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Flashcards in Neuro Deck (23):
1

In which age group may 'Kernig's sign' not be present in meningitis?

Under 18months.
May present as non-specific drowsiness, fever, irritability, poor-feeding.
Kernig's sign- neck stiffness

2

When is a lumbar puncture contraindicated??

Prolonged or focal seizure
Focal neurology
Purpuric rash
Gcs<13
Abnormal pupils or posture
Coagulation disorder
Cushings triad (low hr, high bp, irregular resp)

3

What is the appropriate step wise management for status epilepticus?

1) buccal medazolam/ iv lorazepam
2) Iv lorazepam
3) iv phenytoin (iv phenobarbital if on Reg phenytoin)
4) rapid sequence control using general anaesthetic using thiopental sodium

4

What symptoms would you get if the cerebellar was affected?

Tremors
Mystsgmus
Gait instsbility
Speech difficulty

5

Hyperventilation can trigger what type of seizures ?

Absence epilepsy

Rx- ethosuximide
If associated with other seizure types give sodium valprorate

6

What is the commonest neuromuscular disease/dystrophy?

Dystrophinopathy (duchennes muscular dystrophy) 1/3500 live boys

7

What disease modifying agent can be give in duchenne muscular dystrophy?

Glucocorticoids

8

What is Charcot-Marie-tooth disease?

AD demyelinating peripherals neuropathy (pmp22 gene)
Leads to distal weakness and atrophy and sensory loss.

9

What is spinal muscular atrophy?

Disorder of the SMN1 gene. Low levels in the anterior horn of the spinal cord leads to loss of function and muscle wasting.

10

What causes a floppy baby?

Cerebral
- IVH, hydrocephalus
- structural abnormality
- chromosomal disorders
- perxisomal

Peripheral
- anterior horn cell (SMA)
- demyelination -
- axonal neuropathy
- myasthenia syndromes
- congenital muscle disease (dystrophy, myopathy, myotonic dystrophy)

11

What is tuberous sclerosis?

Neuro-cutaneous disease
Depigmented 'ash leaf' spots, rough skin on lumbar spine,
Development delay, epilespsy, intellectual impairment

12

What is Rolandic epilepsy?

Infrequent partial fits. Unilateral or oropharyngeal sensory motor symptoms. Speech arrest. Hypersalivation

Rx rarely needed, sulthiame sometimes uses.

13

Causes of meningitis in neonates?

Group b strep
Listers
E. Coli

14

Treatment for meningitis?

Ceftriaxone

15

What is seen on eeg in west syndrome epilepsy?

Hypsarrthyimia - chaotic pattern, slow sharp waveforms.

Age 4-6months
Salaam attacks (on waking), low Iq
Rx : vigabatrin

16

What is seen on eeg in Ohtahara syndrome?

Supppression- burst pattern

Rx - chloralhydrate
Onset <3months

17

What is Lennox-gastaut syndrome?

Extension of infantile spasms.
Handicapped (90%) poor prognosis

Eeg : slow spike

Rx- ketogenic diet might help

18

What is rolandic epilepsy?

Benign, brief partial fits often unilateral facial or oropharyngeal sensory motor symptoms (hyper salivation)
Rx - sulthiame

19

Types of cerebral palsy?

70% - spastic (UMN injury)

Dyskinetic - basal ganglia (involuntary uncontrolled movements)

Ataxic - cerebellum damage

Mixed

20

Causes of cerebral palsy?

Pre birth - 80% - toxo, cmv, rubella. Cerebral malformation

Birth - birth asphyxiation, trauma

Post natal - intra ventricular haemorrhage, meningitis, head trauma, kernicterus

21

What is the prognosis for someone with retinoblastoma ?

Many visually impaired
Risk of cancer - sarcoma

22

What is a cephalhaematoma?

Lump from ruptured vessels between skull and periosteum.
Causes prolonged second stage of labour and instrumental delivery

23

What is the difference in presentation for caput succedaneum and cephalhamatoma?

CS - extraperiosteal and crosses the suture lines. Resolves few days.

CH- does not cross suture lines. Resolves few months.