Neuro Flashcards by Meg Dolohanty

most important diagnostic tool in neuro

history

How well did you know this?

Not at all

Perfectly

what test can see the posterior fossa bets?

MRI

How well did you know this?

Not at all

Perfectly

what is a good eval for hydro, hemorrhage, gross structures, calcification

How well did you know this?

Not at all

Perfectly

when do HAs typically begin normally?

middle school aged

How well did you know this?

Not at all

Perfectly

when do you do a CT/ MRI for HA in a kid

Concern about sub-arachnoid, subdural hematoma

Concern about increased IC pressure or hemorrhage

How well did you know this?

Not at all

Perfectly

Red flags for HA

fails to respond to tx
focal neurological findings (first 2-6 months)
progressive frequency/ severity
awake from sleep, worse in morning
AM vomiting
at risk hx or condition

How well did you know this?

Not at all

Perfectly

What are some focal neurologic findings

CN VI palsy
diplopia 
new onset strabismus
papilledema
hemiparesis
ataxia

How well did you know this?

Not at all

Perfectly

can you have photophobia or phonophobia w/ a tension type HA?

Yes, but usually only have 1

How well did you know this?

Not at all

Perfectly

Constant, aching, tight

Occipital, frontal or constricting band around head

Tension type HA

How well did you know this?

Not at all

Perfectly

chronic tension HA is often a sign of what

depression and/or anxiety

How well did you know this?

Not at all

Perfectly

Severe, pulsatile (pounding)
unilateral, can be bilateral
Frontal or temporal regions, retro orbital or cheek

Migraine hA

How well did you know this?

Not at all

Perfectly

what may be the only symptoms of migraine in a kid

vomiting

How well did you know this?

Not at all

Perfectly

tx for migraine

Ibuprofen APAP early
caffiene + ergot 
triptans and DHE 
rest and quiet 
avoid opioids

How well did you know this?

Not at all

Perfectly

Migraine prevention

TCA
beta blockers (propranolol) 
Calcium channel blockers (verapamil)

How well did you know this?

Not at all

Perfectly

A sudden, transient disturbance of brain function manifested by involuntary motor, sensory, autonomic, or psychic phenomena

Seizure

How well did you know this?

Not at all

Perfectly

2 or more seizures not provoked by particular event or cause.

Epilepsy

How well did you know this?

Not at all

Perfectly

a benign condition of childhood with unilateral focal seizures and speech abnormalities, often hereditary.

Rolandic epilepsy

How well did you know this?

Not at all

Perfectly

when should you do studies w/ a migraine

worse on awakening
awakens pt
worse with cough or bending over

How well did you know this?

Not at all

Perfectly

Seizure > 30 min

Sequential seizures without regain LOC > 30min

Status epilepticus

How well did you know this?

Not at all

Perfectly

Onset of seizure begins in one area of one cerebral hemisphere (apparent clinically or via the EEG) with no LOC

simple focal seizure

How well did you know this?

Not at all

Perfectly

Onset of seizure begins in one area of one cerebral hemisphere (apparent clinically or via the EEG) with altered LOC (staring)

complex focal seizure

How well did you know this?

Not at all

Perfectly

a simple or complex partial seizure that ends in a generalized convulsion

secondary generalized seizure

How well did you know this?

Not at all

Perfectly

Seizures arise from both hemispheres, simultaneously

generalized seizure

How well did you know this?

Not at all

Perfectly

unique to kids 6 month- 6 years. happens with changing temp. doesn’t tend to cause damage or increase risk of epilepsy

febrile seizure

How well did you know this?

Not at all

Perfectly

if a second seizure is going to occur, when is it likely?

within 6 months after 1st seizure

if a second seizure is going to occur, when is it likely?

within 6 months after 1st seizure

what type seizures are frequently associated w/ underlying structural brain dz?

generalized seizures

what type of partial seizure may have an aura/ automatisms?

Complex partial

what type seizure will a patient be confused for generalized?

generalized tonic-clonic

symptoms in infants that occur in clusters when drowsy. Have severely abnormal EEG pattern. Due to brian injury at birth and are hard to control.

Infantile spasm (west syndrome)

if a patient has infantile spasms with no hx of birth problems or MRI or meatbolic origin is there a better or worse outcome.

Better

usually 3-13 years old. Normal IQ and MRI. will have twitching and tingling when awake and grand mal when asleep. often runs in families

Benign rolandic epilepsy (benign focal epilepsy of childhood)

when do you Tx for benign rolandic epilepsy

only if seizures are frequent, problem in school or anxiety

effective txs for benign rolandic epilspey

avoidance of sleep deprivatoin carbamazepine, oxcarbamazepine will usually outgrow

when is status epilepticus common

children under 5, especially <12 months

can status epilepticus be the first seizures?

yes, often happens

most common cause of status epilepticus in children

Infection and metabolic disorders

too much potassium can lead to what?

arrhythmia

do you tx febrile szs?

what is a complex febrile seizure?

one side of body shaking, staring prolonged (>15-20 minutes) multiple in 24 hours more likely to lead to epilepsy

If you do have to tx a febrile seizure what do you give?

rectal diazepam

can syncope have rhythmic jerking?

