Neurology

Question 1

Febrile Seizures

Answer 1

2-4% children between 6mo to 6yrs old
Peak incidence 5 months

DEF
Convulsion when temp >38C
Appropriate age range (6mo to 6yrs)

SIMPLE
Generalised
< 15mins
1 per 24hrs
Child returns to baseline quickly

COMPLEX
Focal, > 15 mins or >1 in 24 hrs
Younger and abnormal development
Higher risk of recurrent febrile seizures and non-febrile siezures

Question 2

Febrile Seizure Prognosis

Answer 2

• Recurrence common and related to age of first seizure + height of fever
• 33% will have recurrent febrile seizure (75% within a year)
• Increased risk of febrile convulsion with
  
  • Complex febrile seizures
  • DD
  • FHx
  • Age < 1yr = 50% recurrence
  • Temp at onset - Fever 38.5 (35% recurrence) vs 40.0 (13% recurrence)
  • FHx
• Risk of afebrile seizures 1-2% vs 0.5-1% in gen pop
• Increased risk of seizure disorder with
  
  • Complex febrile seizures
  • DD
  • FHx

Question 3

Ataxia

Answer 3

https://www.rch.org.au/clinicalguide/guideline_index/Ataxia

Question 4

Head injury indications for CT

Answer 4

GCS<14
Focal neurological deficit
Skull #
Signs skull # - haemotynpanum, raccoon eyes, CSF Leak, battle sign
Penetrating injury
Post traumatic seizure

Other considerations
Hx LOC
Persistent vomiting
PTA
Mod to severe HA
Bleeding risk

Severe mechanism of injury
MVA > 60km/hr, ejection, rollover, death passenger
Car vs pedestrian
Fall >1m in <2yo, >1.5m >2yo
Head struck by high impact object