Ch88 Differential Cranial - signs and symptoms Flashcards
(19 cards)
How do you approach a patient with syncope?
Orthostatic vitals ECG / 24 hour tape Review drugs (beta blockers) Glucose EEG if seizure concern MRI brain only if high suspicion of CNS pathology
What is the cause of acute cerebellar ataxia in a child <3 years the resolves with conservative management?
Viral cerebellitis
What is the cause of ophthalmoplegia following diarrhoeal illness?
If immediate think botulism (typically symmetrical, dry mouth and associated with a descending weakness) If delayed think Miller-Fisher variant of GBS
What is the action of botulinum toxin?
Prevents synaptic release of Ach at the NMJ
What tumours cause anosmia?
Foster kennedy syndrome - olfactory groove meningiomas Esthesioneuroblastoma **Congential anosmia with hypogonadism = KALLMAN syndrome**
What is Mobius syndrome?
Congenital facial nerve paralysis. Also associated with complex opthalmoplegia, ptosis and lingual palsy.
What syndrome causes CN6+7 palsy with contralateral hemiparesis?
Gubler-Millard syndrome
What causes osteopetrosis?
A failure of osteoclasts to resorb bone resulting in diffuse hyperostosis causing blindness, deafness and cranial neuropathies.
What causes pulsatile exopthalmos?
CCF NF-1 with sphenoid wing dysplasia / orbital roof defect causing transmitted pulsations Vascular tumours
What causes non-pulsatile exophthalmos?
Optic glioma
Optic nerve sheath schwannoma / neurofibroma
Optic nerve sheath meningioma
Lymphoma
Also think: Metastatic neuroblastoma or LCH in paeds.
Cavernous sinus thrombosis
Grave’s disease
What is Hand-Schuller-Christian syndrome?
LCH with DI, exophthalmos and lytic bone lesions.
What are the causes of ptosis?
CN3 palsy
Horner’s syndrome
Myaesthenia gravis (bilateral)
What are the main causes of macrocephaly?
Familial
Benign enlargement of the subarachnoid spaces / subdural spaces
Hydrocephalus
Which neurocutaneous syndromes cause megalencephaly?
NF
Congenital hypermelanosis
Hemi-megancephaly
(TS and Sturge-weber is less commonly)
Which condition has a cranial bruit in small children?
Vein of Galen malformation
What conditions cause pulsatile tinnitus?
CCF
DAVF
Pial AVM
Glomus jugulare
Hypertension
Hyperthyroidism
IIH / other causes of raised ICP
What causes numbness around the lips?
Low Ca
Syringobulbia
What does compression / damage to the spinal trigeminal tract cuase?
Loss of pain and temperature to the ipsilateral face with preservation of fine touch. The spinal trigeminal extends down to C2.
What does anterior cingulate retraction cause?
Akinetic mutism. Also seen with thalamic injury, mid corpus callosum injury and cerebellar vermis (?dentate nucleus) damage
