Neruology (paeds) Flashcards
what is the definition of childhood epilepsy
a chronic neurological disorder characterised by recurrent unprovoked seizures and transient signs of abnormal, XSn syncoronous neoronal activity
what are the types of epilepsy
Generalised - both hemispheres involved
Focal - one part of the brain (lobar)
what are the types of generalised seizure
absence
myoclonic
tonic
tonic clonic
atonic
what are the types of focal seizure
fromtal
temporal
occipital
parietal
a child has an episode where
they loose conciousness suddenly and then regain immediately
transiently and dont recognise the loss of conciousness
mum says : looks like she is day dreaming all the time
what epilepsy is this
absence
a child has an episode where
very brief, usually under 30s
theres repetative jerky movements ie head ‘banging’
what epilepsy is this
myoclonic
a child has an episode where
tall of a sudden they stiffen and fall (increased muscle tone)
what epilepsy is this
tonic
a child has an episode where
sudden increase in tone causing fall
irregular breathing (can cause cyanosis)
rythmic jerking
xs saliva +/- tongue biting
incontenence
lasting a few mins
followed by deep sleep for hrs
what epilepsy is this
tonic clonic
a child has an episode where
theres suddenly someone becomes all floppy (reduced tone)
and can be accompnied with a jerky repetative movement (myoclonic)
what epilepsy is this
atonic
a child has an episode where
they begin marching and waving arms in circular motions transiently
(jacksonian marck +hyperkinetic movements)
what epilepsy is this
frontal lobe
a child has an episode where
they expieriance auditory and sensory phenomane and a feeling of deja vu
theres lip smacking/sucking at clothing
what epilepsy is this
temporal lobe
a child has an episode where
they report having visual distorsion
what epilepsy is this
occipital
a child has an episode where
they have altered sensation on one side of the body and have a distorted body image in that time
what epilepsy is this
parietal
how would you diagnose epilepsy
EEG
CT
PET
what is the management of epilepsy
valproate
carbamezipine
lamotragine
topiramate
GABApentin in focal epilepsy
what are SE of valproate
weight gain
hairloss
liver failure
what are SE of carbamazipine
rash, neutropenia, hyponatremia
what are SE of Lamotragine
Rash
what are SE of GABApentin
insomnia
describe Juvenile Myoclonic Epilepsy
teens affected mostly which have myoclonic seizures (ie repeated jerky movements) shortly after walking
what is early onset benign occipital epilepsy syndrome
unresposive eye deviation
vomiting
headaches and visual disturbances
what is autistic spectrum disorder
children who fail to accquire normal social and communication skills
what is the presentation of autistic spectrum disorder
impaired social interactions
speech and language disorders
imposition of routienes
sensory issues
give examples of impaired social interactions in autistic spectrum disorder
gaze avoidence
not seeking company from others
struggle to understand social roles and ettiquete
what are 3 presentations of speech and language delay commin in autistic spectrum disorder
delayed speech
over literal comprehension of speech
monotenous without body language
how do you manage autistic spectrum disorder
parental support
applied behavioural analysis (20-30hrs x week)
what are the three core behaviours of ADHD
hyperactivity
innatention
impulsivity
what are three signs of hyperactivity (ADHD)
cant remain still
talkative
noisy
what are three signs of impulsivity
interuptting
blurting out answers
difficulty waiting turns
what is the diagnostic criteria of ADHD
scaring 6/9 for innatention and 6/9 for hyperactivity and impulsivity
symptoms before 12y
occuring in more than 1 place
clear evidence of sx interefering with social and academic functions
how do you manage ADHD
behavioural and educational support
atomoxetine (non stimulant)
methylphonidate / dexamphetamine - stimulants
yearly trials off of medication
what tools are used to diagnose ADHD
ADHD nurse classroom observation
SNAP questionarre
quantative behavioural analysis
what is the definition of cerebral palsey
abnormalities of movement and psoture
causing limited activity
non progressive disturbances / injuries whivh occur en utero or when younger than 2y
what is the presentation of cerebral palsey
reduced cognition
disturbed communication
perceptual and sensory disturbances
behavioural disturbances
seizures
sendary msk prolmens
manifesting over ime due to the abnormal brain developing
what are the types of cerebral palsey
spastic : hemiplegic, quadroplegic, diplegic
or
dyskinetic
what are the characteristics of spastic cerebral palsey
increased muscle tone
brisk reflexes
abnormal gait
describe the presentation of hemiplegic cerebral palsey
facial sparing
arms mostly affected
describe the presentation of quadroplegia cerebral palsey
trunk has extensor posturing
poor central tone
all 4 limbs affected equally
usually caused by hypoxic-ischemic injury (HIE)
what is diplegic cerebral palsey
a type of quadroplegic cerebral palsey but legs are affected worse than arms and hand function is good
what is diplegic cerebral palsey associated with
periventricular brain damage
what is dyskinetic cerebral palsey
characterised by involuntary movements
what is the presentation of cerebral palsey
primitive motor reflexes are present
variable tone
involuntray uncontrolled movements : chorea, athetosis, dystonia
intellect intact
developmental delay
EPS
describe chorea
irregular, sudden, brief non-repetative movements
describe athetosis
slow writhing movements occuring distally ie at fingers
describe dystonia
simultanoeus contractions of extensors and flexors of trunk causing twisting
descrbe ataxic cerebral palsey
hypotonic symmetrically with unilateral signs
what is the presentation of ataxic cerebral palsey
delayed motor development
incoordinate movements
intention tremour
ataxic gait
what are febrile convulsions
a fever accompnied by a seizure without an intercranial infection
what age group is usually affected by febrile convulsions
6y-15y
what feature in the Hx would reassure youits a febrile convulsions
early in illness/fever
whentemp is still rising
what are the features of febrile convulsions
breif
tonic clonic
no brain damage
only once x illness
what are features of a complex febrile convulsions
focal seizure
prolonged
repeated illness
have high risk of developing subsequent epilepsy
what must you do in any ?febrile convulsions
exclude meningitis =
blood and urine cultures
LP if younger than 18m
what is the acute management of a febrile conculsion/ status epilipitcus
A B C
measure BMs
IV lorazapam > (10mins)> Iv lorazapam> (5mins)> IV lorazapam> phenytoin over 20 mins IV> phenobarbitol >PICU
what is the acute management of a febrile conculsion/ status epilipitcus IF you cant get Iv access
A B C
BMs
Ciazapam PR or Midlazapam (per osseus - POs)> 10min> paraldehyde PR> get special assistance
what is the definition of anorexia nervosa
slimming through self restriction (calorie)
and
a phobia of normal body weight
what is the presentation of Anorexia
self induced weight loss
low BMI
laxatives/vomiting/ XS ecersise
Halted pubertal developments
Food idealisation
Slow reflexes
Ankle oedema
XS hair
what is the management of Anorexia
therapy
fam therapy
fluoxetinerefeeding
psychoeductaion
what is bulimia
self induced bouts of overeating and purging via:
vomiting/laxatives/diuretics
what is the presentation of bulimia
wide fluctuations in weight but gereally normal BMI
acidosis
