Neuro Flashcards
Most common soft tissue tumor
Rhabdomyosarcoma
Malignancy with the highest mortality?
PNET
Formerly known as partial seizure
Initial activation of neurons limited to part of 1 cerebral hemisphere
Focal seizures
Most common type of benign epilepsy stndrome with focal seizure
Benign childhood epilepsy with centrotemporal spike
Rolandic seizure
3-10 years old Outgrown during adolescence Buccal and theoat tingling and tonic or clonic contraction Preserved consciousness EEG: broad based centrotemporal spike
Benign epilepsy syndrome with focal seizure
Treatment for benign epilepsy with focal seizure
AED such as carbamazepine
Seen in early childhood
Complex partial seizure with ictal vomiting
Benign epilepsy
Panayiotopoulus type
Seen in late childhood
Complex partial seizure with visual auras, migrain headache
Benign epilepsy
Gastaut type
Early myoclonic infantile encephalopathy starts during the 1st 2 months
Severe myoclonic seizures and burst suppression pattern on EEG
What is the usual cause
Inborn errors of metabolism
Similar onset with Early myoclonic infantile encephalopathy but manifests as tonic seizures
Caused by brain malformations or syntaxin binding protein mutation
Ohtahara syndrome
Early infantile epileptic encephalopathy
Starts as focal febrile status epilepticus and later as myoclonic and other seizure types
Dravet syndrome
Severe myoclonic epilepsy of infancy
Usually 2-12 months Triad: infantile epileptic spasms developmental regression hypsarrhythmia on EEG
“As if doing sit ups”
West syndrome
2-10 years old Triad: Developmental delay Multiple seizure type Slow waves, polyspike bursts in sleep and slow background in wakefulness
Lennox-Gastaut
Treatment for focal seizure
Carbamazepine
Treatment for absence seizure
Ethosuximide
When to do lumbar tap?
Local guidelines: <18 months
All infants younger than 6 months who present with fever and seizure or at any age if there are symptoms of concern
Major risk factors for recurrence of febrile seizures
Age <1 year
Duration of fever <24 hours
Fever 38-39C
Most common seizure disorder during childhood
Simple febrile seizure
Febrile seizure becomes complex type when the duration is _____ and repeat seizures occur within ______
More than 15 mins
Less than 24 hours in between
Status epilepticus that has failed to respond to at least 2 medications
Refractory status epilepticus
Initial emergent therapy for status epilepticus usually involves
IV diazepam, lorazepam, midazolam
What viral infection is most commonly associated with febrile status epilepticus?
HHV 6 and 7
Greatest risk of occurrence of subsequent epilepsy when the child has
Neurodevelopmental abnormalities
Triad of Imaging Findings in TB Meningitis
Hydrocephalus
Basal enhancements
Infarcts
Usual cause of obstructive or non communicating type of hydrocephalus
Aqueduct stenosis
CSF flow pattern
Come Let Me Treat Sisa For Lunch Maybe Somewhere in Ayala
Choroid plexus Lateral ventricle Foramen of Monroe Third Ventricle Aqueduct of sylvius Fourth ventricle Lushka/Magendie Sinus Arachnoid
Prefrontal headache
High fever
Disturbance in smell
Swimming in warm water
Naegleria fowleri
Bell’s palsy
Systemic disease
Carditis
Cutaneous lesions
Borrelia burgdorferi
Ascending paralysis with history of GI infection
Campylobacter
Ascending paralysis with history of respiratory infection
Hib
Lethargy and irritability
History of viral infection
Chicken pox
Asprin use
Reye syndrome
Ocular nerve palsies
History of TB or active TB
TB meningitis
Indications for surgery in brain abscess include: Presence of gas Multiloculated Fungal Associated infection like mastoiditis And in what location in the brain?
