Neurology Flashcards
Define syncope
Fainting - term used to describe the event of temporarily losing consciousness due to a disruption of blood flow to the brain, often leading to a fall.
Signs of syncope
Prodrome - hot clammy, sweaty, Heavy, dizzy or lightheaded, vision going blurry or black, headache
Sudden loss of conciousness and falling tot he ground
Unconscious for a few seconds
May be some twitching shaking or convusion activity
Slightly groggy but no true post ictal period
May lose continence
Causes of syncope
Dehydration
Missed meals
Extended standing
Vasovagal response
Secondary
Hypoglycaemia
Dehydration
Anaemia
Infection
Anaphylaxis
Arrhythmias
Valvular heart disease
Hypertrophic obstructive cardiomyopathy
Investigations in syncope
ECG - 24 hours
Echo
Bloods - glucose
Management of syncope
Reassurance and advice
Avoid triggering factors - dehydration, meals,
Define epilepsy
Umbrella term for a condition where there is a tendency to have seizures - transient episodes of abnormal electrical activity in the brain
Management of generalised tonic clonic seizures
Sodium valproate
2 - lamotrigine or carbamazepine
Management of focal seizures
Carbamazepine or lamotrigine
2 - sodium valproate or levetiracetam
Management of absence seizures
Sodium valproate or ethosuximide
Management of atonic seizures
Sodium valproate
Lamotrigine
Management of myoclonic seizures
Sodium valproate
Lamotrigine
Levetiracetam
Topiramate
Define febrile convulsions
Type of seizure that occurs in children with high fever
Not caused by epilepsy or ounderlying condition
Must be between 6 months and 5 years
Presentation of febrile convusions
18 months old with 2-5 minute seizure during high fever - often due to underlying viral illness
Management of febrile convulsions
Reassurane and education
Causes of head aches
Tension headaches
Migraines
ENT infection
Analgesic headache
Problems with vision
Raised intracranial pressure
Tumour
Meningitis
Encephalitis
Carbon monoxide poisoning
Define cerebral palsy
Permanent neurological problems resulting from brain damage around time of birth -
Causes of cerebral palsy
Antenatal - maternal infection, trauma in pregnancy
Perinatal - birth asphyxia, pre-term
Post natal - meningitis, severe neonatal jaundice, head injury
Types of cerebral palsy
Spastic - hypertonia, upper motor neurone damage
Dyskinetic - muscle tone, athetoid movemets oro-motor problems, basal ganglia damage
Ataxic - coordination, cerebellar damage
Mixed
Patterns of spastic cerebral palsy
Monoplegia
Hemiplegia
Diplegia
Quadriplegia
Classic presentation of cerebral palsy
Failure to meet milestones
Increased or decreased tone
Hand preference below 18 months
Problems with coordination speech or walking
Feeding or swallowing problems
Learning difficulties
Clinical signs of upper motor neurone lesion
Normal muscle bulk
Hypertonia
Normal power
Brisk reflexes
Clinical signs of lower motor neurone lesion
Reduced muscle bulk
Hypotonia
Reduced power
Reduced reflexes
Fasciculations
Complications of cerebral palsy
Learning diability
Epilepsy
Kyphoscoliosis
Muscle contractures
Hearing and visual impairment
GORD
Management of cerebral palsy
Supportive management from a multidisciplinary team
Muscle relaxants
Anti-epileptics
Glycopyrronium bromide
Define strabismus
Squint - refers to the misalignment of the eyes
Define amblyopia
Affected eye becomes passive and has reduced function compared to dominant eye
Define esotropia
Inward positioned squint - towards the nose
Define exotropia
Outward positioned squint - towards the ears
Define hypertropia
Upward positioned squint
Define hypotropia
Downward positioned squint
Causes of strabismus
Idiopathic
Hydrocephalus
Cerebral palsy
Space occupying lesions - retinoblastoma
Trauma
Management of strabismus
Occlusive eye patch
Atropine drops in goof eye
Define hydrocephalus
Describes cerebrospinal fluid building up abnormally within the brain and spinal cord. Results from either over production or issues draining CSF
Causes of hydrocephalus
Arachnoid cysts
Arnold-Chiari malformation - cerebellum herniates through the foramen magnum blocking outflow of CSF
Chromosomal - malformation
Presentation of hydrocephalus
Enlarged and increasing head
Bulging fontanelle
Poor feeding and vomiting
Poor tone
Sleepiness
Management of hydrocephalus
Vetriculoperitoneal shunt - infections, blockages, too much drainage, intraventricular haemorrhage
Define craniosynostosis
Premature closure of skill sutures - results in abnormal head shapes and growth restriction
Define muscular dystrophy
Umbrella term for genetic conditions that cause gradual weakening and wasting of muscles
Types of muscular dystrophy
Duchennes !
Beckers
Myotonic
Fascioscapulohemeral
Oculopharyngeal
Limb-girdle
Emery-Dreifuss
Clinical signs of muscular dystrophy
Gower’s Signs - uses hand to push self p legs
Define duchennes muscular dystrophy
Defective gene for dystrophin - on X chromosome
X linked recessive
Define myotonic dystrophy
Prolonged muscle contractions - unable to let go after shaking hand
Progressive muscle weakness
Cataracts
Cardiac arrhythmias
