Neuro

Question 1

What is migraine associated with?

Answer 1

FH

Question 2

What is the oresentationof a migraine?

Answer 2

Headache- unilateral, severe, throbbing, photo and photophobia
Focal s+s= visual disturbance, paraestoesia, weakness
pallor
Associated abdominal pain, N&V

Question 3

What is the acute management of migraine?

Answer 3

Analgesia- paracetamol, ibuprofen, triptans

Antiemetics

Question 4

What is the indication for preventative management of migraines?

Answer 4

At least 2 a month

Question 5

What are the options for prevention of migraines?

Answer 5

Propanolol
Pizotifen
Topiramate

Question 6

What are the indications for imaging in headache?

Answer 6

Features of cerebellar dysfunction
Features of raised ICP
New focal neuroleptic deficit
Seizures
Personality change
Unexplained deterioration in schoolwork

Question 7

What is epilepsy?

Answer 7

Tendency to recurrent seizures caused my abnormal electrical activity int he brain

Question 8

What type of seizures are normally seen in children?

Answer 8

Generalised

Absence typically in kids

Question 9

What investigations are done for a 1st generalised seizure>

Answer 9

ECG

FBC, U&Es, glucose

Question 10

What investigation is done for a 2nd generalised seizure?

Answer 10

ECG
FBC, U&Es, glucose
EEG

Question 11

When is MRI done for seizures?

Answer 11

<2yo
Focal seizures
Not responding to treatment

Question 12

What is the management of generalised seizures?

Answer 12

1st= sodium valproate
2nd= lamotrigdine, carbamazepine

Question 13

What is the management of absence seizures?

Answer 13

1st= ethosuximide
2nd= sodium valproate

Question 14

What is the management of focal seizures?

Answer 14

1st= carbamazepine, lamotrigdine
2nd= sodium valproate

Question 15

What is the management of status epilepticus?

Answer 15

Hospital= IV lorazepam
Community= buccal midazolam, rectal diazepam

Question 16

What are some non pharm options of epilepsy management?

Answer 16

Ketogenic diet
Vagus nerve stimulation
Surgery

Question 17

What are some types of non epileptic seizures/seizure like activity seen in children?

Answer 17

Febrile convulsions
Reflex anoxic seizures
Psychogenic
Syncope
Parasomnias
Behavioral stereotypes

Question 18

What are febrile convulsions?

Answer 18

Brief and generalised tonic/tonic-clonic seizure caused by rapid rise in temp in viral infection

Question 19

What age are febrile convulsions seen in?

Answer 19

6 months- 5yo

Question 20

What is the presentation of febrile convulsions?

Answer 20

Usually <5 mins

Tonic-clonic/tonic

Question 21

What is the prognosis of febrile convulsions?

Answer 21

1/3 ill have another

Anti-pyrexials don’t decrease chance of another

Question 22

What is the inheritance of Duchenne MD?

Answer 22

X linked recessive

Question 23

What is the presentation of Duchenne MD?

Answer 23

3-5yo
Delayed gross motor skills
Symmetrical proximal weakness
Waddling gait
Calf hypertrophy
Gower's sign + 
Cardiomyopathy
Respiratory involvement as progresses

Question 24

What is Gower’s sign?

Answer 24

Uses arms to get to standing from lying due to pelvic girdle weakness

Question 25

What investigation is done for Duchenne MD?

Answer 25

CK- elevated

Question 26

What is the management of Duchenne?

Answer 26

Oral steroids- slow progression Creatinine supplementation Supportive

Question 27

Whatis the prognosis of Duchenne?

Answer 27

25-30 year life expectancy

Question 28

What is Beckers MD?

Answer 28

Like Duchenne but less severe

Question 29

What is myotonic dystrophy?

Answer 29

Usually presents in adulthood | key feature= prolonged muscle contractions- if you shake their hand, they will hold on unable to let go

Question 30

What is cerebral palsy?

Answer 30

Disorder of movement and posture due to non progressive lesion of motor pathway in developing brain

Question 31

What are the causes of cerebral pals?

Answer 31

Antenatal= 80% Intrapartum 10% Postnatal= 10%

Question 32

What are the antenatal cases of cerebral pals?

Answer 32

Cerebral malformation | Congenital infection- rubella, toxoplasmosis, CMV

Question 33

What are some intrapartum causes of cerebral palsy?

Answer 33

Asphyxia | Trauma

Question 34

What are some post natal causes of cerebral palsy?

Answer 34

Intraventricualr haemorrhage Meningitis Trauma

Question 35

What is the most common type of cerebral palsy?

Answer 35

Spastic

Question 36

What is associated with cerebral palsy?

Answer 36

Learning difficulties Epilepsy Hearing impairment

Question 37

What is the presentation of cerebral palsy?

Answer 37

Failure to meet milestnes Increased or decreased tone Problems with coordination Hand preference <18 months

Question 38

What is the management of cerebral palsy?

Answer 38

Spasticity= diazepam, baclofen, Botulinum toxin A | Surgery