Neurology

Question 0

How common in cerebral palsy?

Answer 0

2:1000

Question 1

What is cerebral palsy?

Answer 1

Disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain.

Question 2

What are the three categories of the causes of cerebral palsy?

Answer 2

Antenatal -80%
Intrapartum (during birth)-10%
Post-natal- 10%

Question 3

What are the three types of cerebral palsy?

Answer 3

Spastic
Ataxic hypertonic
Dyskinetic

Question 4

In spastic cerebral palsy what is the difference between diplegia and hemiplegia?

Answer 4

Diplegia - All 4 limbs affected but the legs are worse

Quadriplegia- all 4 limbs to a similar degree.. But arms may be worse

Question 5

What is the most common cause of ataxic hypotonic cerebral palsy?

Answer 5

Genetic cause

Question 6

An infant presents with floppiness, delayed motor development with abnormal movements. No cognitive delay. What type of cerebral palsy do they have?

Answer 6

Dyskinetic

Question 7

A child had poor balence, delayed motor, poor coordination that is symmetrical. What type of cerebral palsy?

Answer 7

Ataxic hypotonic

Question 8

There is a history of birth asphyxia, what type of cerebral palsy?

Answer 8

Spastic - quadriplegic

Question 9

A child with fisting of the left hand, with pronated flexed forearm?

Answer 9

Spastic - hemiplegic

Question 10

What is the cardinal sign that difderentiate a headache from a space occupying lesion (ie tumour)?

Answer 10

If space occupying lesion the head ache will be worse when lying flat.

Question 11

What is benign raised ICP?

Answer 11

Raised ICP without a space occupying lesion caused by blockage of the CSF system.

Question 12

What is the likelyhood the febrile seizures will recurr?

Answer 12

30%

Question 13

Describe a non-paralytic squint (concomitant)..

Answer 13

Both eyes have full range of movement but one is directed off centre at a constant angle.

Question 14

Describe a paralytic squint (incomitant)

Answer 14

Where the squint only becomes apparent when the eye is moving with the help of the extra ocular muscle that supplies that direction

Question 15

What is amblyopia?

Answer 15

Failure of the immature neuroretina to develop during early childhood

Question 16

What are the causes of amblyopia?

Answer 16

Visual deprivation

Squint in childhood

Question 17

What is a latent squint?

Answer 17

Mild heterophoria - a squint that can sometimes be seen when someone is looking into the distance or day dreaming

Question 18

At what age should intermittent squints disappear?

Answer 18

3 months eyes should be fully aligned

Question 19

What is the difference between a trophia and a phoria?

Answer 19

Eye misalignment that is present all the time (trophia) or some of the time (phoria)

Question 20

How do brain tumours in children present?

Answer 20

Signs or raised ICP so 
Headache 
Blurred vision 
Cranial never palsies (squint) 
Vomiting in morning

Question 21

What signs might suggest raised ICP?

Answer 21

Pappiloedema
Hypertension
Brady cardia

Question 22

With a brain tumour when are the headaches worse?

Answer 22

When lying down
In the morning
Can wake up at night

Question 23

Is having a headache an indication for neuro imaging?

Answer 23

No just a headache but if it is abnormal or accompanied with nerve palsies

Question 24

What influences the outcome of a brain tumour?

Answer 24

Anatomical position | Hisrological subtype

Question 25

What is the most common type of brain tumour in children?

Answer 25

Astrocytoma

Question 26

The second most common type is medulloblastoma, how does this present?

Answer 26

Ataxia Headache Vomiting

Question 27

What brain tumour might present with cranial nerve defects ataxia pyramidal tract signs but no raised ICP?

Answer 27

Brain stem glioma

Question 28

What are the two types of dyskinesic cerebral palsy?

Answer 28

Dystonic Choreoathetoid

Question 29

What would 'involuntary and uncontrollable muscle tone fluctuations sometimes involving whole body' Dystonic or choreoathetoid?

Answer 29

Dystonic

Question 30

What would small rapid irregularly repetitive unwanted movements be? Choreoathetoid or dystonic?

Answer 30

Choreoathetoid

Question 31

What proportion of children have normal intelligence with cerebral palsy?

Answer 31

33%

Question 32

In spastic hemiparesis cerebral palsy is the arm or leg more affected?

Answer 32

Arm

Question 33

At what stage of sleep do night terrors occur?

Answer 33

In non-REM between stage 3 and 4 | Where there are delta waves

Question 34

What does the child do in a night terror?

Answer 34

Cries and screams and is difficult to wake, they don't remember their dream

Question 35

How long after sleep does a night terror occur?

Answer 35

90 mins

Question 36

At what stage do nightmares occur?

Answer 36

Rem sleep