Neuro Flashcards
What is migraine associated with?
FH
What is the oresentationof a migraine?
Headache- unilateral, severe, throbbing, photo and photophobia
Focal s+s= visual disturbance, paraestoesia, weakness
pallor
Associated abdominal pain, N&V
What is the acute management of migraine?
Analgesia- paracetamol, ibuprofen, triptans
Antiemetics
What is the indication for preventative management of migraines?
At least 2 a month
What are the options for prevention of migraines?
Propanolol
Pizotifen
Topiramate
What are the indications for imaging in headache?
Features of cerebellar dysfunction Features of raised ICP New focal neuroleptic deficit Seizures Personality change Unexplained deterioration in schoolwork
What is epilepsy?
Tendency to recurrent seizures caused my abnormal electrical activity int he brain
What type of seizures are normally seen in children?
Generalised
Absence typically in kids
What investigations are done for a 1st generalised seizure>
ECG
FBC, U&Es, glucose
What investigation is done for a 2nd generalised seizure?
ECG
FBC, U&Es, glucose
EEG
When is MRI done for seizures?
<2yo
Focal seizures
Not responding to treatment
What is the management of generalised seizures?
1st= sodium valproate 2nd= lamotrigdine, carbamazepine
What is the management of absence seizures?
1st= ethosuximide 2nd= sodium valproate
What is the management of focal seizures?
1st= carbamazepine, lamotrigdine 2nd= sodium valproate
What is the management of status epilepticus?
Hospital= IV lorazepam Community= buccal midazolam, rectal diazepam
What are some non pharm options of epilepsy management?
Ketogenic diet
Vagus nerve stimulation
Surgery
What are some types of non epileptic seizures/seizure like activity seen in children?
Febrile convulsions Reflex anoxic seizures Psychogenic Syncope Parasomnias Behavioral stereotypes
What are febrile convulsions?
Brief and generalised tonic/tonic-clonic seizure caused by rapid rise in temp in viral infection
What age are febrile convulsions seen in?
6 months- 5yo
What is the presentation of febrile convulsions?
Usually <5 mins
Tonic-clonic/tonic
What is the prognosis of febrile convulsions?
1/3 ill have another
Anti-pyrexials don’t decrease chance of another
What is the inheritance of Duchenne MD?
X linked recessive
What is the presentation of Duchenne MD?
3-5yo Delayed gross motor skills Symmetrical proximal weakness Waddling gait Calf hypertrophy Gower's sign + Cardiomyopathy Respiratory involvement as progresses
What is Gower’s sign?
Uses arms to get to standing from lying due to pelvic girdle weakness
What investigation is done for Duchenne MD?
CK- elevated
What is the management of Duchenne?
Oral steroids- slow progression
Creatinine supplementation
Supportive
Whatis the prognosis of Duchenne?
25-30 year life expectancy
What is Beckers MD?
Like Duchenne but less severe
What is myotonic dystrophy?
Usually presents in adulthood
key feature= prolonged muscle contractions- if you shake their hand, they will hold on unable to let go
What is cerebral palsy?
Disorder of movement and posture due to non progressive lesion of motor pathway in developing brain
What are the causes of cerebral pals?
Antenatal= 80%
Intrapartum 10%
Postnatal= 10%
What are the antenatal cases of cerebral pals?
Cerebral malformation
Congenital infection- rubella, toxoplasmosis, CMV
What are some intrapartum causes of cerebral palsy?
Asphyxia
Trauma
What are some post natal causes of cerebral palsy?
Intraventricualr haemorrhage
Meningitis
Trauma
What is the most common type of cerebral palsy?
Spastic
What is associated with cerebral palsy?
Learning difficulties
Epilepsy
Hearing impairment
What is the presentation of cerebral palsy?
Failure to meet milestnes
Increased or decreased tone
Problems with coordination
Hand preference <18 months
What is the management of cerebral palsy?
Spasticity= diazepam, baclofen, Botulinum toxin A
Surgery
