Flashcards in Neuro Deck (23):
In which age group may 'Kernig's sign' not be present in meningitis?
May present as non-specific drowsiness, fever, irritability, poor-feeding.
Kernig's sign- neck stiffness
When is a lumbar puncture contraindicated??
Prolonged or focal seizure
Abnormal pupils or posture
Cushings triad (low hr, high bp, irregular resp)
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
What symptoms would you get if the cerebellar was affected?
Hyperventilation can trigger what type of seizures ?
If associated with other seizure types give sodium valprorate
What is the commonest neuromuscular disease/dystrophy?
Dystrophinopathy (duchennes muscular dystrophy) 1/3500 live boys
What disease modifying agent can be give in duchenne muscular dystrophy?
What is Charcot-Marie-tooth disease?
AD demyelinating peripherals neuropathy (pmp22 gene)
Leads to distal weakness and atrophy and sensory loss.
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.
What causes a floppy baby?
- IVH, hydrocephalus
- structural abnormality
- chromosomal disorders
- anterior horn cell (SMA)
- demyelination -
- axonal neuropathy
- myasthenia syndromes
- congenital muscle disease (dystrophy, myopathy, myotonic dystrophy)
What is tuberous sclerosis?
Depigmented 'ash leaf' spots, rough skin on lumbar spine,
Development delay, epilespsy, intellectual impairment
What is Rolandic epilepsy?
Infrequent partial fits. Unilateral or oropharyngeal sensory motor symptoms. Speech arrest. Hypersalivation
Rx rarely needed, sulthiame sometimes uses.
Causes of meningitis in neonates?
Group b strep
Treatment for meningitis?
What is seen on eeg in west syndrome epilepsy?
Hypsarrthyimia - chaotic pattern, slow sharp waveforms.
Salaam attacks (on waking), low Iq
Rx : vigabatrin
What is seen on eeg in Ohtahara syndrome?
Supppression- burst pattern
Rx - chloralhydrate
What is Lennox-gastaut syndrome?
Extension of infantile spasms.
Handicapped (90%) poor prognosis
Eeg : slow spike
Rx- ketogenic diet might help
What is rolandic epilepsy?
Benign, brief partial fits often unilateral facial or oropharyngeal sensory motor symptoms (hyper salivation)
Rx - sulthiame
Types of cerebral palsy?
70% - spastic (UMN injury)
Dyskinetic - basal ganglia (involuntary uncontrolled movements)
Ataxic - cerebellum damage
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
What is the prognosis for someone with retinoblastoma ?
Many visually impaired
Risk of cancer - sarcoma
What is a cephalhaematoma?
Lump from ruptured vessels between skull and periosteum.
Causes prolonged second stage of labour and instrumental delivery