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Paediatrics > Neurology > Flashcards

Neurology Flashcards

1
Q

What are some headache disorders?

A

Isolated acute
Recurrent acute
Chronic progressive
Chronic non-progressive

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2
Q

How to do an examination for a headache?

A 
Growth parameters
Sinuses, teeth and visual acuity 
Fundoscopy
Visual fields
Cranial bruit
Focal neurological signs
Cognitive and emotional status
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3
Q

What are some pointers to childhood migraine?

A

Associated abdominal pain, nausea and vomiting
Focal signs before, during and after (visual disturbances, paresthesia and weakness)
Pallor
Aggravating factors
Relation to fatigue and stress
Helped by: rest, sleep, dark or quiet
FH often positive

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4
Q

What are migraine headache S+S

A 
Hemicranialpain
Throbbing
Abdo pain, nausea and vomiting
Relieved by rest
Photophobia
Visual, sensory and motor aura
Positive FH
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5
Q

What are the tension headaches S+S?

A

Diffuse and symmetrical
Band-like distribution
Present most of the day

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6
Q

What are some pointers to raised ICP?

A

Aggravated by activities

  • Coughing
  • Straining
  • Bending

Woken from sleep with headache +/- vomiting

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7
Q

What are some pointers to analgesic overuse headache?

A

Back before allowed another dose

Paracetamol / NSAID’s

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8
Q

What are some indicators for neuroimaging?

A 
Cerebellar dysfunction
Features of raised ICP
New focal neuro signs
Seizures
Personality change
Unexplained deterioration of school-work
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9
Q

How do you manage a migraine?

A

Acute = effective pain relieve (tryptans)

Preventative (at least 1 a week) = Propanolol, amitryptyline and valproate

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10
Q

How do you treat a tension headache?

A 
Reassurance
MDT management
Attention to any underlying problems
Acute = simple analgesia
Prevention = amitryptiline
Discourage analgesia in chronic
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11
Q

What is a seizure or fit?

A

Any sudden attack from whatever cause

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12
Q

What is syncope?

A

Faint

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13
Q

What is a convulsion?

A

Seizure where there is prominent motor activity

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14
Q

Define epileptic seizure

A

An abnormal excessive hyper-synchonous discharge from a group of neurons
-Change in motor, sensory or cognitive function
Depends on location and degree of spread

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15
Q

What is epilepsy?

A

A tendency to recurrent, unprovoked epileptic seizures

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16
Q

Are EEG’s used to diagnose epilepsy ?

A

Used only for supportive evidence

17
Q

Is a seizure epileptic?

A

Not always

18
Q

What can acute symptomatic seizures be due to?

A

Hypoxia-ischaemia
Hypoglycemia
Infection
Trauma

Syncope
Parasomnias
Febrile seizure

19
Q

When do febrile convulsions occur?

A

Between 3 months and 5 years old

Associated with fever

20
Q

What can cause a jerk or shake seizure?

A

Clonic
Myoclonic
Spasms

21
Q

What can cause a stiff seizure?

A

Usually tonic

22
Q

What type of seizure can cause a fall?

A

Atonic
Tonic
Myoclonic

23
Q

What can cause a vacant attack seizure?

A

Absence

Complex partial

24
Q

What happens in an atonic seziure

A

sudden loss of tone and they can hurt themselves

25
Q

What happens in a tonic seizure?

A

Hold posture but can fall

26
Q

Absence seizure

A

Abrupt and short lasting

Looks space out but can have eye rolling

27
Q

What is a myoclonic seizure?

A

Very quick and causes arm jerking movements

28
Q

What is a tonic-clonic seizure

A

Few myoclonic jerks
Patient then stiffens
Then there is the clonic phase of rhythmic jerking (gets less as it goes on)

29
Q

What is a reflex-anoxic seizure

A

Over activity of the vagus N.

Blue - loose tone and start jerking

30
Q

What is the mechanism of epileptic seizures?

A

Decreased inhibition
Excessive excitation
Excessive influx of Na and Ca

31
Q

What are the 2 types of seizures?

A

Partial

Generalised

32
Q

How do you diagnose epilepsy?

A 
History
Video recording
ECG in convulsive seizures
MRI brain
Genetic testing
Metabolic tests
33
Q

What is the management of epilepsy in children?

A

AED only considered if diagnosis is clear
-Role is to control them not cure
-Start with 1 and titrate up slowly
(carbamazepine, sodium valporate, lamotrigine)
-Steriods, immunoglobulins, ketogenic diet

34
Q

How many bones are there in the head?

A

22

35
Q

How do you measure a babies head?

A

Occipitofrontal circumference

above eyebrow to occipital prominence

36
Q

What is microcephaly?

A

<2SD below the mean

If <3SD = may indicated the brain is small

37
Q

What is macrocephaly?

A

> 2SD above the mean

38
Q

When do you suspect a NM disorder?

A 
Floppy baby
Paucity of limb movements
Alert but less motor activity
Delayed motor milestones
Able to walk but frequent falls
39
Q

What are the differences in head shapes called?

A

Plagiocephaly ‘flat-head’
Brachycephaly ‘short head or flat at back’
Scaphocephaly ‘boat shaped skull’
Craniosynostosis

Paediatrics (15 decks)

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