Neurology Flashcards by Bridie Peters

What percentage of infants experience at least one febrile seizure?

0.5-1%

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What proportion of infants who have had a febrile seizure have an additional seizure?

30%

RIsk is higher the younger the child

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What is the risk of developing epilepsy following febrile seizures?

Only slightly greater than the rest of the population

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What type of seizure does not occur in newborns and very rarely occurs in children < 2

Generalised tonic-clonic

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What is the most common seizure type seen in Lennox-Gastaut syndrome?

Astatic seizures (drop attacks)

Also tonic-clonic and atypical absence

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How can absence seizures be induced?

Hyperventilation

Ask the child to blow on a piece of paper or windmill for 2-3 minutes

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What is the treatment for absence seizures?

Ethosuximide

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What is the definition of a simple febrile convulsion?

A generalised tonic-clonic seizure lasting < 15 minutes that does not recur within the same febrile illness

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What are the features of a complex febrile convulsion?

Focal features at onset or during the seizure
Duration of more than 15 minutes
Recurrence within the same febrile illness
Incomplete recovery within 1 hour

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What role does paracetamol play in febrile convulsions?

Does NOT reduce the risk of further febrile convulsions

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What EEG pattern is seen in absence seizure

3Hz spike and wave

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What is the first line treatment for focal epiliepsy (including with secondary generalisation)?

Carbamazepine

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What is the earliest sign of dose-related toxicity with carbamazepine use?

Diplopia, starting 30-60 minutes after the morning dose

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What allele should be screened for in patients with Asian origin before starting carbamazepine?

HLA-B*1502

Risk of SJS

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How can temporal lobe epilepsy associated with hippocampal sclerosis be treated surgically?

Temporal lobectomy

Up to 80% of patients have long term control

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How are neonatal seizures treated?

Phenobarbitone IM/IV immediately

Stopping the seizure immediately is critical

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When and how does intervention occur during a febrile seizure?

After 5 minutes - midazolam

After another 5 minutes - midazolam

After another 5 minutes - phenytoin/phenobaritone

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Within what age group do febrile seizures occur?

6 months - 5 years

Mostly 12-18 months

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Why is magnesium sulfate given to mothers at risk of preterm delivery?

Prevention of cerebral palsy

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What are the most common delayed motor milestones in children with cerebral palsy?

Not sitting by eight months (corrected for gestational age [GA])

Not walking by 18 months (corrected for GA)

Early asymmetry of hand function (hand preference) before one year (corrected for GA)

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Which type of cerebral palsy is most common in preterm infants?

Spastic diplegia

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What is the most common type of cerebral palsy?

Spastic (70-80%)

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Which region of the brain is involved in spastic cerebral palsy?

UMN of pyramidal tract

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Which region of the brain is affected in athetoid/dyskinetic cerebral palsy?

Study These Flashcards

Basal gangia

Which region of the brain is affected in ataxic cerebral palsy?

Cerebellum

Kernicterus is most associated with which type of cerebral palsy?

Dyskinetic

Periventricular leukomalacia is most commonly associated with which type of cerebral palsy?

Spastic diplegia

How are the two genders affected differently by muscular dystrophy?

Duchenne and Becker's only affect males (x-linked recessive)

When do clinical features of muscular dystrophy appear?

Duchenne: 2-5 years Becker: no earlier than 15

Where does muscular weakness begin in muscular dystrophy?

Proximal lower limbs Then spreads to upper body and distal areas

Epilepsy is most likely to occur in which type of cerebral palsy?

Spastic quadriplegia

How is a diagnosis of Hirschprung's disease confirmed?

Full-thickness rectal biopsy

What are 3 antispasmodics which can be used for cerebral palsy?

Botulinum toxin Baclofen Dantrolene Benzodiazepines

What is the mechanism of baclofen?

GABA analogue

What is athetosis?

Abnormal muscle contraction causes involuntary writhing movements Seen commonly in cerebral palsy

What is dystonia?

Sustained or repetitive muscle contractions result in twisting and repetitive movements or abnormal fixed postures

How can glucose on CSF help distinguish viral from bacterial meningitis?

Bacterial: low Viral: normal

How can CSF protein levels help distinguish viral from bacterial meningitis?

Viral: slightly elevated Bacterial: high

How can the CSF:blood glucose ratio on CSF help distinguish viral from bacterial meningitis?

Viral: normal Bacteria: low (decreased CSF glucose)

What is the triad of rasied ICP (Cushing's)?

1. Systemic hypertension 2. Bradycardia 3. Respiratory depression

What is craniosynostosis?

The premature fusion of one or more cranial sutures ## Footnote *Surgically managed*

What are the CSF findings in Guillain-Barre syndrome?

Elevated protein (increased permeability of the blood-nerve-barrier) Normal cell counts ***Albuminocytologic dissociation***

What is spinal muscular atrophy?

A group of autosomal recessive motor neuron diseases Caused by apoptosis of lower motor neurons

Which supplement is often used for migraine prevention?

Riboflavin (B2)

What are the main types of CP?

1. Spastic 2. Ataxic 3. Dyskinetic

When in the course of acute rheumatic fever does Sydenham's chorea occur?

1-8 months after inciting infection *Antibody cross-reaction with the basal ganglia and cortical structures*

How long do symptoms of Sydenham's chorea persist?

3-4 months, sometimes persisting up to 2 years

What type of CP is associated with chronic bilirubin encephalopathy? What is the specific movement pattern?

Dyskinetic Choreoathetoid Chorea (irregular migrating contractions) and athetosis (twisting and writhing)

What is the most common feature of chronic bilirubin encephalopathy?

High-frequency sensorioneural deafness

A "milk maid's grip" is characteristic of which encephalopathy?

Sydenham's chorea

What is a decorticate posture?

What is a decerebrate posture?

What is spina bifida occulta?

Failure of one or more vertebrae to close completely The spinal cord, meninges and overlying skin remain intact

What is a meningocele?

A neural tube defect The **meninges** protrude through the gap made by failed of the closure of a vertebrae

What is a myelomeningocele?

A neural tube defect The **meninges and spinal cord** protrude through the gap made by failed of the closure of a vertebrae

What is the most common cause of meningitis in children and teens?

*Neisseria meningitidis*

What is the empirical treatment for meningitis in neonates and children \< 2 months?

Cefotaxime + benzylpenicillin/amoxycillin Add acyclivir if encephalitis is suspected

What is the empirical treatment for meningitis in infants and children \> 2 months?

Ceftriaxone + dexamethasone Add acyclivir if encephalitis is suspected

Neurology Flashcards

(58 cards)