RCSI Society of Neuroscience

06/04/2021

Back with the case of the week! Be sure to fill out the google doc ( https://forms.gle/kRz71D4oXa8ExPRCA ) with your answers for a chance to win a special prize ☺️!!!

History and Physical exam findings:
A 65-year-old man attends the GP office with his wife because of a 6-month history of worsening left shoulder pain and arm pain. He is retired but previously worked as a painter, often working with his hands raised above his head. His wife has also recently noticed that his left eye “looks smaller” than his right eye. The patient’s past medical history is significant for hypertension, hyperlipidemia and an inguinal hernia repaired surgically one year ago. The patient drinks approximately 10 units of alcohol per week and has smoked a pack of ci******es daily for the last thirty years. On cranial nerve exams, visual fields are full. The left pupil is 3mm and the right pupil is 5mm and both react to light. There is a slight ptosis of the left eyelid.

Questions:

1. What is the most likely pathology?
2. What further testing would you want?
3. What are your top 3 differentials?

21/03/2021

Only 4 days left to register!!!!

Please note you must EMAIL us in order to register - we cannot register you from FB messages or Insta DMs.

If you are an individual looking for a team please reach out and we will do our best to pair you with other students!

10/03/2021

Greetings and salutations everyone!

The highly anticipated Nerves of Steel competition is happening on April 1st 5pm via Microsoft Teams (link posted in bio closer to date)!
Come out and represent with your teams of 3 for this fun experience and also a chance to win the notable Tom Farrell Neuroscience medal !
Registration of teams are open NOW , so be sure to do so before March 25th by shooting us an email at neuroscience@rcsi.ie!
You surely don’t want to miss this event! We look forward to seeing you there!!

08/03/2021

Here is the link Come out to SMJ's fourth journal club of the year in collaboration with Neurology Society!
Topic of discussion will be "I’m just not a Sudoku person: analysis of stroke survivor, carer, and healthcare professional perspectives for the design of a cognitive rehabilitation intervention" - an interesting topic not to miss out on!

Dr. Niamh Merriman will be joining us as the guest speaker. We will be giving away four 20€ vouchers!

DATE: Monday, March 8th, 2021
LOCATION: Microsoft Teams
TIME: 7PM
Teams Link: https://bit.ly/3sSnMQa
Link to paper: https://www.tandfonline.com/doi/full/10.1080/09638288.2019.1594400

(2020). “I’m just not a Sudoku person”: analysis of stroke survivor, carer, and healthcare professional perspectives for the design of a cognitive rehabilitation intervention. Disability and Rehabilitation: Vol. 42, No. 23, pp. 3359-3369.

01/03/2021

Hey everyone! Hope you had a great Monday- here’s the case for this week!
Be sure to submit your answers in the google doc (https://forms.gle/ZCosg9Qdt5jVrd2z5) for your chance to win a prize !!

History and physical exam findings:
A 21-year-old male student presents to the emergency department with a severe headache. The headache started 2 days ago and has progressively worsened. He describes it as a generalised headache and says he prefers to sit in a dark, quiet room. He also reports associated nausea and vomiting. He had a sinus infection a week ago but did not seek medical attention for it. On examination, he has a fever, a stiff neck and finds it difficult to move his head. There are no focal neurological deficits and fundoscopy is normal. Cardiovascular and respiratory examinations are normal.

A lumbar puncture is performed and reveals the following:

Appearance ​ Cloudy
WCC​ 98 (mainly polymorphs)
Protein​ 200 (15- 45 mg/ dL)
CSF Glucose​ 1.2
Serum Glucose 6.7

Questions:
1. What is the most likely diagnosis?
2. What are some common pathogens in this age group?
3. What is the empirical treatment for this condition?

25/02/2021

Hello everyone! These are answers for the last case! But here’s a recap of the case:

History and physical exam findings:

A 70-year-old man is brought to the emergency department by his wife because of a 2-week history of progressive disorientation and a 2-day history of left-sided weakness and difficulty speaking. The wife reports that the patient had a minor fall 5 months ago, during which he may have hit his head. He has hypertension and hyperlipidaemia. He drinks 4 bottles of beer daily. He is only oriented to person. Neurological examination shows moderate spastic weakness, decreased sensation, and increased deep tendon reflexes in the left upper and lower extremities.

