Neurology Flashcards
Unilateral pupillary dilation
Compression of CN3
Uncal herniation
Headache that gets worse when lying flat and/or with Valsalva
Papilledema
Optic disc atrophy
Blindness
Idiopathic intracranial hypertension
Management for idiopathic intracranial hypertension
Acetazolamide
Diuretics
Seriously LP
CSF shunt
Steroids
Most common childhood malignant brain tumor
Medulloblastoma
Brain tumor
Headache
Ataxia
Obstructive hydrocephalus
Medulloblastoma
Headache
Vomiting
Ataxia
Afebrile
Head tilt
Torticollis
Infrantentorial/posterior fossa tumors
Headache
Seizure
Hemiparesis
Supratentorial tumors
Endocrinopathies
Behavioral changes
Visual disturbances
3rd ventricle obstruction
Hydrocephalus
Calcification in the sella turcica
Craniopharyngioma
Sinusitis
Headache
Vomiting
Focal neuro deficits
Brain enhancing lesion
Brain abscess
Neonate
Cranial bruit
Hydrocephalus
CHF
Vein of Galen malformation
Red blotches on skin/eyes
CNS effects
Intellectual disability
Decreased IgA and IgG
Respiratory tract infections
Hodgkin’s lymphoma (elevated AFP)
Autosomal recessive
Ataxia Telangiectasia
Slow/clumsy gait
Decreased strength
Decreased reflexes
Elevated plantar arch
Cardiomyopathy/CHF
Glucose intolerance (DM)
Autosomal recessive
Friedreich ataxia
Clumsiness
Distal muscles weakness
Absence of Lower DTRs
High plantar arch
Weakness
Distal calf muscle atrophy
Autosomal dominant
Charcot-Marie-Tooth disease
Syndeham chorea
Acute rheumatic fever
Chorea
Hypotonia
Emotional lability
Autosomal dominant
Huntington chorea
Treatment for chorea
Supportive
Haloperidol
Fluphenazine
Risperidone
Tetrabenazine
Neck hyperextension
Decreased extraocular movement
Treatment
Acute dystonic reaction
Benadryl
Specific repetitive movement
Improves/disappears with purposeful movement
Voluntarily suppressed
Tic
Weakness
Paresthesias
Localized back pain
Fever
Reduced LE sensation and bowel/bladder tone
Treatment
Epidural abscess
Abx
Steroids
Surgical decompression
Virus
Fever
Weakness then hypertonia/hyperreflexia
Bowel/bladder dysfunction
Lymphocytic infiltration and demyelination
Acute transverse myelitis
Treatment for extrinsic spinal cord lesion
High dose IV dexamethasone
Degeneration of anterior horn cells
Only motor dysfunction
Infancy
Poor suck
Tongue fasciculations
Spinal muscular atrophy (SMA) type 1
Minimal vertebral opening
Spinal cord and nerves intact
Asymptomatic
Spina bifida occulta
Larger vertebral opening
Herniation if CSF and meninges
Intact spinal cord
Asymptomatic
Meningocele
Widely split vertebral opening
Herniation of CSF, meninges, spinal cord
Paralysis
Ortho and uro problems
Myelomeningocele
Steroid choice for spinal trauma
IV methylprednisolone 30mg/kg
Decreased forehead wrinkling
Decreased smiling on affected side
Treatment
Bell’s palsy
Supportive
Prednisone
+/- acyclovir/valacyclovir
Increase protein in CSF with normal cell count
Campylobacter jejuni
Proximal muscle weakness
Guillain barre syndrome
Descending paralysis
Poor suck
Ptosis
Constipation, urinary retention
Disconjugate gaze
Diplopia
Dysphagia
Dysarthria
Botulism
Blocks ACh release
Proximal muscle weakness worsens with activity
Ptosis
Thymoma
Myasthenia gravis
ACh receptor antibodies
Diagnosis and management of myasthenia gravis
Tensilon test - edrophonium (ACh inhibitor)
Pyridostigmine (ACh inhibitor)
