Neuro Flashcards
(94 cards)
causes of abnormal motor development
central (CP), myopathy, spinal cord lesion (spina bifida), global developmental delay
what is cerebral palsy
abnormality in posture and tone, brain injuries before 2 years.
CP are the lesions progressive
no, clinical manifestations emerge over time
causes of CP antenatal
placental insufficiency- occlusion, chromosomal, genetic, infection
causes of CP
antenatal 80%, hypoxic-ischaemic encephalopathy 10%, postnatal 10%
causes of CP postnatal
meningitis, encephalitis, encephalopathy, hypoglycaemia, kernicterus, hydrocephalus
how does CP present
abnormal posture and tone, delayed motor milestones, feeding difficulties, abnormal gait, hand asymmetry before 1y
what happens to primitive reflexes in CP
may persist and become obligatory
what are the 3 types of CP
spastic, dyskinetic and ataxic
what signs are seen in spastic CP
UMN lesion so increased tone, brisk reflexes, extensor plantar responses. tone is velocity dependent so clasp knife can be seen. initial hypotonia at birth
3 main types spastic CP
hemiplegia, diplegia, quadriplegia
how does hemiplegic spastic CP present
unilateral involvement arm and leg; fisting affecting hand, flexed arm, pronated forearm, asymmetric hand function; tip toe walking. birth history may be normal
how does quadriplegic spastic CP present
all 4 limbs involved, severe, trunk involved- opisothonus, poor head control, low central tone.
what is quadriplegic assoc with and what can happen in birth to lead to it
seizures, microcephaly, intellectual impairment. hypoxic-ischaemic encephalopathy
how does diplegic spastic CP present
all 4 limbs involved but legs more than arms so hand function may appear normal. abnormal walking.
what can happen to cause diplegic
periventricular brain damage
what is asymmetrical hand function before 12m likely to be due to
hemiplegic spastic CP
what tracts are affected in spastic CP
pyramidal and corticospinal tracts
what is damaged in dyskinetic CP
basal ganglia, extra pyramidal
how does dyskinetic CP present
abnormal involuntary movements more obvious with active movement and stress. tone is variable. chorea, athetosis, dystonia. intellect can be unimpaired
what is ataxic CP
early trunk and limb hypotonia, poor balance, delayed motor development
what are the causes of ataxic CP
most genetically determined. if brain injury- signs on same side as lesion. cerebellum
causes of headache
tension- tight band like headache, common in adolescents usually with abdominal pain; migraine; raised ICP; sinusitis; benign intracranial hypertension
symptoms raised ICP
headache worse on lying down and when waking up, vomiting especially in the morning, visual field defects, CN 6 palsy, gait abnormalities, papilloedema (late sign)