16 - Neuro Flashcards
CN I:
Olfaction / smell
CN II:
Vision - newborns 20/200, by 6mos 20/20
Features of Horner syndrome
Interruption of sympathetic innervation to the pupil
- Ptosis
- Miosis
- Facial anhydrosis
Rooting reflex is associated with which cranial nerve?
V (trigeminal)
What is Gower sign?
Patient arises from lying on floor by using arms to “climb up” legs and body
Lower motor neuron lesions and cerebellar lesions result in muscle tone increase or decrease?
Decrease (hypotonia)
Upper motor neuron lesions result in muscle tone increase or decrease?
Increase (hypertonia or spasticity)
What is the MC recurrent pattern of primary HA’s in children and adolescents?
Tension HA
Triptans are contraindicated for:
Focal neuro deficits with migraines or basilar migraines (syncope) -> stroke risk
Who gets migraine prophylaxis?
> 1 disabling migraine per week
BB’s (propanolol)(CI: asthmatics and DM)
TCA’s
Anti-convulsants
CCB’s
SSRI’s
Antihistamines
Jacksonian march?
Complex partial seizure spreading from face to arm to leg
Txt for absence seizures?
Ethosuximide or valproic acid
Stat-ep
> 30mins
Causes: new-onset epilepsy, drug intox or withdrawal, electrolytes, hypoxia, stroke, head trauma
Lorazepam, diazepam, midazolam
MCC of seizure between 6mo and 6yrs?
Febrile seizure
What is spinal muscular atrophy?
SMA
Progressive anterior horn cell degeneration
“Floppiness”
Absent DTR’s
Tongue fasciculations
Where is polio endemic?
Nigeria
India
Pakistan
Afghanistan
MCC of acute flaccid paralysis in children?
Guillain Barre syndrome
Postinfectious autoimmune peripheral neuropathy
Symmetrical ascending weakness over hours to weeks
Cam affect respiratory function
Slow spontaneous resolution
Tx: IVIG, plasma exchange, immunosuppresive drugs
Charcot-Marie-Tooth dz
Ankle-weakness, frequent tripping, pes cavus
Slow progression
No txt
What are the three types of childhood myasthenia gravis?
Juvenile myasthenia gravis
Transient neonatal myasthenia gravis
Congenital myasthenia gravis (not AI - genetic mutations)
Txt for MG?
Acetylcholinesterase inhibitor (pyridostigmine)
Thymectomy (reduced antibody burden)
Steroids
Seizures and concussion?
At time of injury - ok
Within 7 days - ok
After seven days - can lead to epilepsy (glial scarring)
Sxs for concussion last how long?
Less than 3 days
Most resolve within a week
Return to play after concussion
- Rest
- Walking
- Sport-specific exercise
- Non-contact resistance training
- Full-contact
- Game play
Q24h step-up
Epidural hemorrhage
Onset minutes to hours
Lucid interval followed by progressive neuro deficits
Lens-shaped extra-cerebral hemorrhage compressing the brain
Txt - surgical evactuation
