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Medicine & Surgery > Neurology > Flashcards

Neurology Flashcards

1
Q

What is the International Headache Society definition of migraine?

A 
At least 5 attacks, lasting 4-72 hours with 2/4:
A. Unilateral
B. Pulsatile
C. Moderate-severe intensity
D. Aggravated by or causing avoidance of routine physical activity
During the headache at least 1/2:
A. Nausea/vomiting
B. Photo/phonophobia
Not attributable to other causes
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2
Q

What are features of migraine with aura?

A

Reversible focal neurological symptoms lasting <60 minutes, develop progressively over 5-20 minutes
+/- typical migraine headache

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3
Q

What is the treatment of migraine headache?

A

NSAIDs
parenteral dopamine antagonist ie. metaclopramide
may add dexamethasone 10 mg IV x 1 to prevent recurrence of migraine (NNT = 9)

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4
Q

What are 10 can’t miss headache diagnoses

Which show up on CT?

A 
SAH*
Traumatic ICH*
Meningitis/Encephalitis
CVST
Temporal arteritis
CO toxicity
Angle closure glaucoma
Cerebral artery dissection
Tumor*
Idiopathic intracranial HTN
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5
Q

Criteria for simple febrile seizure?

A

developmentally normal child
38
NOT result of CNS infection/metabolic abnormality
normal neurologic exam pre and post

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6
Q

Features of complex febrile seizure?

A

focal features
>15 minutes
>1 episode in 24 hours

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7
Q

When to consider a lumbar puncture in febrile seizures?

A

signs of meningitis
antibiotic treatment (? partially treated)
incomplete/no vaccinations

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8
Q

When to consider a lumbar puncture in febrile seizures?

A

signs of meningitis
antibiotic treatment (? partially treated)
incomplete/no vaccinations

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9
Q

What investigation do you need to do in a first unprovoked seizure in pediatrics? (in absence of focal neurologic

A

outpatient EEG

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10
Q

What investigation do you need to do in a first unprovoked seizure in pediatrics? (in absence of focal neurologic

A

outpatient EEG

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11
Q

What is first line anticonvulsant therapy in neonates?

A

IV phenobarbital

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12
Q

What is first line anticonvulsant therapy in neonates?

What is an adjunctive therapy for infants in status epilepticus to consider?

A 
IV phenobarbital 
Consider pyridoxine (vit B6)
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13
Q

Describe infantile spasms

A

brief contractions of neck, trunk, extremities
followed by phase of sustained muscular contraction
Most frequent when awakening/going to sleep
often followed by small gasp

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14
Q

What is the classic EEG finding in infantile spasms?

A

Hypsarrhythmia

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15
Q

What is the #1 cause of infantile spasm?

A 
Tuberous sclerosis 
Others: 
metabolic disorders
genetic disorders
infectious
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16
Q

What is the #1 cause of infantile spasm?

A 
Tuberous sclerosis 
Others: 
metabolic disorders
genetic disorders
infectious
17
Q

Describe an episode of benign paroxysmal vertigo in pediatrics

A

Will be playing/active, followed by sudden episode where they will not move, be terrified, stunned, lasts a few minutes and they will go back to activity immediately after

  • often have hx of motion sickness or migraines
  • migraine equivalent
18
Q

Describe an episode of benign paroxysmal vertigo in pediatrics

A

Will be playing/active, followed by sudden episode where they will not move, be terrified, stunned, lasts a few minutes and they will go back to activity immediately after

  • often have hx of motion sickness or migraines
  • migraine equivalent
19
Q

What is the difference between vestibular neuritis vs. labrynthitis?

A

Vestibular neuritis - acute onset vertigo, N/V, ataxia

Labrynthitis - includes hearing loss, tinnitis

20
Q

What is the difference between vestibular neuritis vs. labrynthitis?

A

Vestibular neuritis - acute onset vertigo, N/V, ataxia

Labrynthitis - includes hearing loss, tinnitis

21
Q

What are the diagnostic criteria for migraine headaches in children?

A

bilateral pain
1-72 hours (shorter duration)
need to infer associated symptoms ie. photophobia, phonophobia or the presence of
nausea aggravated by physical activity
consider other associated symptoms, ie. difficulty thinking, fatigue, and
lightheadedness

22
Q

3 migraine variants in pediatrics

A

abdominal migraine
benign paroxysmal vertigo
cyclic vomiting

23
Q

3 migraine variants in pediatrics

A

abdominal migraine
benign paroxysmal vertigo
cyclic vomiting

24
Q

When to consider imaging in pediatric headaches?

A 
awakens from sleep
occipital location
AM headache that improves when upright, aggravated by valsalva maneuvers
associated with neurologic deficits
rapidly increasing headache frequency 
nonresolving focal neurologic deficits
25
Q

What are features of guillan barre syndrome?

A

symmetric ascending weakness
areflexia
post infectious autoimmune polyneuropathy

26
Q

What are 3 characteristics of the Miller Fisher variant?

A

ophthalmoplegia
ataxia
areflexia
(often no limb weakness)

27
Q

List 8 ddx considerations in acute cerebellar ataxia

A 
intoxication (ETOH)
cerebellar/brainstem tumors
neuroplastoma (opsoclonus-myoclonus-ataxia syndrome)
encephalitis
labrynthitis
vascular disorders (lupus, cerebellar hemorrhage)
post infectious/immune disorders
trauma
28
Q

List 8 ddx considerations in acute cerebellar ataxia

A 
intoxication (ETOH)
cerebellar/brainstem tumors
neuroplastoma (opsoclonus-myoclonus-ataxia syndrome)
encephalitis
labrynthitis
vascular disorders (lupus, cerebellar hemorrhage)
post infectious/immune disorders
trauma
29
Q

What are the rules of 50 in dextrose replacement?

A

1 cc/kg of D50W
2 cc/kg of D25W
5 cc/kg of D10W
10 cc/kg of D5W

30
Q

What are the rules of 50 in dextrose replacement?

A

1 cc/kg of D50W
2 cc/kg of D25W
5 cc/kg of D10W
10 cc/kg of D5W

31
Q

What diagnosis to consider in lethargy out of proportion to clinical findings and workup?

A

abdominal intussuception

32
Q

List 5 stroke mimics

A 
seizure
hypoglycemia
migraine
hypo/hypernatremia
hepatic encephalopathy
multiple sclerosis
peripheral neuropathies 
conversion disorder

Medicine & Surgery (10 decks)

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