Neuro Flashcards
Indications for neuro imaging
cerebellar dysfunction
raised ICP symptoms
focal neurological deficit (new squint)
seizures (esp focal)
personality change
unexplained deterioration of school work
how do you treat a migraine?
acute attack: triptans
Preventative: propranolol, amitriptyline, valproate
how do you treat tension type headaches?
treat underlying physical, psychological or emotional problems
simple analgesia
amitriptyline
what symptoms would point towards childhood migraine?
abdominal pain, N+V
focal signs (visual disturbance, paraesthesia, weakness)
‘pallor’
aggravated by bright light/ noise
relation to fatigue/ stress
FH
helped by sleep/ rest/ dark, quiet room
symptoms of a tension type headache
more of a ‘constant ache’
band-like distribution
present most of the time but there are periods where people are symptom free
convulsion
seizure with prominent motor activity
epilepsy
recurrent, unprovoked (spontaneous) epileptic seizures
non-epileptic type seizures
acute symptomatic seizures (hypoglycaemia, hypoxia, infection, trauma)
reflex anoxic seizures
syncope
parasomnias (night terrors)
what is a febrile convulsion?
seizure occurring in infancy/ childhood usually between 3 months and 5 years
associated with fever but without evidence of intracranial infection/ any cause for a seizure
what is the most common cause of an acute symptomatic seizure in a child?
febrile convulsion
jerking shaking seizures are what type?
clonic, myoclonic, spasms
stiff seizures are what type?
tonic
falls in children that are having seizures are what type?
atonic, tonic, myoclonic
vacant attack seizures are what type?
absence, complex partial seizure
questions to ask when diagnosing epilepsy!
is the paroxysmal event epileptic in nature?
is it epilepsy?
what seizure type?
what is the aetiology?
what are the social and educational effects on the child?
EEG is useful in what?
identifying seizure types, syndrome and aetiology
diagnosing epilepsy involves:
history
recording of event
ECG in convulsive seizures
EEG
MRI of brain (aetiology)
genetics
how do you manage epilepsies in children?
anti-epileptic drugs (only if diagnosis is clear - they control seizures not cure it)
(slow upward titration)
what drugs are used in the management of epilepsy?
sodium Valproate
levetiraceptam
carbamezapine
how do you assess a child with an unusual head?
occipitofrontal circumference
sutures and fontanelles
asymmetry in the face
large and small heads
macrocephaly
microcephaly
microcephaly
small brain
macrocephaly
big head
