II. Neurology Flashcards
Most severe form of neural tube defect (dysraphism) due to failure of the neural tube to close spontaneously between the 3rd to 4th week of in utero development with the ff signs: flaccid paralysis of the LE, absence of DTRs, lack of response to pain and touch, hip subluxation, clubfeet, bowel and bladder incontinence, associated with hydrocephalus (type II Chiari)
Meningocoele (Tx: Folic acid 0.4mg once a day)
Due to failure of closure of the rostral neuropore resulting to a large calvarium, meninges, and scalp associated with a rudimentary brain consisting of connective tissue, vessels, and neuroglia
Anencephaly
Absent cerebral convolutions and poorly formed sylvian fissure due to faulty neuroblast migration
Lissencephaly (agyria)
unilateral or bilateral clefts within the cerebral hemispheres
Schizencephaly
Presence of cysts or cavities within the brain in the sylvian fissure
Porencephaly
Due to defective cleavage of prosencephalon and inadequate induction of the forebrain structures with evidence of noncleaved midline brain structures
Holoprosencephaly
A condition with the ff signs: setting sun sign (eyes deviate downward due to impingement of dilatged suprapineal recess on the tectum), long-tract signs (brisk DTRs, spasticity, clonus, babinski sign), cracked pot sensation on percussion of the skull and Macewen sign (separation of sutures)
Hydrocephalus (Tx: Acetazolamide and Furosemide provde temporary relief by reducing CSF production)
Type of hydrocephalus due to abnormality of the aqueduct (aqueductal stenosis) or a lesion on the 4th ventricle resulting to obstruction within the ventricular system
Obstructing or Non-communicating type
Type of hydrocephalus due to subarqachnoid hemorrhage resulting to obliteration of the subarachnoid cisterns and malfunction of the arachnoid villi
Non-obstructing or communicating type
Major cause of VP shunt complications
Staph. epidermidis
Sudden cessation of motor activity or speech with a blank facial expression and flickering of the eyelids (never associated with an aura or postictal state, rarely persist longer than 30secs and patients do not lose body tone)
Absence seizures (Tx: Eva - Ethosuximide and Valproic Acid)
Rhythmic clonic contractions alternating with relaxation of all muscle groups with a post ictal state (vomiting and intense headache), loss of sphincter control, associated with an aura, sudden loss of consciousness, cyanosis, and apnea
Generalized Tonic-Clonic seizure (Tx: P-P-Ca-La-Va-G: phenobarbital, phenytoin, carbamazepine, lamotrigine, valproic acd, gabapentin)
Repetitive seizures consisting of brief often symmetric muscular contractions with loss of body tone and falling or slumping forward
Myoclonic seizures
Begin at 4-8 months, brief symmetric contractions of the neck, trunk, extremities, and EEG shows hypsarrythmia (high voltage bilaterally asynchronous, slow wave activity)
Infantile Spasms (Tx: Vigabatrin)
Most common seizure disorder in chooldhood, peaking at 14-18 months, rare before 9 months and after 5 yrs old, normal neurologic exam, normal EEG, with a positive family history
Febrile seizure
Lasts a few secs and rarely greater than 15mins, occurs only once in 24hrs
Simple febrile seizure
Lasts greater than 15mins, repeated convulsions occuring with 24hrs, with focal seizure activity
Complex febrile seizure
One seizure lasting 30mins or multiple seizures during 30mins without regaining consciousness usually caused by breakthrough seizures (missed doses of anti-epileptic drugs)
Status Epilepticus (Tx: Phenytoin)
Recurrent headache with symptom free intervals and at least 3 of the ff: (+) family history, relief following sleep, unilateral location, assoc aura, abdominal pain, nausea and vomiting, throbbing in character (F-R-U-A-N-T)
Migraine (Tx: 1. Analgesics - acetaminophen or Ibuprofen 2. Antiemetics - metoclopramide 3. Prophylaxis - Propanolol or Flunarizine)
A phenomenon associated with high CNS hydrogen and potassium ions with release of ntrous oxide that leads to excitation of trigeminal vascular system, release of VIP, vasodilation, extravasation of plasma proteins from dural vessels, inflammation of dural vessels and excitation of pain sensitive receptors
Cortical spreading depression
Most prevalent type of migraine, family history in the maternal side with throbbing or pounding pain in bifrontal and temporal areas, light neadedness, photophobia, osmophobia, and phonophobia
Migraine without aura
Type of migraine with blurred vision, photopsia, and fortification spectra (brilliant white zigzag lines)
Migraine with aura
Treatment for status migrainosus (headache lasting greater than 3 days)
IV Prochlorperazine
Common after onset of puberty, band-like tightness or pressure around the head usually on the frontal region, sometimes in the occipital region, and not associated with nausea and vomiting
Tension Headache
