Neurology Flashcards
Agenesis of cerebellar vermis
Cystic dilatation of the 4th ventricle
Enlargement of the posterior fossa
Dandy-Walker Malformation
Short webbed neck
Decreased ROM of the cervical vertebrae
Low posterior hairline accompanied by hydrocephalus
Klippel-Feil Syndrome
Obstruction within the ventricular system
Abnormality of the aqueduct or a lesion in the 4th ventricle
Obstructive or Noncommunicating Hydrocephalus
Obliteration if the subarachnoid cisterns; malfunction of arachnoid villi
Follows a subarachnoid hemorrhage; leukemic infiltrates
Nonobstructive or communicating Hydrocephalus
Single nocturnal seizure with clonic movement of the mouth and gurgling
Usually begins 5-10y/o; resolves by 16y/o
Benign Rolandic Epilepsy
Prior history of febrile seizures or head trauma
Prodrome: lethargy
Oral or motor automatisms, altered consciousness, head and eye deviation, contralateral twitching or tonic-clonic movements, posturing
Temporal lobe epilepsy
Sudden cessation of motor activity or speech with a blank facial expression and flickering of the eyelids
Uncommon before 5 y/o
NEVER associated with an aura
NOT associated with postictal state
DO NOT lose body tone
Absence Seizure
Associated with an aura
Sudden loss of consciousness -> cyanotic -> apneic
Loss of sphincter control
With postictal state: vomiting confusion, somnolence, intense headache
Generalized tonic clonic seizure
Repetitive seizures consisting of brief often symmetric myoclonic contractions with loss of body tone and falling or slumping forward
Myoclonic Seizure
Begin at 4-8mos
Brief symmetric contractions of the neck, trunk, extremities
EEG: hypsarrhythmia
Infantile Spasms
DOC for infantile spasm
Vigabatrin
DOC for absence seizure
Ethosuximide and Valproic Acid
Management for GTC
Phenobarbital Phenytoin Carbamazepine Lamotrigine Valproic acid Gabapentin
Most common seizure disorder in childhood
Normal EEG, normal neurologic exam
(+) family history
Febrile seizure
Lasts a few seconds to 15 minutes
Initially generalized and tonic clonic followed by a brief period of post-ictal drowsiness
Occurs only once in 24 hours
Simple febrile seizure
Duration is more than 15minutes
Focal seizure activity
Repeated convulsions occur within 24hours
Complex febrile seizure
Recurrent headache with symptom-free intervals and atleast three of the following:
(+) family history Associated with aura Relief after sleep Abdominal pain Unilateral Nausea and vomiting Throbbing in character
Migraine
Headache most apparent during school day Common after puberty Waxes and wanes Band-like tightness or pressure Most are in the frontal region
Tension headache
Cafe au lait macules that spare the face; axillary or inguinal freckling; Lisch nodules; optic glioma
Neurofibromatosis (Von-Reckling-hausen)
Multisystemic; seizures; mental retardation
Tubers in the periventricular area (candle dripping appearance); ash leaf, shagreen patch
Tuberous Sclerosis
Most common etiologic agent in bacterial Meningitis
1st 2 mos: Group B Streptococcus
2mos - 12 years: S. pneumoniae, H. influenza, N. Meningitidis
CSF analysis in Bacterial Meningitis
Pleocytosis, high CSF protein level, low CSF sugar
Treatment for Bacterial meningitis
N. meningitides: Penicillin IV
S. pneumoniae: 3rd gen Cephalosporin or Penicillin IV
L. monocytogenes or Hib: Ampicillin
Most likely organism to cause viral meningitis
Echovirus
CSF analysis in Viral Meningitis
Normal glucose, normal to slightly increased protein, lymphocytosis
Most common location of brain abscess
Cerebrum (80%)
Indication for surgery in brain abscess
(+) gas in the abscess Multiloculated abscesses Posterior fossa location Fungal cause Assoc. infections like mastoiditis, periorbital abscess, sinusitis
Earliest and most constant signs in Myasthenia Gravis
Ptosis
Some degree of extraocular muscle weakness
Due to immune mediated neuromuscular blockade
Decreased availability of Ach receptors due to circulating receptor binding Abs
Rapid fatigue of muscles (proximal muscle)
Myasthenia gravis
Acute unilateral facial nerve palsy that is not assoc with other cranial neuropathies or brainstem dysfunction
Usually develops abruptly 2 weeks after a systemic viral infection
Bell’s palsy
Autoimmune reaction that develops in response to a previous infection leading to aberrant demyelination of peripheral nerves and ventral motor nerve roots
Campylobacter jejuni and herpesvirus infection
Guillain barre Syndrome
Weakness begins in the lower extremities and progressively involves the trunk, upper limbs, bulbar muscles (Landry ascending paralysis)
Tendon reflexes are the last function to recover and lower extremity weakness is last to resolve
Guillain barre Syndrome
Diagnostic of Guillain barre Syndrome
Dissociation between high CSF protein and a lack of cellular response (albuminocytologic dissociation)
Most common solid tumors
2nd most cost prevalent malignancy in childhood
Brain tumors
2 distinct patterns of presentation
Increased ICP and focal neurologic signs
Most common infratentorial tumor
With best prognosis
Cerebellar astrocytoma
Most often found in cerebellum; heterogenous enhancements often invading the 4th ventricle and can cause obstructive hydrocephalus
M>F; 4-8y/o
Homer-wright rosettes - circular patterns of tumor cells surrounding a center of neutrophils
Medulloblastoma
Solid and cystic areas that tend to calcify; short stature; pressure to optic chiasm producing bitemporal visual defects
Craniopharyngioma
