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Year 5 > Neurology > Flashcards

Neurology Flashcards

1
Q

What are they main types of spina bifida?

A

Spina bifia occulta- mild and most common. 1 or more posterior spinal arches missing - small gap in the spine
Meningiocoele - meninges protrude through the defect of the spinal arches. CSF filled.
Myelomeningeocoele - the spinal cord and its covering herniates through the defect. Severe and causes neurological problems - If above L3 affected may be non-ambulant

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2
Q

What is cerebral palsy?

A

A permanent neurological condition that occurs due to damage of the brain around the time of birth. Esp hypoxic-ischaemic-encephalopathy
‘A dynamic and changing disorder of posture and movement due to a NON-progressive lesion to a developing brain’

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3
Q

How might a child with cerebral palsy present?

A
  1. Not meeting milestones e.g. not sitting by 8 months and not walking by 18 months
  2. Inc or dec tone generalised or in specific limbs
  3. Hand preference before 18 months *
  4. Walking on tip toes
  5. Problems with coordination, speech or walking
  6. Problems with swallowing or feeding
  7. LD
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4
Q

What is Muscular dystropy?

A

Umbrella term for genetic conditions causing gradual weakness and wasting of muscles.
Duchennes and beckers - both X-linked mutations in the dystrophin gene

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5
Q

What is myotonic dystrophy and what are some features?

A

Mutation to DMPK. Presents in adulthood
Muscle weakness
*Prolonged contraction
Cataracts, cardiac arrythmias

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6
Q

What is the normal ICP?

A

0-10mmHg

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7
Q

What are some causes of hydrocephalus?

A

Congenital - congenital arachnoid cyst, arnold chairi malformation, spina bifida, aqueduct stenosis
Acquired - infection, haemorrhage, tumour

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8
Q

What is a febrile convulsion?

A

A seizure occurring in a child with a high fever

~6m-5y

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9
Q

What is a simple febrile convulsion?

A

A generalised tonic clonic convulsion, lasting < 15min, with only a single seizure in that febrile period

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10
Q

What is a complex febrile convulsion?

A

A partial or focal seizure lasting >15min, with multiple per febrile episode

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11
Q

What is a tonic clonic seziure?

A

Loss of consciousness with muscles tensing then jerking. Associated with incontinence, tongue biting, irregular breathing.
Prolonged post-ictal period where they may feel irritable, low or confused.
1st - Na valproate

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12
Q

What is a focal seizure?

A

Usually starts in the temporal lobe. Associated with memory, hearing, speech or emotions. E.gs. hallucinations, deja vu, flashbacks (e.g. a smell)
1st - Lamotrigine or carbamazepine

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13
Q

What are absence seizures?

A

Usually in childhood. Go blank and stare into space. Abruptly goes back to normal. During episode they are unaware of environment and will no respond.
1at - Na valproate

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14
Q

What is an atonic seizure?

A

‘Drop attack’, brief lapses in muscle tone. Last <3min. Associated with Lennox-Gastaut syndrome??
1st - Na valproate

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15
Q

What is a myoclonic seizure?

A

A sudden brief muscle contraction, like a ‘jump’. Patient remains awake. Common in juvenile myoclonic epilepsy
1st - Na valproate

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16
Q

What is a stroke?

A

Rapid onset cerebral deficit (usually focal) lasting >24hours or leading to death

17
Q

What is a TIA?

A

A transient episode of neurological dysfunction due to a temporary focal cerebral ischaemia without infarction, lasting <24 hours with complete recovery
Triaged by ABCD2

18
Q

Where is broca’s area?

A

Left inferior posterior frontal gyrus

19
Q

Where is wernicke’s area?

A

Left superior-posterior temporal gyrus

20
Q

What are the causes of an ischaemic stroke?

A

Primary thrombosis - In the vessel itself

Secondary to an embolic - MI, AF

21
Q

How do you manage an ischaemic stroke?

A

Onset within 4.5hr - Thrombolysis (IV alteplase)
>4.5h - 300mg Aspirin immediately
Within 6h - Endovascular surgery to remove the clot

22
Q

What is a hemiplegic gait?

A

Where there is circumduction of the leg to prevent dragging the foot
Due to a CNS lesion, unilateral weakness and spasticity.
Spastic flexion of upper limb and extension of lower

23
Q

What is a diplegic gait?

A

Like hemiplegic but bilateral.
Hips and knees flexed and abducted with ankles extended and IR. Knees forced together causing overlap and so circumduction of both legs - scissoring

24
Q

What is a parkinsonians gait?

A 
Slow or hesitant INITIATION
STEP LENGTH is reduced and may get smaller as they attempt to retain balance (shuffling)
Reduced ARM SWING
Flexed neck and trunk - stooping POSTURE
RESTING TREMOR
Impaired balance on TURNING
25
Q

What is an ataxic gait?

A

Cerebellar, vestibular or loss of proprioception

  1. Broad based gait
  2. Staggering, slow and unsteady
  3. Difficulty turning
26
Q

What is a neuropathic/ high stepping gait?

A

Due to weak dorsiflexion of foot. Hips and knee flex excessively to compensate for foot drop - high step
Common peroneal injury?

27
Q

What is a neurodegenerative disease?

A

Progressive and selective loss of neurones/ dysfunction due to depositions of pathologically altered protein causing functional and clinical symptoms

28
Q

When tau becomes hyperphosphorylated it can become an insoluble neurofibrillary tangle, what conditions may arise?

A 
Alzheimers dementia 
Frontotemporat dementia 
Progressive supranuclear palsy 
Corticobasilar degneration
Chronic truamtic encephalopathy
29
Q

What may been seen on MRI in progressive supranuclear palsy?

A

Atrophy of the midbrain

Dementia, vertical gaze palsy, falls

30
Q

When alpha synuclein gets misfolded, it forms lewy bodies, what pathology has lewy bodies?

A

Multiple systems atrophy (parkinsonism + cerebellar/autonomic features)
Parkinsons
Lewy body dementia

31
Q

Where in the spinal cord do the sympathetic neurones run?

A

T1-L2

32
Q

Where in the spinal cord do the parasympathetic neurones run?

A

Brainstem (CN 3,7,9,10)

S2-S4

33
Q

What signs might indicate FTD?

A

Frontal release signs - ‘release’ of primitive reflexes that are normally inhibited - palmomental reflex, grasp relfex, glabellar tap, snout and rooting relfexes

34
Q

What things are seen histologically in FTD?

A

Picks bodies

35
Q

How would you treat an acute attack of migraine and what would you use as preventative?

A

Acute - Triptans + NSAIDs or Triptans + paracetmaol

Preventative - Topiramate or propranolol

Year 5 (9 decks)

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