcohol withdraw, required treatment for withdraw Long term anticonvulsant may not be needed For NONwithdraw seizure 2 year seizure recurrent risk 23-71% higher if abnormal neuro exam or remote brain insult, including stroke Treatment reduce recurrence by...

Nice table from Neurology Residents AED table 1 – side effect, Pregnancy class AED dosage, formulation table Epilepsy Foundation on medications Drugs that lower seizure threshold Antidepressants and seizure incidence Antiepileptic drugs in transplant patients Sharpen your skill in reading EEG...

Dose over 50 MME/day, greater than 2x risk for overdose MME = Morphine milligram equivalent Over 50 MME means over 50 mg of hydrocodone (Norco) or over 33 mg of oxycodone or over 12 mg of methadone For other drugs, use conversion table to calculate...

Tranexamic acid for adults with acute traumatic brain injury an antifibrinolytic agent CRASH-3 trial over 9000 adults atudied within 3 hour Glasgow Coma Scale < 13 or evidence of intracranial bleed on CT patients with nonreactive pupils excluded Tranexamic Acid (Lysteda) generic available 1 gram over 10 min iv,...

Bell’s palsy involve the 7th cranial nerve and results in paralysis of the facial muscles, both the upper and lower part of the face. Evaluate eye closure may need eye protection Mild to moderate Prednisone 60-80 daily for 7 days Severe to complete Prednisone as above Valacyclovir (Valtrex) 1...

Unilateral electric shock like pain involves one or more division of Trigeminal nerve over 80% caused by an aberrant loop of artery Less common: acoustic neuroma, meningioma, cyst, rarely an aneurysm or avm Treatment Carbamazepine, (Tegretol) most studied and effective. Start 100 to 200 mg bid, up to max...

Looking forward Bloomberg – When, and How, Does the pandemic end? Just to get a quick update Google – covid19- map Bing – search update by location USA today – Tracking the outbreak CNN – Tracking Covid-19 Aliazeera – world In the mean time, work and learn from home...