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Flashcards in Neuro Deck (117)
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1

What are periodic syndromes?

Syndromes which affect children and are often precursors of migraine
Child is well between episodes

2

What is cyclical vomiting?

A periodic syndrome.
Recurrent stereotyped episodes of vomiting and intense nausea associated with pallor and lethargy
Child is well in between episodes

3

What is abdominal migraine?

Idiopathic recurrent disorder
Episodic midline abdominal pain in bouts lasting 1-72 hr
Pain moderate to severe in intensity
Associated with vasomotor symptoms, nausea and vomiting

4

What is benign paroxysmal vertigo of childhood?

Heterogenous disorder
Characterised by brief episodes of vertigo which occur without warning and resolve spontaneously
Children otherwise healthy with normal neuro, auditory and vestibular exam

5

When can sumatriptan be given in children with headaches? Route

Nasal preparation
Licensed for use in children over 12 years of age

6

What are febrile seizures?

Seizure accompanied by a fever in absence of intracranial infection due to meningitis or encephalitis

7

Incidence and age prevalence of febrile seizures?

3% of children between 6 months and 6 years

8

Inheritance of febrile seizures

Genetic predisposition with 10% chance if first degree relative had them

9

When during illness does seizure usually occur

Early on in viral infection when temperature is rising rapidly

10

What sort of seizures are febrile seizures?

Usually tonic-clonic seizures

11

What % of 1st febrile seizure will have further ones

30-40%

12

What increases likelihood of having more febrile seizures? x4

Earlier on in illness
Younger age of child
Lower temperature at time of seizure
Positive family history

13

When is there an increased risk of developing epilepsy with febrile seizures? x3

If complex febrile seizures
Aka, prolonged, repeated in same illness or focal seizures

14

If febrile seizure goes on longer than 5 mins

Buccal midazolam or rectal diazepam

15

What happens in breath-holding attacks?

Happens in toddlers when they are upset
Child cries, holds breath, goes blue. Will sometimes briefly lose consciousness but rapidly recover

16

What is reflex anoxic seizure

Occurs in infants or toddlers when scared or shocked (head trauma, cold food, fright or fever)
Becomes pale and falls to the floor
Hypoxia may induce tonic-clonic seizure
Due to cardiac asystole from vagal inhibition
Child recovers quickly after brief seizure

17

Pseudoseizures vs fabricated seizures

Pseudoseizures - child feigns seizure
Fabricated - by parents

18

When do you do metabolic investigations with seizures?

When there is developmental regression or when seizures are related to feeds or fasting

19

What is West syndrome?

Violent flexor spasms of head, trunk and limbs followed by extension of arms
Flexor spasms last 1-2s and usually 20-30 spasms
Often occur on waking
EEG signs
2/3 have underlying neuro cause

20

What age is West syndrome?

4-6 months

21

How do you treat West Syndrome? Response rate and future development

Vigabatrin or corticosteroids
Good response in 30-40%
Most lose skills and develop learning disability or epilepsy

22

What is Lennox-Gastaut syndrome?

Multiple seizure types - mostly drop attacks, tonic seizures and atypical absences
Also have neurodevelopmental arrest/regression and behavioural disorder

23

Age and prognosis of Lennox-Gastaut

1-3 years
Often other complex neurological problems and history of infantile spasms
Prognosis poor

24

First line for tonic-clonic seizures x2

Valproate and carbamazepine

25

First line for absence seizure x2

Valproate and ethosuximide

26

First line for myoclonic seizure x1

Valproate

27

First line for focal seizures x2

Carbamazepine and valproate

28

Signs of myopathy in children?

Waddling gait or positive Gowers sign (need to turn prone to rise to standing, use arms to stand up)

29

When is positive Gowers sign normal?

Before the age of 3 years

30

Investigative signs of myopathy

Serum creatine phosphokinase markedly elevated in muscular dystrophy and inflammatory myopathies