Neuro Flashcards
def. of epilepsy
chronic, recurrent, unprovoked seizures
- 2 or more afebrile seizures
main types of seizures
- partial - discrete areas of brain
- simple - focal neuro signs with no impaired consciousness
- complex - focal neuro with impaired cons - generalized - whole brain
- absence - staring spells, consc impaired
- myoclonic - rapid jerks
- tonic - rigid and stiff
- clonic - rhythmic jerks
- tonic-clonic - jerk and stiff
- atonic - loss of tone
DDx for seizure
- syncope
- breath holding spells
- GERD
- self stim behaviour - ASD
- chorea
Phx for seizures
- ABC
- general for Infeciton
- neuro exam - LOC, meningitis, focal neuro
imaging for seizure
- labs based on Hx
- CT or MRI
- LP to examine CSF
- ECG, EEG
mgmt of seizure
- rule out provoked causes meds after 2 unprovoked or 1 unprovoked with abnoral EEG - valproic acid for general - carbamazepine for partial surgical
def. status epilepticus
def is 30 minutes, but should treat if longer than 5
mgmt of stat epi
p 208
2 main types of febrile seizures
- simple febrile - brief, generalized and once in 24 hrs
2. complex - >15 mintues with or without focal features or recurs in 24 hours
tests for febrile seizures
- labs as indicated
LP - for those under 12 months
- or meningeal signs
mgmt of feb. seizure
safety - none in mouth, roll on side
- treat infection
- Tx of fever not effective
prog. of febrile seizures
simple
- increased risk of another
complex
- increased risk of epi, not another febrile
most common headache in children
migraine
5 main classes of HA and some types
- acute general
- infections
- CSF leak
- post-ictal
- HTN - acute local
- sinusitis
- AOM
- TMJ
- eye strain - acute recurrent
- migraine
- cluster
- tension
- exertional - chronic progessive
- ICP
- CNS tumor
- pseudotumor cerebri
- venous thrombus - chronic non-prgressive
- depression
- chronic tension
- post-concussion
- caffeine or analgesic induced
when to image HA (red flags)
- neuro Sx
- progressive pattern
- new or severe
- increased with strain,cough sneeze
- explosive or suddne
- systemic Sx
- sleep related - in AM or wakes up
- clinical suspicion
mgmt for all HA
- education
- sleep hygene
- diary
- exercise, regualr meals
mgmt of migraines
- tylenol
- advil
- 5-HT1 agon
- triptans
mgmt of tension
advil/tylenol
def. of cerebral palsy
non-progressive motor impairments caused by lesions or injuries to dev. brain
- hypertonia is primary abnormality
risk factors for CP
- premature
- LBW
- breech birth
- multiples
- toxins
- maternal seizures
- asphyxia
- hemmorage
- post-natal meningitis
4 main types of CP
- spastic - stiffness
- hemi, di or quadraplegic - ataxic
- dyskinetic - invol, uncontrolled movements
- mixed
Phx for CP
- complete PE
- screen for accompanying impariments
- neuro exam
invest for CP
MRI - for etiology and timing
EEG - only in children with CP and suspected sizures
mgmt of CP
- physio
- OT
- speech therapy
- assistive devices
- medical therapy
def. of hypotonia
reduced restistance to passive ROM in joints
DDx for hypotonia
- cerebral
- congenital
- chromosomes
- metabolic - spinal cord disorders
- hypoxic ischemic myelopathy - polyneuropathies
- disorders of neuromusc. transmission
- MG or botulism - muscular dystrophies
important part of HPI
onset - floppy at birth or progressive
maternal Hx questions for hypotonia
- toxins
- decreased fetal movelment in utero
- APGAR
Phx for hypotonia
- tone
- lying
- horizontal suspension
- vertical suspension
- in traction - strength/power
- muscle bulk
- deep tendons
- plantar response
- laxity
labs for hypotonia
- CBC
- ext. lytes
- LFTs
- renals
- Ammonia
- glucose
- karyotype/FISH
imaging for dystonia
MRI for central
neuromusc. tests for hypotonia
CK
EMG
muscle Bx
table for hypotonia
p216
most common causes of head trauma
- falls
- sports related
- hit with object
- bike or MV
classification of severity by GCS
mild - 14-15
mod - 9-13
severe
when to xray head
when to CT (CATCH rule) 7
any of
1. GCS
mgmt of mild, mod and severe head
mild - DC to respnosible parents - observe if LOC mod - CT severe - stabilize and intubate, then CT - then trauma center
def. concussion
mild TBI caused by mech forces
main Sx of concussion
usual Sx - HA, NV, dizzy, photo/phonophobia behav. changes cog impairments sleep disturbances
red flags for concussion
- worsening HA
- seizures
- increased confusion
- cannot recognize ppl and places
- strange behav. changes
- repeated vomiting
Phx for concussion
HEENT exam CNs motor - pronator drift sensation reflexes balance coordination cognition
mgmt of concussion
graded return to work/play
see table p221
