Lecture 9 Paediatric Neurology

Question 1

Name the features of a migraine

Answer 1

Hemicranial pain
Throbbing
Abdo pain, nausea and vomiting
Relieved by rest
Photophobia
Visual, sensory and motor aura
\+ family history

Question 2

Name the features of at tension headache

Answer 2

Diffuse, symmetrical
Band-like distribution
Present most of the time
Constant ache

Question 3

What are pointers to raised intracranial pressure

Answer 3

Aggravated by activities such as coughing, bending or straining
Woken from sleep with headache

Question 4

What are key pointers for analgesic overuse headache

Answer 4

Headache is back before allowed to use another dose
Paracetamol/ NSAIDs
Particular problem with compound analgesics eg. Cocodamol

Question 5

What medication can be used for the treatment of migraine

Answer 5

Triptans

Pizotifen, Propranolol, Amitryptyline, Topiramate, Valproate

Question 6

What medication can be used for the treatment of Tension headache

Answer 6

Treat underlying cause
Acute attacks: simple analgesia
Prevention: Amitryptiline

Question 7

What is an Epileptic Seizure

Answer 7

An abnormal excessive hyper synchronous discharge from a group of cortical neurons

Question 8

What is the mechanism of an epileptic fit

Answer 8

Decreased inhibition (GABA)
Excessive excitation (glutamate and aspartate)
Excessive influx of Na and Ca ions

Question 9

What fontanelle closes first anterior or posterior

Answer 9

Posterior

Question 10

When would you suspect a neuromuscular disorder in a baby

Answer 10

Floppy at birth
Slips from hands
Paucity of limb movements
Delayed motor milestones

Question 11

What mutation is seen in Duchenne Muscular Dystrophy

Answer 11

Xp21

Question 12

What are the clinical presentation of Duchenne Muscular Dystrophy

Answer 12

Delayed gross motor skills
Waddling gait
Calf hypertrophy
Gower's sign positive
Cardiomyopathy
Respiratory involvement in teens