PLEX
Prednisone
Thymectomy
X-linked recessive
Absence of dystrophin protein
Gower sign
Pseudohypertrophied calves
Elevated CPK
Xp21 abnormality
Duchenne muscular dystrophy
Autosomal dominant
Striated and smooth muscle affected
Distal muscle weakness
Slow relaxation after contraction
Myotonic muscular dystrophy
Marcus Gunn phenomenon
Abnormal interaction of trigeminal and oculomotor nerves
Seizures
6mo to 6 yr
Most common
Febrile illness
Febrile seizures
Simple febrile seizure
Generalized
< 15 min
1 episode in 24 hr
Complex febrile seizure
Focal
> 15 min
> 1 episode in 24 hr
3 hz per second spike and wave
Absence seizure
Seizure caused by hyperventilation
Absence seizure
Treatment for absence seizure
Ethosuximide
Lamotrigine
Valproic acid
Side effects of valproic acid
Thrombocytopenia
Elevated LFTs and pancreatic enzyme levels
Teratogenic (meningomyelocele)
Hyperammonemia
Side effect of Topiramate
Glaucoma
Side effect of Lamotrigine
Steven Johnson syndrome
Side effect of phenytoin
Teratogenic (fetal hydantoin syndrome)
Myoclonic jerks of bilateral UE upon awakening
Generalized tonic clonic seizure
Absence seizure in 1/3 of patients
Juvenile Myoclonic epilepsy
4-6 hz polyspike and wave discharges
Juvenile Myoclonic epilepsy
Infantile spasms
Hypsarrhytmia (inferictal on EEG)
Developmental delay
3-9 mo
Repetitive flexing of head, trunk, extremities
Infantile spasm (west syndrome)
Periventricular or cortical tubers
Infantile spasms, seizures
Cardiac rhabdomyomas
Renal angiomyolipoma
Shagreen patches
Ash leaf spots
Angiofibromas
Autosomal dominant
Tuberous sclerosis
Treatment for tuberous sclerosis
ACTH
Vigabatrin
Treatment for simple partial complex seizure
Carbamazepine
Twitching, grunting, tongue rolling, choking sensation
Often cannot speak if occurs during wakefulness
Most common type of partial seizure in childhood
Autosomal dominant
Biphasic focal centrotemporal spikes and slow waves on EEG
Benign Rolandic epilepsy
(Benign childhood epilepsy with centrotemporal spikes)
Spontaneous remission by 12 yo
Most common risk factor for cerebral palsy in premature newborns
Perinatal infection
Spastic diplegic CP
Bilateral spasticity of legs
Delayed walking
Tip toe walking g
Normal cognition
No Seizures
Spastic hemiplegic CP
Ipsilateral spasticity
1/4 cognitively impaired
Spastic quadriplegic CP
Increased tone in all extremities
Intellectual disability
Seizures
Dyskinetic (athetoid) CP
Spastic quadriplegia +
Dystonic and strange movements
Ataxic CP
Hypotonia
Delay in motor and language milestones
Retention of primitive reflexes and or hyperactive reflexes
Most common cause of hemorrhagic stroke in children
AV and cavernous malformations
Next diagnostic step after presented with CVA on head CT
Cerebral angiography
Stroke
Lactic acidosis
Sensorineural deafness
Best diagnostic study
MELAS
Mitochondrial encephalopathy, Lactic Acidosis, Stroke-like episodes
Molecular analysis of mitochondrial DNA
Prophylaxis for cluster headache
Verapamil
1st line treatment for infantile spasms
ACTH
Prednsolone
Vigabatrin
Prophylaxis for migraine headache
Topiramate
Impaired upward gaze
Dilated pupils
Better reactivity to accommodation than light
Retraction/conversion nystagmus with lid retraction
Compression or infiltration of midbrain rectum (pineal tumors)
Parinaud syndrome
