Neurology

Question 1

Motor Neuron Disease / ALS

Answer 1

• Combined LMN atrophy
• UMN hyper-reflexia

Progressive muscle atrophy
Sensation is intact - sensory system not involved
Cranial nerves not involved

Autosomal Dominant
(Child 50% chance inheriting disease)

Clinical Diagnosed

Question 2

Types of seizures

Answer 2

GENERALISED seizures
(Loss of consciousness)

• tonic clonic
• clonic
• myoclonic
• secondary generalised

Motor - non-convulsive
- tonic (drop attacks)
- atonic (drop attacks)

Non-motor
- atypical absence (petit-mal) and juvenile
- atypical absence
- eyelid myoclonia

FOCAL (PARTIAL)
(Consciousness retained)

Simple partial
- with motor signs (Jacksonian)
- with somatosensory symptoms
- with psychic symptoms

NB Complex partial
(Loss of consciousness)

Question 3

GENERALISED SEIZURES

Answer 3

TONIC CLONIC
- aura, stiffen (tonic) convulsion (clonic), mild coma or drowsiness, post/octal confusion
- can be associated with cyanosis, snoring, eyes rolling back head, +- tongue biting, +- urinary incontinence

Stiffen and fall = tonic
Floppy and fall = atonic
Shaking only = clonic

Motor - non-convulsive
Tonic = drop attacks
Atonic = drop attacks

ABSENCE SEIZURE

from 4 years to puberty
- child ceased activity and states
- child is motionless (may blink or nod)
- no warning
- sometimes clonic - jerky fingers, face, eyelid
- lip smacking ir chewing
- lasts a few second 5-10 seconds
- child carries on as if nothing has happened
- usually several per day
- may lead to generalised seizures in adulthood