Posterior fossa
Empiric treatment for brain abscess
3rd gen cephalosporin and metronidazole
Neisseria meningitidis carriage is usually found in this organ
Nasopharynx
Preferred treatment for Neisseria meningitis
Ceftriaxone
Poor prognostic factors for meningitis
Petechiae <12 hours before admission
Absence of meningitis
Low or normal ESR
Antibiotic prophylaxis for meningitis
Rifampin
Fulminant form of meningococcemia where there is adrenal hemorrhage without vasculitis, DIC, coma and death
Waterhouse - Friderichsen syndrome
Drug of choice for meningococcemia
Penicillin G
Antibiotic prophylaxis in meningococcemia for children and adults
Children: rifampin 4 doses
Adults: Ciprofloxacin single dose
Sepsis, seizure, irritability, lethargy, bulging fontanelles, rigidity, patient less than 2 months old
GBS
Headahce, fever, confusion, lethargy, nuchal rigidity, vomiting
No proper vaccination
<5 years old
Hib
Headahce, fever, confusion, lethargy, nuchal rigidity, vomiting
Properly vaccinated, abrupt onset, toxic looking rashes all over
N. meningitidis
Headahce, fever, confusion, lethargy, nuchal rigidity, vomiting
Young adults
S.pneumonia
Pneumococcus
Headahce, fever, confusion, lethargy, nuchal rigidity, vomiting
Renal transplant patient
Listeria
Headahce, fever, confusion, lethargy, nuchal rigidity, vomiting
Gradual onset, not toxic looking
Enterovirus
Headahce, fever, confusion, lethargy, nuchal rigidity, vomiting
RBC in CSF
HSV
Most severe form of neural tube defect
Meningocele
Meningocele results from the failure of the neural tube to close in the week of development
3rd and 4th
Most common site of meningocele
Lumbosacral
Meningocele is associated with what type of Arnold Chiari malformation?
Type 2
Arnold Chiari malformation that includes elongation of cerebellar tonsils in the vertrebral canal
Type 1
What type of Arnold Chiari malformation includes elongation of the posterior vermis and brainstem with myelomeningocele and hydrocephalus?
Type 2
What type of Arnold Chiari malformation includes a bony defect at occipitocervical level with herniation of cerebellum into encephalocele?
Type 3
Pathogenesis of aura in migraine is called
Cortical spreading depression
Prophylaxis for migraine
Propanolol
Neurocutaneous syndromes usually arise from a defect in differentiation of this embryonic structure
Primitive ectoderm
Tuberous sclerosis has characteristic brain lesions called tubers that are usually present in what area of the brain?
Subependymal region
In tuberous sclerosis, The tubers in the brain undergo calcification and produce this appearance in imaging
Candle dripping appearance
Infantile spasm
Hypopigmented lesions -ash leaf
Shagreen patch- orange peel lesion in lumbosacral region
Subungual fibromas
Mulberry retinal tumors, rhabdomyosarcoma of the heart
Tuberous sclerosis
Von recklinghausen disease is located on what chromosome?
Chromosome 17
Most prevalent type of neurofibromatosis
NF 1
Cafe au lait spots sparing the face are included in the criteria for diagnosis of neurofibromatosis. How many should be present?
6 or more that is >5mm in prepubertals and >15 mm in post pubertals
How many criteria should be fulfilled for the diagnosis of neurofibromatosis?
2/7
Hamartomas within the iris in neurofibromatosis is also called
Lisch nodules
This finding is present in NF 2
Acoustic neuroma
Infection usually implicated in the development of Guillain Barre syndrome
Campylobacter jejuni
HSV
This is usually the last function to recover in GBS
tendon reflexes
Usually the last symptom to resolve in GBS
Lower extremity weakness
CSF finding in GBS
Increased protein
Normal glucose
Normal cells
Most common site of medulloblastoma
Cerebellum
Homer Wright rosettes
Medulloblastoma
Most common infratentorial tumor and the best prognosis
Cerebellar astrocytoma
Supratentorial
Solid and cystic areas that tend to calcify
Short stature
Pressure to optic chiasm- visual defects
Craniopharyngioma
Most common cause of arterial ischemic stroke in children
Arteriopathy
Type of intracranial hemorrhage associated with trauma
Epidural
Type of intracranial hemorrhage associated with abusive trauma
Subdural
Most common cause of childhood subarachnoid and intraparenchymal hemorrhagic stroke
AV malformation