Neuro Flashcards Preview

Year 5 Paediatrics COPY > Neuro > Flashcards

Flashcards in Neuro Deck (67)
Loading flashcards...
1

Breath holding attack

Toddlers with temper
Cry, hold breath, hypoxia, cyanosis, may briefly lose consciousness

Behavior modification therapy and distraction

2

Myoclonic seizures

Brief, oft repetitive, jerking movements of limbs, neck, or trunk

3

Generalized seizures

Always LOC, no warning, symmetrical seizure, B/L synchronous activity on EEG or varying asymmetry

4

Absence seizures

Transient LOC, abrupt onset and termination
No motor phenomena except flickering eyelids or minor alteration in tone
Can be precipitated by hyperventilation

Few seconds, multiple, often not doing well at school. "Dazing out", "daydreaming"

5

Tonic clonic seizures

Rhythmic muscle contractions following tonic phase. May fall to ground during tonic phase, do not breathe. May become cyanosed.
Clonic phase has irregular breathing, cyanosis may persist, saliva may accumulate.
Tongue biting, urinary incontinence may be a feature

6

West syndrome

4-6mo.
"Salaam spasms": violent flexing of neck followed by hyperextension shoulders (watch a youtube video--easier to see than explain)
1-2s oft in multiple bursts of 20-30, often on waking
May occur throughout day
Social interaction often deteriorates

7

Tx-West Syndrome

Vigabatrin, steroids

Note "gaba" in vigabatrin...helps remember MOA :)

8

Lennox-Gastaut syndrome

1-3 years. Multiple seizure types, mostly drop attacks, tonic clonic, and atypical.
Neurodevelopmental arrest or regression and behavior disorder

9

Benign epilepsy with centrotemporal spikes

4-10 years
Tonic clonic seizures in sleep or simple focal seizures with awareness abnormal feelings in tongue and distortion in face
15% childhood epilepsies
Does not always require treatment-almost all remit in adolescence

10

Juvenile myoclonic epilepsy

Adolescence-adulthood
Myoclonics but generalized tonic-clonic and absences may occur.
Usu after waking
Typical hx of throwing drinks and cornflakes

11

First line treatment for all generalized seizures

Valproate

Can also use ethosuximide for absence

12

Second line for all generalized seizures

Lamotrigine

13

First line for focal seizures

Carbamazepine, valproate.
Lamotrigine good efficacy, but titrate slowly

14

Side effects carbamazepine

Rash, neutropenia, hyponatremia, ataxia

15

Side effects valproate

Weight gain, hair loss
Rare idiosyncratic liver failure

16

Management status epilepticus

1. Call for help
2. ABC
3. Glucose
4. If vasc access: 0.1mg/kg lorazepam. Repeat if not working
No vasc access: 0.5mg/kg buccal midazolam or 0.5mg/kg PR diazepam.
5. Paraldehyde 0.4mL/kg PR
If no response, SENIOR HELP
6. Phenytoin 18mg/kg IV over 20min or phenobarb 15mg/kg if already on oral phenytoin

17

Reflex anoxic seizures

Infants/toddlers
Pain or discomfort (e.g. minor head trauma, fever, fright, cold food) causes them to go pale, then lose consciousness. May have tonic clonic.
Due to cardiac asystole from vagal inhibition
Spontaneous resolution

18

Febrile convulsions

6mo-6years
Rapid increase in temperature (not prevented by antipyretics)
3% kids
If complex, increases risk subsequent epilepsy.
30-40% chance will have another

Ix: BM, cause of fever, rule out meningitis

19

Noncommunicating hydrocephalus

Obstructive lesion

20

Communicating hydrocephalus

Problem of arachnoid villi absorbing CSF

21

Causes non-communicating hydrocephalus

Congenital: aqueductal stenosis, Dandy Walker, Arnold Chiari
Posterior fossa neoplasm or vascular malformation
Intraventricular hemorrhage in preterm

22

Treatment hydrocephalus

Ventricular shunt

23

Key feature neuromuscular diseases

Weakness

24

Presentation of anterior horn cell problems

Weakness, loss of reflexes, fasciculation, wasting

25

Diseases that affect anterior horn cells

Polio
SMA
ALS

26

Presentation neuropathy

Often distal nerves
Weakness, loss of reflexes, sensory loss, temperature change

27

presentation myopathy

Weakness, wasting, changes in gait

28

Presentation of neuromuscular junction disorders

Worsening of weakness throughout day

29

Ix for myopathy

CK (increased in Duchenne's, Becker's)
Muscle biopsy
USS muscles
MRI muscles
DNA testing

30

Ix-neuropathy

Nerve conduction studies
DNA testing
EMG differentiates myopathy vs neuropathy