neuro

Question 1

when does infantile spasms present

Answer 1

first 4-8 months of life (males)

Question 2

features infantile spasms

Answer 2

flex trunk, head, arms –> extension of arms // last 1-2 seconds but up to 50 times // progressive mental handicap // (poor prognosis)

Question 3

invx infantile spasm

Answer 3

EEG –> hypsarrhythmia // CT

Question 4

mx infantile spasm

Answer 4

vigabatrin +/- steroids

Question 5

what conditions are assoc with infantile spams

Answer 5

tuberous sclerosis, encephalitis, birth asphyxia

Question 5

age abscence seizures kids

Answer 5

4-8 years

Question 6

EEG absence seizure

Answer 6

3

Question 7

mx absence seizure

Answer 7

ethosuximide (or valproate)

Question 8

onset + features lennox gastuat

Answer 8

age 1-5 // atypical absence, falls, jerks // handicap

Question 9

mx lennox gastaut

Answer 9

keto diet

Question 10

onset + features benign rolandic epilepsy

Answer 10

age 4-12 // seizure at night // partial (eg paraesthesia of the face –> secondary eg tonic clonic // v good prognosis

Question 11

EEG benign rolandic epilesy

Answer 11

centrotemporal spike

Question 12

onset + symptoms juvenile myoclonic epilepsy

Answer 12

teenage girls // general seizure in the morning // day time absence // sudden myoclonic jerks

Question 13

mx juvenile myoclonic epilepsy

Answer 13

valproate

Question 14

what is a reflex anoxic seizure

Answer 14

syncopal episode in response to pain or emotion –> vagal syncope

Question 15

age and features reflex anoxic seizure

Answer 15

age 6months - 3 years // pale, fall to floor, rapid recovery // may have secondary seizure

Question 16

features febrile convulsion

Answer 16

6 months - 5 years

Question 17

simple febrile convulsion

Answer 17

<15 mins // general seizure // typically no recurrence within 24 hours // complete recovery within 1 hour

Question 18

complex febrile convulsion

Answer 18

last 15 - 30 mins // focal seizure // repeat 24 hours

Question 19

febrile status epilepticus

Answer 19

> 30 mins

Question 20

mx febrile convulsions

Answer 20

phone ambulance if > 5 mins // benzo rescue meds eg rectal diazepam or buccal midazolam

Question 21

RF further seizure febrile convulsion

Answer 21

<18 months // fever <39 // short duration fever // FH

Question 22

RF epilepsy from febrile convulsion

Answer 22

FH, complex seizure, neurodevelopment delay

Question 23

central causes hypotonia

Answer 23

downs, prader willi, hypothyoir, cerebral palsy

Question 24

neuromusclar causes hypotonia

Answer 24

spinal muscular atrophy // spina bifida // GBS // myasthenia gravis, muscular dystophy

Question 25

most common primary headache kids

Answer 25

migraine without aura

Question 26

mx migraine kids

Answer 26

ibuprofen // NASAL triptan if >12

Question 27

prophylaxis migraine kids

Answer 27

1) pizotifen and propanolol // 2) valproate, topiramate, amitryptilline

Question 28

meningitis organisms neonates

Answer 28

group B strep // e coli // listeria

Question 29

meningitis >3 months

Answer 29

neisseria meningitis // strep pneumo // (haem influ pre-school)

Question 30

invx meningitis kids

Answer 30

LP

Question 31

CI LP in kids

Answer 31

focal neuro // papillodema // bulging fontanelle // DIC // herniation // meningcoccal

Question 32

invx meningococcal

Answer 32

blood culture + PCR

Question 33

mx meningitis <3 months

Answer 33

IV amox + IV cefotaxime

Question 34

mx meningitis > 3 months

Answer 34

IV cefotaxime + dexamethasome (if purulent CSF, WCC, bacteria)

Question 35

prophlaxis of contacts meningitis

Answer 35

ciprofloxacin

Question 36

presentation intraventricular haemorrhage neonates

Answer 36

first 72 hours life// spontaneous // hyrodcephalus //

Question 37

mx intraventricular haemorrhage kids

Answer 37

if hydrocephalus + raised ICP --> SHUNT

Question 38

CT kids head inury

Answer 38

LOC >5 mins // amnesia // drowsy // 3+ vomiting // seizure