Yes, can have some

can syncope have rhythmic jerking?

Yes, can have some

Transient LOC and postural tone due to cerebral ischemia or anoxia.

syncope

can syncope have a prodrome?

Yes Dizziness, lightheadedness, nausea, sweating, pallor

Neurally mediated Transient hypotension from vasodilation and/or decreased heart rate Arousal 1-2 min up to 1h

Vaso-vagal or neurocardiogenic syncope

tx for syncope

Direct management of any cardiac cause | Reassurance and avoidance of triggers for vaso-vagal stimulation

causes of increased ICP

Cerebral edema | Mass lesion

children will have HA, diplopia/ strabismus, papilledema, herniation syndromes

increased ICP

management for hydrocephalus caused by obstruction that will get better as kid ages

shunt that drains into peritoneal cavity

where is pain with supratentorial elevated ICP

eye forehead temple

where pain with infratentorial increased ICP

occiput | neck

when are HA from elevated ICp worse

morning awakening standing up at night

Increased intracranial pressure without identifiable mass or hydrocephalus. Obese teenage girl with HA tinnitus, papilledema, visual loss. normal MRI>

pseudotumor cerebri

most common causes or childhood stroke

cyanotic heart dz sickle cell anemia meningitis hypercoaguable state

symptoms of childhood stroke

hemiplegia, unilateral weakness, seizures.

most common cause of concussion in children

fall

Brief loss of consciousness or stunned for minutes to hours. Amnesia is common and transient

Head Injury -Concussion

what kids with a concussion should be evaluated

All children with amnesia or who were unconscious should be evaluated in ER.

what will a meningomyelocele often have on prenatal screen?

elevated alpha fetoprotein

displaced cerebellum through foramen magnum into spinal canal – posterior laminectomy. Sx will hve progressive ataxia or vertigo. low lying tonsils alone

Arnold Chiari I

displaced cerebellum plus meningomyelocele – surgical repair and shunt. low lying tonsils + hydrocephalus

Arnold Chiari II

occipital encephalocele – surgical repair | Hydrocephalus common

Arnold Chiari III (anencephaly)

smooth brain Severe delay, seizures. Associated with syndromes Most common disorder of neuronal migration

Lissencephaly

Premature closure of sutures | Sporadic and idiopathic

Craniosynostosis

what type Craniosynostosis will have a short wide head (brachycephalic)

coronal sutures

Tx for craniosynostosis

Treatment is surgical excision of fused suture line – best done prior to 6 months of age

Autosomal Dominant | Café au lait spots - >6 of 5mm prepubertal pt

Neurofibromatosis

AD, rare , characterized by benign tumors in vital organs such as the brain, eyes, kidneys, heart and skin. will have ash leaf spots, Adenoma Sebaceum Shagreen Patch

Tuberous sclerosis

Diagnostics for tuberous sclerosis

CT for calcified nodules | MRI for demyelination

Unilateral port wine stain over upper face | Follows cranial nerve V. Can have leptomeningeal vascular anomaly and calcifications can lead to seizures.

Sturge Weber

Impairment of coordination and balance of voluntary movement | Cerebellar problem

ataxia

most common cause of ataxia in children

post-infectious or drug intoxication

Sudden onset of ataxia,staggering, frequent falls Nystagmus, vomiting, irritaility, lethargy possible Sensory and reflexes preserved No evidence increased ICP will recover in 1-4 weeks

post infectious acute cerebellar ataxia

do you need to tx post infectious acute cerebellar ataxai

No, most get between in 1-4 weeks by themselves

kids uses hands to walk up legs to standing position

Gower sign

what are 2 disorders of the anterior horn cells?

Spinal muscular atrophy (SMA) | poliomyelitis

If you have a lower motor neuron lesions will be it be high tone or low tone?

low tone

Neuromucular junction problem

Myasthenia gravis

muscle weakness, which may manifest with floppiness, delayed motor milestones, unsteady gait or muscle fatiguability. Progressive with normal mental development but body fails.

SMA (spinal muscular atrophy)

>10 years old, ophthalmoplegia and ptosis, loss of facial expression and difficulty chewing

Juvenile myasthenia gravis

Similar to Duchenne except later, less severe | Death usually in adulthood

Becker muscular dystrophy

``` X-Linked recessive Onset at 2-6 yrs Proximal muscles affected before distal Waddling gait, difficulty with stairs pseudohypertrophic calf Gower Sign – pelvic weakness Elevated CPK 75% mortality by age 20 ```

Duchenne muscular dystrophy

what is used to tx spastic cerebral palsy?

botox

Neuro Flashcards

(84 cards)