Neuro Flashcards
In which age group may ‘Kernig’s sign’ not be present in meningitis?
Under 18months.
May present as non-specific drowsiness, fever, irritability, poor-feeding.
Kernig’s sign- neck stiffness
When is a lumbar puncture contraindicated??
Prolonged or focal seizure Focal neurology Purpuric rash Gcs<13 Abnormal pupils or posture Coagulation disorder Cushings triad (low hr, high bp, irregular resp)
What is the appropriate step wise management for status epilepticus?
1) buccal medazolam/ iv lorazepam
2) Iv lorazepam
3) iv phenytoin (iv phenobarbital if on Reg phenytoin)
4) rapid sequence control using general anaesthetic using thiopental sodium
What symptoms would you get if the cerebellar was affected?
Tremors
Mystsgmus
Gait instsbility
Speech difficulty
Hyperventilation can trigger what type of seizures ?
Absence epilepsy
Rx- ethosuximide
If associated with other seizure types give sodium valprorate
What is the commonest neuromuscular disease/dystrophy?
Dystrophinopathy (duchennes muscular dystrophy) 1/3500 live boys
What disease modifying agent can be give in duchenne muscular dystrophy?
Glucocorticoids
What is Charcot-Marie-tooth disease?
AD demyelinating peripherals neuropathy (pmp22 gene)
Leads to distal weakness and atrophy and sensory loss.
What is spinal muscular atrophy?
Disorder of the SMN1 gene. Low levels in the anterior horn of the spinal cord leads to loss of function and muscle wasting.
What causes a floppy baby?
Cerebral
- IVH, hydrocephalus
- structural abnormality
- chromosomal disorders
- perxisomal
Peripheral
- anterior horn cell (SMA)
- demyelination -
- axonal neuropathy
- myasthenia syndromes
- congenital muscle disease (dystrophy, myopathy, myotonic dystrophy)
What is tuberous sclerosis?
Neuro-cutaneous disease
Depigmented ‘ash leaf’ spots, rough skin on lumbar spine,
Development delay, epilespsy, intellectual impairment
What is Rolandic epilepsy?
Infrequent partial fits. Unilateral or oropharyngeal sensory motor symptoms. Speech arrest. Hypersalivation
Rx rarely needed, sulthiame sometimes uses.
Causes of meningitis in neonates?
Group b strep
Listers
E. Coli
Treatment for meningitis?
Ceftriaxone
What is seen on eeg in west syndrome epilepsy?
Hypsarrthyimia - chaotic pattern, slow sharp waveforms.
Age 4-6months
Salaam attacks (on waking), low Iq
Rx : vigabatrin
