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Pediatrics PLE > Neurology > Flashcards

Flashcards in Neurology Deck (38):
1

Agenesis of cerebellar vermis

Cystic dilatation of the 4th ventricle

Enlargement of the posterior fossa

Dandy-Walker Malformation

2

Short webbed neck

Decreased ROM of the cervical vertebrae

Low posterior hairline accompanied by hydrocephalus

Klippel-Feil Syndrome

3

Obstruction within the ventricular system

Abnormality of the aqueduct or a lesion in the 4th ventricle

Obstructive or Noncommunicating Hydrocephalus

4

Obliteration if the subarachnoid cisterns; malfunction of arachnoid villi

Follows a subarachnoid hemorrhage; leukemic infiltrates

Nonobstructive or communicating Hydrocephalus

5

Single nocturnal seizure with clonic movement of the mouth and gurgling

Usually begins 5-10y/o; resolves by 16y/o

Benign Rolandic Epilepsy

6

Prior history of febrile seizures or head trauma

Prodrome: lethargy

Oral or motor automatisms, altered consciousness, head and eye deviation, contralateral twitching or tonic-clonic movements, posturing

Temporal lobe epilepsy

7

Sudden cessation of motor activity or speech with a blank facial expression and flickering of the eyelids

Uncommon before 5 y/o
NEVER associated with an aura
NOT associated with postictal state
DO NOT lose body tone

Absence Seizure

8

Associated with an aura

Sudden loss of consciousness -> cyanotic -> apneic

Loss of sphincter control

With postictal state: vomiting confusion, somnolence, intense headache

Generalized tonic clonic seizure

9

Repetitive seizures consisting of brief often symmetric myoclonic contractions with loss of body tone and falling or slumping forward

Myoclonic Seizure

10

Begin at 4-8mos

Brief symmetric contractions of the neck, trunk, extremities

EEG: hypsarrhythmia

Infantile Spasms

11

DOC for infantile spasm

Vigabatrin

12

DOC for absence seizure

Ethosuximide and Valproic Acid

13

Management for GTC

Phenobarbital
Phenytoin
Carbamazepine
Lamotrigine
Valproic acid
Gabapentin

14

Most common seizure disorder in childhood

Normal EEG, normal neurologic exam
(+) family history

Febrile seizure

15

Lasts a few seconds to 15 minutes
Initially generalized and tonic clonic followed by a brief period of post-ictal drowsiness
Occurs only once in 24 hours

Simple febrile seizure

16

Duration is more than 15minutes
Focal seizure activity
Repeated convulsions occur within 24hours

Complex febrile seizure

17

Recurrent headache with symptom-free intervals and atleast three of the following:

(+) family history
Associated with aura
Relief after sleep
Abdominal pain
Unilateral
Nausea and vomiting
Throbbing in character

Migraine

18

Headache most apparent during school day
Common after puberty
Waxes and wanes
Band-like tightness or pressure
Most are in the frontal region

Tension headache

19

Cafe au lait macules that spare the face; axillary or inguinal freckling; Lisch nodules; optic glioma

Neurofibromatosis (Von-Reckling-hausen)

20

Multisystemic; seizures; mental retardation

Tubers in the periventricular area (candle dripping appearance); ash leaf, shagreen patch

Tuberous Sclerosis

21

Most common etiologic agent in bacterial Meningitis

1st 2 mos: Group B Streptococcus
2mos - 12 years: S. pneumoniae, H. influenza, N. Meningitidis

22

CSF analysis in Bacterial Meningitis

Pleocytosis, high CSF protein level, low CSF sugar

23

Treatment for Bacterial meningitis

N. meningitides: Penicillin IV

S. pneumoniae: 3rd gen Cephalosporin or Penicillin IV

L. monocytogenes or Hib: Ampicillin

24

Most likely organism to cause viral meningitis

Echovirus

25

CSF analysis in Viral Meningitis

Normal glucose, normal to slightly increased protein, lymphocytosis

26

Most common location of brain abscess

Cerebrum (80%)

27

Indication for surgery in brain abscess

(+) gas in the abscess
Multiloculated abscesses
Posterior fossa location
Fungal cause
Assoc. infections like mastoiditis, periorbital abscess, sinusitis

28

Earliest and most constant signs in Myasthenia Gravis

Ptosis
Some degree of extraocular muscle weakness

29

Due to immune mediated neuromuscular blockade

Decreased availability of Ach receptors due to circulating receptor binding Abs

Rapid fatigue of muscles (proximal muscle)

Myasthenia gravis

30

Acute unilateral facial nerve palsy that is not assoc with other cranial neuropathies or brainstem dysfunction

Usually develops abruptly 2 weeks after a systemic viral infection

Bell's palsy

31

Autoimmune reaction that develops in response to a previous infection leading to aberrant demyelination of peripheral nerves and ventral motor nerve roots

Campylobacter jejuni and herpesvirus infection

Guillain barre Syndrome

32

Weakness begins in the lower extremities and progressively involves the trunk, upper limbs, bulbar muscles (Landry ascending paralysis)

Tendon reflexes are the last function to recover and lower extremity weakness is last to resolve

Guillain barre Syndrome

33

Diagnostic of Guillain barre Syndrome

Dissociation between high CSF protein and a lack of cellular response (albuminocytologic dissociation)

34

Most common solid tumors

2nd most cost prevalent malignancy in childhood

Brain tumors

35

2 distinct patterns of presentation

Increased ICP and focal neurologic signs

36

Most common infratentorial tumor

With best prognosis

Cerebellar astrocytoma

37

Most often found in cerebellum; heterogenous enhancements often invading the 4th ventricle and can cause obstructive hydrocephalus

M>F; 4-8y/o

Homer-wright rosettes - circular patterns of tumor cells surrounding a center of neutrophils

Medulloblastoma

38

Solid and cystic areas that tend to calcify; short stature; pressure to optic chiasm producing bitemporal visual defects

Craniopharyngioma