1. List 3 differential diagnoses.
2. What imaging would you perform?
3. What would you expect to see on imaging?
4. What is the most likely pathophysiology?

Answer/Diagnosis:

1. Chronic subdural hematoma, stroke, intracranial tumour
2. Non-contrast CT brain
3. Right-sided hypodense crescent-shaped accumulation of blood that crosses suture lines
4. Tearing of bridging veins

Explanation:

This CT scan shows a classic subdural hematoma. The history of minor head trauma followed by the gradual onset of unilateral neurological symptoms (spastic paresis, hyperreflexia, decreased sensation) is consistent with a chronic subdural hematoma. This type of bleeding results from tears in the bridging veins that cross the subdural space.

(P.S Be sure to check the comment section of the previous cases to see the answers‼️)

17/02/2021

What date will suit you best for the infamous NERVES OF STEEL event?? Don't miss your chance to vote now for the date! Voting will close on Friday!
https://forms.gle/VMjgSeDiQxhCTF3LA

15/02/2021

Hello everyone! Here’s this week’s case! Don’t forget to answer the questions via this google doc link >> https://forms.gle/SF1YHZxjSk22Rhrg9

08/02/2021

Hey guys here’s the second case of the week ! Don’t forget to answer the questions via this google doc link for your chance to win a prize! https://forms.gle/VhpJB7WYjwKiqVuT6

*EDIT*: check comment section for answers!

H&P:
A 27-year-old woman presents to the emergency department with a 3-week history of headaches. The headaches are throbbing in nature, bifrontal and 5/10 severity. She cannot recall any inciting event and there hasn’t been any trauma. The patient has also recently noticed blurring of her vision and a single episode of double vision. Past medical history includes type 2 diabetes, hypertension and polycystic ovarian syndrome. Her medications include metformin, ramipril and an over the counter weight loss supplement she started taking 3 months ago. The supplement contains caffeine as well as high doses of vitamins C, A, D and B12. A cranial nerve exam reveals decreased peripheral vision in both eyes. Fundoscopy reveals the following finding. Upper and lower limb neurologic exams as well as a cardiovascular exam are unremarkable. The patient undergoes an MRI which shows excess CSF within the sella turcica and a small pituitary gland.

Questions:
1. Name the finding shown in the picture.
2. What is the most likely diagnosis? Justify with clues from the history.
3. Briefly outline the management of this patient

26/01/2021

Hi everyone! We’re starting our cases of the week segment which is a fun way to revise/ learn more about some common neurological presentations. Every Monday for the next couple weeks, a new case will be posted and to participate simply click this link >> https://forms.gle/aqV9xsu8SL94esHb9 where you’ll be redirected to a google doc to answer the questions. This allows the winner at the end to be selected fairly. To top things off , the person who answers the most cases correctly will win a prize (TBA)!!! Submissions are due every Friday by 5pm! Answers will be posted thereafter in the comment section of the post! Good luck! (Please don’t comment answers in comment section!)
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Case #1
H&P:
A 32-year-old right-handed female presents to the emergency department with blurry vision in one eye ongoing for 48 hours. There is no past medical history of note, but on further questioning you find out that she has had numbness and tingling in both of her hands and arms starting 2 months ago. She also had one episode of urinary retention 6 months ago that required catheterization in the emergency department.

On physical examination she has RAPD on the swinging light test (as seen in video below) and decreased sensation in the hands. She has brisk patellar reflexes. The remainder of the neurological examination is normal.

Question:
1. Where is the location of the lesion(s)?
2. What is the underlying pathophysiology of the most likely disease?

15/01/2021

Last but not least, we would like to introduce the final speaker for our NANSIG x RCSI Neuro Soc presents: Neuro Career Day happening tomorrow, Saturday January 16 at 10:30AM. Dr. Susan Byrne, a paediatric neurologist and RCSI FutureNeuro researcher. She will be talking about her career as a clinician-scientist. Come hear her speak tomorrow at our event.
You can tune in on MS Teams: https://teams.microsoft.com/l/meetup-join/19%3ameeting_MDFkYzgyYTEtNjY0Yi00YzU2LTkzOGUtYmM2ZmE0YmUyNTI3%40thread.v2/0?context=%7b%22Tid%22%3a%22607041e7-a812-4670-bd30-30f9db210f06%22%2c%22Oid%22%3a%22c7efafda-6557-43e3-9a24-c65c8233d547%22%7d