Neurology

Question 1

What does head circumference measure?

Answer 1

Brain growth

Question 2

How does hydrocephalus present physically?

Answer 2

Increased head circumference

Question 3

What causes hydrocephalus?

Answer 3

Excess production or blockage of drainage of CSF

Question 4

Core signs of neurological conditions

Answer 4

Developmental delay
Floppy infants
Acute confusion
Sleep disturbances
Disturbed vision/hearing
Numb/tingle/weak
Abnormal behaviour
Psychomotor regression
Speech disorders
Back pain
Peripehral weakness
Funny walk, foot deformity
Eye movement abnormalities
Abnormal facial movements/sensation

Question 5

If problem with motor cortex what causes?

Answer 5

Problems with muscle power and tone

Question 6

General physical neurological exam. Cushings triad, signs of raised ICP

Answer 6

Anterior fontanelle - bulging, depressed
Signs of raised ICP - irritability, confusion, decreased consciousness, posturing, bulging fontanelle/enlarged OFC, sun setting
Cushings triad - wide pulse pressue, HTN, bradycardia

Question 7

Neuro exam

Answer 7

AVPI
GC if older
Pupils equal and reactive to light and accomodation
Head injury 0 brusiing, blood, CSF from nose/ears, open wounds
Meningeal signs
Cranial nerves
Limbs: bulk, tone, power, co-ordination, reflexes, gait

Question 8

What is dravets syndrome

Answer 8

Severe myoclonic epilepsy of infancy with recurrent febrile or afebrile hemiclonic or generalused seizures or status epilepticus when previously well
Resistant to antiepileptics
Developmental arrest or regression
Up to 15 months age onset
15% mortality

Question 9

What is lennox gastaut syndrome

Question 10

What is juvenile myoclonic epilepsy

Answer 10

Teen years
Early morning myoclonic jerks, arms and shoulders
GTC later evolve
Autosomal dominant

Question 11

What is panayiotopoulos syndrome

Answer 11

Common multifocal autonomic childhood disorder
3-6 years onset
Prolonged seizures, auatonomic smyptoms eg ictal vomitting
Occipital dominance with shifting focus on EEG
Confused with non epileptic disorders

Question 12

Benign rolandic epilepsy

Answer 12

Also benign focal epilepsy
Nocturnal seizures - twitching, aphasia
4-10 years, more common in boys

Question 13

Benign childhood epilepsy with centretemporal spikes

Answer 13

Older children - focal or generalised seizures
Large spikes on EEG - Rolandic area (dont confuse!!)
Not ass with structure, excellent prognosis

Question 14

What to do when EEG gails

Answer 14

Sleep/sleep deprication EEG

Question 15

When do MRI for epilepsy

Answer 15

> 2 seizures
Focal onset
First line Antiepileptics dont work