Neurology Flashcards
How common in cerebral palsy?
2:1000
What is cerebral palsy?
Disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain.
What are the three categories of the causes of cerebral palsy?
Antenatal -80%
Intrapartum (during birth)-10%
Post-natal- 10%
What are the three types of cerebral palsy?
Spastic
Ataxic hypertonic
Dyskinetic
In spastic cerebral palsy what is the difference between diplegia and hemiplegia?
Diplegia - All 4 limbs affected but the legs are worse
Quadriplegia- all 4 limbs to a similar degree.. But arms may be worse
What is the most common cause of ataxic hypotonic cerebral palsy?
Genetic cause
An infant presents with floppiness, delayed motor development with abnormal movements. No cognitive delay. What type of cerebral palsy do they have?
Dyskinetic
A child had poor balence, delayed motor, poor coordination that is symmetrical. What type of cerebral palsy?
Ataxic hypotonic
There is a history of birth asphyxia, what type of cerebral palsy?
Spastic - quadriplegic
A child with fisting of the left hand, with pronated flexed forearm?
Spastic - hemiplegic
What is the cardinal sign that difderentiate a headache from a space occupying lesion (ie tumour)?
If space occupying lesion the head ache will be worse when lying flat.
What is benign raised ICP?
Raised ICP without a space occupying lesion caused by blockage of the CSF system.
What is the likelyhood the febrile seizures will recurr?
30%
Describe a non-paralytic squint (concomitant)..
Both eyes have full range of movement but one is directed off centre at a constant angle.
Describe a paralytic squint (incomitant)
Where the squint only becomes apparent when the eye is moving with the help of the extra ocular muscle that supplies that direction
What is amblyopia?
Failure of the immature neuroretina to develop during early childhood
What are the causes of amblyopia?
Visual deprivation
Squint in childhood
What is a latent squint?
Mild heterophoria - a squint that can sometimes be seen when someone is looking into the distance or day dreaming
At what age should intermittent squints disappear?
3 months eyes should be fully aligned
What is the difference between a trophia and a phoria?
Eye misalignment that is present all the time (trophia) or some of the time (phoria)
How do brain tumours in children present?
Signs or raised ICP so Headache Blurred vision Cranial never palsies (squint) Vomiting in morning
What signs might suggest raised ICP?
Pappiloedema
Hypertension
Brady cardia
With a brain tumour when are the headaches worse?
When lying down
In the morning
Can wake up at night
Is having a headache an indication for neuro imaging?
No just a headache but if it is abnormal or accompanied with nerve palsies
What influences the outcome of a brain tumour?
Anatomical position
Hisrological subtype
What is the most common type of brain tumour in children?
Astrocytoma
The second most common type is medulloblastoma, how does this present?
Ataxia
Headache
Vomiting
What brain tumour might present with cranial nerve defects ataxia pyramidal tract signs but no raised ICP?
Brain stem glioma
What are the two types of dyskinesic cerebral palsy?
Dystonic
Choreoathetoid
What would ‘involuntary and uncontrollable muscle tone fluctuations sometimes involving whole body’
Dystonic or choreoathetoid?
Dystonic
What would small rapid irregularly repetitive unwanted movements be?
Choreoathetoid or dystonic?
Choreoathetoid
What proportion of children have normal intelligence with cerebral palsy?
33%
In spastic hemiparesis cerebral palsy is the arm or leg more affected?
Arm
At what stage of sleep do night terrors occur?
In non-REM between stage 3 and 4
Where there are delta waves
What does the child do in a night terror?
Cries and screams and is difficult to wake, they don’t remember their dream
How long after sleep does a night terror occur?
90 mins
At what stage do nightmares occur?
Rem sleep
