Neurology Flashcards
(30 cards)
what is a febrile convulsion
generalised tonic-clonic seizure occurring in child with fever
what is a breath holding attack
child is upset/crying/worked up and stops breathing, becomes cyanotic and loses consciousness
- recover within 1 minute
what is a reflex anoxic seizure
occurs when child is startled
- vagnus nerve sends signals to heart for it to stop beating
- child goes pale, collapses and may have some seizure like muscle twitching
- heart returns to normal within 30s and child regains consciousness
what are the types of epileptic seizures
focal seizures absence seizures atonic seizures myoclonic seizures tonic seizures clinic seizures tonic-clonic seizures
where to focal seizures occur
temporal lobe
difference between
- simple focal seizure
- complex focal seizure
simple = without loss of consciousness complex = with loss of consciousness
symptoms of focal seizure
hallucinations
deja vu
memory flashbacks
repetitive movements on autopilot
Tx of focal seizures
- 1st line
1st line: carbamazepine / lamotrigine
2nd line: sodium valproate
how does an absence seizure present
child becomes blank, stares into space, unresponsive then upruptly returns back to normal
- typically lasts 10-20 s
- majority stop having seizures as they grow up
tx of absence seizures
1st line: sodium valproate or ethosuximide
how does a atonic seizure present
sudden loss of muscle tone causing collapse - ‘drop attack’
tx of atonic seizures
1st line: sodium valproate
2nd line: lamotrigine
presentation of a myoclonic seizure
sudden brief jerks in arms + legs
what is juvenile myoclonic epilepsy
early morning myoclonic seizures
daytime absences
tx of myoclonic seizures
sodium valproate
presentation of a tonic seizure
stiffening of muscles in back / arms / legs
presentation of a clonic seizure
rhythmic jerking movements
presentation of a tonic clonic seizure
‘grand mal’ seizure
- loss of consciousness
- muscle tensing + rhythmic jerking movements
- post ictal period
- may experience tongue biting / incontinence
tx of tonic-clonic seizures
1st line: sodium valproate
2nd line: lamotrigine
what is sodium valproate’s mechanism of action?
what are the side effects?
increases GABA activity
- teratogenic
- liver damage / hepatitis
- hair loss
- temor
what is lamotrigine’s mechanism of action?
what are the side effects?
blocks sodium channels
- Steven Johnston syndrome
what channels does carbamazepine act on?
what are the side effects of carbamazepine?
sodium channels
- agranulocytosis
- aplastic anaemia
- induces p450 system
what is hydrocephalus
increased CSF within brain/spinal cord
either due to
- overproduction
- problem with draining / absorption
signs of hydrocephalus in an infant
enlarging head size
bulging fontanelles
poor feeding / vomiting
papilloedema
