Neurology Flashcards
what examination should be done for a headache in a child?
Growth parameters, OFC, BP Sinuses, teeth, visual acuity Fundoscopy Visual fields (craniopharyngioma) Cranial bruit Focal neurological signs Cognitive and emotional status
state some symptoms of childhood migraines?
abdo pain, nausea, vomiting visual disturbance, paresthesia, weakness pallor photosensitive improved by darkness and quiet
describe the features of a tension headache?
band like distribution
diffuse and symmetrical
constant headache
what is a feature of an increased cranial pressure headache?
aggravated by activities that raise ICP such as coughing, straining
what are indications of neuroimaging ?
cerebellar dysfunction raised ICP seizures personality change unexplained deterioration of school work
what is the management of a migraine ?
pain relief
prevention = beta blocker, TCA, valproate
what is the management of a tension type headache ?
simple analgesia
prevention = TCA
what causes a Epileptic seizure?
electrical change in the brain
- An abnormal excessive hyper synchronous discharge from a group of (cortical) neurons
what is epilepsy ?
A tendency to recurrent, unprovoked (spontaneous) epileptic seizures
what is a Febrile convulsion?
acute symptomatic seizure’
- An event occurring in infancy/ childhood, usually between 3 months and 5 years of age, associated with fever but without evidence of intracranial infection or defined cause for the seizure
what changes in inhibition and excitation in the brain during an epileptic fit?
Decreased inhibition (gama-amino-butyric acid, GABA)
- Excessive excitation (glutamate and aspartate)
- Excessive influx of Na and Ca ions
what is the 1st line of Tx for generalised epilepsies ?
sodium valproate
what is the 1st line of Tx for focal epilepsies ?
carbamazepine
state some types of non-epileptic seizures?
Reflex anoxic seizure: common in toddlers Syncope Parasomnias eg. night terrors Behavioural stereotypies Psychogenic seizures (NEAD)
state some common neurological problems in children?
headache
migraine
fits
faints
are all seizures epileptic ?
no
state some causes of seizures apart from epilepsy ?
hypoxia-ischaemia hypoglycaemia infection trauma syncope parasomnias
what investigation can be used to measure the electrical activity in the brain?
electroencephalogram
as well as EEG what other investigations could be done?
video recording event
MRI brain
genetics
metabolic tests
state some side effects of anti epileptic drugs ?
sedation
effect on learning
cognition
behaviour
what are some features of neuromuscular disorder?
hypotonia
alert but less motor activity
delayed motor milestones
state a neuromuscular junction disorder?
myasthenia gravis
during neuropathy are reflexes saved or lost early?
lost early
state a myopathy which affects young boys?
duchenne muscular dystrophy
what is a blood test to show duchenne muscular dystrophy?
elevated creatinine kinase levels
