Neurology Flashcards
1
Q
What are the different clinical categories of headache?
A
- isolated acute
- recurrent acute
- chronic progressive
- chronic non-progressive
2
Q
What are features of childhood migrane?
A
- abdominal pain, N + V
- focal signs before/during/after
- visual distrubance, paraesthesia, weakness
- pallor
- aggrevated by bright light, noise
- relation to fatigue, stress
- helped by sleep, rest, dark quiet room
- often +ve family H
3
Q
What are signs of a migraine?
A
- hemicranial pain
- throbbing, pulsatile
- abdo pain, N + V
- relieved by rest
- photophobia, phonophobia
- visual, sensory, motor aura
- +ve family H
4
Q
What are signs of a tension headache?
A
- diffuse, symmetrical
- band-like distribution
- present most of time
- ‘constant ache’
5
Q
What are signs of a headache caused by raised ICP?
A
- ggrevated by activites that raise ICP
- coughing, straining, bending
- woken from sleep with headache, vomiting
6
Q
What are signs of a headache caused by analgesia overuse?
A
- headache is back before allowed to use another dose
- paracetamol/NSAIDs
- particular problems with compound analgesia
- cocodamol
7
Q
What are indication for neuroimaging?
A
- features of cerebellar dusfunction
- features of raised ICP
- new focal neurological deficit
- seizures (esp focal)
- personality change
- unexplained deterioration of school work
8
Q
What is the management for a migraine?
A
Acute attack:
- effective pain relief
- triptans
Prevention:
- pizotifen
- propanolol
- amitryptyline
- topiramate
- volproate
9
Q
What is the management for tension type headache?
A
- treat underlying; chronic physical , psychological, emotional problems
- simple analgesia
- amitryptiline
- discourage analgesia in chronic TTH
10
Q
What is the management of epilepsy in children?
A
- anti-epileptic drugs (AED)
- sodium volproate (except girls)
- levetiracetam
- carbamazepine
- lamotrigine
- perampanel
- steroid, immunoglobulins, ketogenic diet
- vagus nerve stimulation (VNS)
- surgery
11
Q
What is microcephaly?
A
- occipitofrontal cirumference (OFC)
- < 2 SD- mild
- < 3 SD- moderate/severe
- usually indicate small brain (micranencephaly)
- prenatal or postnatal onset
- antenatal, postnatal, genetic, environmental
12
Q
What is macrocephaly?
A
- occipitofrontal circumferance (OFC)
- > 2 SD
- sutures, frontanelles, familial, hydrocephalus, large brain, development
- facial features, hepatosplenomegaly, bony deformities
13
Q
What are indications for a neuromuscular disorders?
A
- baby ‘floppy’ from birth
- slips from hands
- paucity of limb movements
- alert, but less motor activity
- delayed motor milestones
- able to walk but frequent falls
14
Q
What are features of Duchenne muscular distrophy?
A
- Xp21 dystrophin gene, 1/3500 male infants
- delayed gross motor skills
- symmetrical proximal weakness
- waddling gait, calf hypertrophy
- Gowers +ve sign
- elevated creatinine kinase levels (> 1000)
- cardiomyopathy
- respiratory involvement (in teens)
