Neuro Flashcards

1
Q

Absence seizures

A

Females

Periods of absence/ stop what they are doing  but they remain conscious 
Can be misdiagnosed as 
- ADHD
- Behavioural problems
- Hearing problems 
- NAI 

EEG - 3Hz spike and wave
Hearing test
ADHD assessment

Management
Valproate
Ethosux
Not carbemazapine

Prognosis

  • can –> JME in later life
  • Can –> tonic clonic
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2
Q

prognosis of absence

A

10% –> JME

can also –> tonic clonic

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3
Q

JME

A

Presentation
Throwing their cornflakes - jerky movements
Teens - females
can be absence seizure in childhood then –> JME
can also have absence + TC

EEG - polyspike and wave

Management
Valproate

Not associated with other conditions later in life but need to be on lifelong Rx

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4
Q

West syndrome

A

Salaam attacks - can be up to 50 times
lasts 1-2 seconds per jerk
INFANTILE SPASMS - 4-6 months

EEG - hypsarrythmia

Management
Vigabatrin

Prognosis - poor
progressive mental handicap

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5
Q

Febrile seizure

A

when there is a RAPID RISE in temp
eg remember roseola infantum

Give paracetamol to bring temp down

partial = 1-2% risk of developing epilepsy
Complex = 2-4% risk of developing epilepsy
Future febrile seizure risk 1/3

Tonic clonic risk in later life

Management
buccal midaz
rectal diazepam

When to worry 
>1hr to recover 
Partial seizure 
1st seizure 
>1 in 24hrs 
>15m
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6
Q

Lennox gestau

A

Ketogenic diet

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7
Q

ADHD

Presentation

A

epidemiology
4-7%
Males

1) Inattention
2) Hyperactivity
3) Impulsivity

Investigations
- School nurse reports, school reports, home report

Management 
- watch and monitor for 10 weeks 
- ADHD parenting program 
- Pharmacological 
methylphenidate (trial for 6w)
Lisdexamphetamine 

Monitor weight as can cause reduced appetite and weight loss, stunted growth
Cardiotoxic - do ECG

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8
Q

Autism

A

Triad

1) Global language +communication impairment
2) Impaired social skills
3) Repetitive, ritualistic

Investigations

Management
timetables
parenting therapy
Applied behavioural analysis

Complications

  • Learning difficulties
  • Seizures
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9
Q

Congenital cataracts

A

associated with rubella
Loss of light reflex
done

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10
Q

Squints

A

Aetiology
- 60% hereditary

Types
Concomitant - imbalance of extra-ocular muscles - usually convergent

Paraplegic - paralysis of one or more extra ocular muscles (rarer) - sinister - can be due to SOL

Investigations

  • Cover test
  • Corneal light reflex - should reflect back symmetrically
  • visual acuity test
  • MRI if suspect sinister lesion
Management 
- prevent amblyopia 
Patch 
Glasses 
Prism 
Surgery - to cut the muscles
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11
Q

Cerebral palsy

Types + presentation

A
Types 
1) Spastic 
Damage to the motor cortex - UMN - cerebral malformation eg maternal infection 
Symptoms 
- ^tone, ^ reflexes, upping plantars, clasp knife 
Types 
- Hemiplregic - tip toe walk
- Diplegic - PVL - knock knee 
- Quadraplegic - extensor posturing 
2) Dyskinetic 
Problem in the basal ganglia + extrapyramidal tracts - associated with HIE 
- Chorea 
- Athetosis - writhing movement 
- Dystonia 

3) Ataxic - lesion in the Cerebellum
- Broad gait
- Hypotonia
- Poor balance

4) Mixed (in the name babes)

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12
Q

Cerebral palsy
definition
early presentation

A

Non progressive disorder of movement and posture that occurs in the developing CNS

Early presentation

1) Poor feeding
2) Delayed motor miles stones
3) Asymmetrical hand use <1
4) Hypotonia
5) Abnormal gait
6) Persistent primitive reflexes

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13
Q

Cerebral palsy aetiology

A
Antenatal 80%
- Infection 
- Genetics 
- Vascular occlusion 
Birth 
- Cord compression 
- Uterine rupture 
- (HIE)
Post birth
- trauma 
- meningitis 
- PVL
- BPD 
- Kernicterus
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