Neurology

Question 1

what examination should be done for a headache in a child?

Answer 1

Growth parameters, OFC, BP
Sinuses, teeth, visual acuity
Fundoscopy 
Visual fields (craniopharyngioma)
Cranial bruit
Focal neurological signs
Cognitive and emotional status

Question 2

state some symptoms of childhood migraines?

Answer 2

abdo pain, nausea, vomiting 
visual disturbance, paresthesia, weakness
pallor 
photosensitive 
improved by darkness and quiet

Question 3

describe the features of a tension headache?

Answer 3

band like distribution
diffuse and symmetrical
constant headache

Question 4

what is a feature of an increased cranial pressure headache?

Answer 4

aggravated by activities that raise ICP such as coughing, straining

Question 5

what are indications of neuroimaging ?

Answer 5

cerebellar dysfunction 
raised ICP 
seizures 
personality change 
unexplained deterioration of school work

Question 6

what is the management of a migraine ?

Answer 6

pain relief

prevention = beta blocker, TCA, valproate

Question 7

what is the management of a tension type headache ?

Answer 7

simple analgesia

prevention = TCA

Question 8

what causes a Epileptic seizure?

Answer 8

electrical change in the brain

- An abnormal excessive hyper synchronous discharge from a group of (cortical) neurons

Question 9

what is epilepsy ?

Answer 9

A tendency to recurrent, unprovoked (spontaneous) epileptic seizures

Question 10

what is a Febrile convulsion?

Answer 10

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

Question 11

what changes in inhibition and excitation in the brain during an epileptic fit?

Answer 11

Decreased inhibition (gama-amino-butyric acid, GABA)

     - Excessive excitation (glutamate and aspartate)
     - Excessive influx of Na and Ca ions

Question 12

what is the 1st line of Tx for generalised epilepsies ?

Answer 12

sodium valproate

Question 13

what is the 1st line of Tx for focal epilepsies ?

Answer 13

carbamazepine

Question 14

state some types of non-epileptic seizures?

Answer 14

Reflex anoxic seizure: common in toddlers
Syncope
Parasomnias eg. night terrors
Behavioural stereotypies
Psychogenic seizures (NEAD)

Question 15

state some common neurological problems in children?

Answer 15

headache
migraine
fits
faints

Question 16

are all seizures epileptic ?

Answer 16

no

Question 17

state some causes of seizures apart from epilepsy ?

Answer 17

hypoxia-ischaemia 
hypoglycaemia 
infection 
trauma 
syncope 
parasomnias

Question 18

what investigation can be used to measure the electrical activity in the brain?

Answer 18

electroencephalogram

Question 19

as well as EEG what other investigations could be done?

Answer 19

video recording event
MRI brain
genetics
metabolic tests

Question 20

state some side effects of anti epileptic drugs ?

Answer 20

sedation
effect on learning
cognition
behaviour

Question 21

what are some features of neuromuscular disorder?

Answer 21

hypotonia
alert but less motor activity
delayed motor milestones

Question 22

state a neuromuscular junction disorder?

Answer 22

myasthenia gravis

Question 23

during neuropathy are reflexes saved or lost early?

Answer 23

lost early

Question 24

state a myopathy which affects young boys?

Answer 24

duchenne muscular dystrophy

Question 25

what is a blood test to show duchenne muscular dystrophy?

Answer 25

elevated creatinine kinase levels