Neurology Flashcards
In what Sarnat stage are seizures most common?
Stage 2,
Most common in sarnat stage 2. Stage 3 there is severe neuronal damage that prevents progression of seizures.
A glycine cerebrospinal fluid to plasma ratio >1 is consistent with ?
non-ketotic hyperglycinemia
Are Chiari I or Chiari II malformations associated with myelomenigocele?
Chiari Malformation II
Chiari 2, involve both cerebellum and brainstem extending into foramen magnum
Difference between OAE and ABR hearing
OAE tests auditory pathway to cochlear hair response
ABR evaluates complete auditory and neural pathways
Intermittent, Limited, Extensive, Pervasive help classify what?
level of support needed for Mental deficiency
(Intermittent being least, constant need for support not needed
Pervasive being most need, almost all activities)
Is gross motor affected in spastic CP?
It is affected, but fine motor is not
increase in tone
cognitive function is normal
MCAD deficiency predisposes to what kind of seizures?
Hypoglycemia
Myelomeningocele is almost associated with?
Chiari II malformation and tethered cord
Until what gestational age is an aEEG usually discontinuous?
28 weeks, after that it it’s mainly confined to sleep
Whare the 5 neurocutaneous syndromes?
Sturge-Weber
Tuberous Sclerosis
Neurofibromatosis
McCune Albright
Von Hippel-Lindau
What are common radiologic signs of Chiari II malformation?
Frontal calavarial scalloping (lemon sign)
anteriorly curved cerebellum (banana sign)
cereberal tonsilar herniation
What are some features of infantile spinal muscular atrophy?
infants show tongue fasciculations, decreased tendon reflexes, and hypotonia.
What do you see in imaging in Sturge Weber Syndrome?
Gyriform calcifications can be seen on skull x-rays and are classically described as a “tram-track” sign. Computed tomography is the best modality to detect calcifications and to show other changes, such as cortical atrophy and leptomeningeal enhancement in post-contrast studies
What does alobar holoprosencephayl look like radiology?
single ventricle with fused thalami
What does EEG show in non-ketotic hyperglycinemia?
myoclonic seizures and burst supression
what does hipsarrythmia and infantile spasms show on eeg?
“very high voltage, random, slow waves and spikes in all cortical areas.”
What is dermatologic finding in McCune Albright?
irregular brown pigmentations
(coast of maine apperance)
What is dermatologic finding in Neurofibromatosis Syndrome?
Cafe au lait spots, do not cross midline (sharp borders), not present at birth, freckling in axilla, inguinal folds and perineum
What is dermatologic finding in Sturge-Weber Syndrome?
Pink-Purple, flat, hemangioma (Port Wine) distrubtion of trigeminal nerve
What is dermatologic finding in Von Hippel Lindau?
Multiple systemic hemangiomata
What is dermatologic finding in Tuberous Sclerosis?
50% hypopigmented lesions, ashe leaf macules, variable in number, most on back and butt
What is treatment for non-ketotic hyperglycinemia?
Sodium Benzoate and dextromethoprhan
what suture is closed prematurely in bracnycephaly?
bicoronal suture
what suture is closed prematurely in palgeocephaly?
lamboid
what suture is closed prematurely in scalphocephaly?
saggital
Scaphocephaly and dolichocephaly
are both types of flat head syndrome
that involve an elongated head shape. Scaphocephaly is a more specific term for a type of dolichocephaly with a distinct skull
shape.
what suture is closed prematurely in trigoncephaly?
metopic suture
leads to triangle shape head and hypertelorism
what type of weakness do you see in Werdnig Hoffman?
weakness, proximal muscle weakness predominates. affected children may never sit or stand.
When do most newborns recover from facial nerve palsy?
1-3 weeks
When does myelomengocele occur?
Myelomeningocele occurs during a defect in primary neurulation when the caudal neuropore fails to close approximately during day 27.
Why are infants more susceptible to IVH?
Blood vessel morphology in the germinal matrix of the neonate differs from that in other cortical areas, mainly due to the increased metabolic demand required by the rapid turnover of precursor cells in this region.
Blood vessels supplying the germinal matrix have a higher density and area than other cortical regions.
How could you treat hipsarrythmia?
ACTH
(induces steroid release)
Where is Erb’s Palsy located?
C5-C6
what happens if the forebrain vesicle DOES NOT differentiates into a diencephalon and a telencephalon
holoprosencephaly.
When does palmar grasp disappear?
5-6 months
Brain structures most commonly affected by HIE
white matter, basal ganglia, thalamus, globus pallidus
What medicine should you give to infant who is suffering from medically refractory seizures
trial of pyroxidine,
might have pyridoxine-dependent epilepsy
When does neural tube close?
5-6 week of gestation
(ventral induction)
7th to 20th week of gestation marks which stage of neurodevelopment in fetus?
Neuroepthileal cell proliferation and migration
Age of dissapearance of primitive reflex in order
Step, Moro, Grasp, Palmar, rooting
Step (2 months) < Rooting (3 months) < Moro & Tonic Neck (5-6 months) < Palmar (6 months) < Plantar grasp (9-10 months)
How does phenobarbital work?
hyperpolarize by keeping CL channels open via GABA-A receptors
IVH outcomes depend on what?