Neurology Flashcards
Which antielileptic drug causes significant weight gain ?
Sodium valproate
Which antiepileptic drug causes gingival hyperplasia?
Phenytoin
Which antiepileptic drug causes aplastic anaemia ?
Carbamazepine
What is the inheritance pattern of duchenne muscular dystrophy?
X linked recessive
What is the inheritance pattern of congenital myotonic dystrophy?
Autosomal dominant
Children with which type of cerebral palsy are most at risk of hip replacement?
Spastic quadriplegia
What percentage of children with autism will have accompanying intellectual impairment?
50%
Which anticonvulsant is most likely to decrease the half life of lamotrigine in a clinically significant manner ?
Carbemazepine
What is the HLA type associated with narcolepsy ?
HLA - DQB1
Pimple disease is associated with facial weakness - T/F?
False
Mutation in GAA gene - prevents alpha glucosidase from breaking down glycogen - builds up in lysosomes
Presents with severe generalise myopathy and cardiomyopathy hepatomegaly
What is the inheritance of NF1?
Autosomal dominant
What is the deficiency in NF1 vs NF2?
NF1 - neurofibromin (tumour suppressor)
NF2 - schwannomin (membrane organising protein)
What is the diagnostic criteria for NF 1?
2 of: 5 + cafe au lait spots 2 + neurofibromas Lisch nodules Axillary / inguinal freckling Optic glioma Family history
What are the diagnostic criteria for NF2?
Bilateral acoustic neuromas or vestibular schwannomas
Or Fam hx + Unilateral vestibular schwannoma Meningioma Glioma Juvenile cortical cataract Lenticular opacity
What is the inheritance of Tuberous Sclerosis ?
Autosomal dominant
What is the genetic defect in TS?
mTOR pathway
TSC1 Hamartin
TSC2 tuberin
What are the diagnostic criteria for TS?
Major Hypomelanitoc macules Facial angiofibromas Shagreen patch Ungual fibroma Retinal hamartoma Cortical dysplasia (tubers) Subependymal nodules Cardiac rhabdomyoma Angiomyolipomas Renal cysts Dental enamel pits
What is the diagnosis? Cerebellar ataxia Choreoathetosis Sinopulmonary infections Raised AFP
Ataxia telangiectasia
What is the diagnosis ?
Opisthotonos
Deficiency in galactocerebrosidase
Krabbe disease
What is the diagnosis? Milestone regression Optic atrophy Cherry red spot CSF: deficiency of aryl sulfatase A
Metachromatic leukodystrophy
What is the gene mutated in Adrenoleukodystrophy?
ABCD1
X linked
What is the diagnosis ?
Abnormal startle response to light
Cherry red spot
Hexosaminisase A deficiency
Tay Sachs
What is the diagnosis?
Oculomotor apraxia
Cherry red spot
Sphingomyelinase deficiency
Niemann Pick
What is the inheritance and gene mutation in Wilson disease ?
Autosomal recessive
ATP7B
What is the diagnosis? Boy Hypogmented stubbly hair Hyper mobility Walnut brain on MRI
Menkes
What is the diagnosis ?
Optic atrophy
Increases signal in basal ganglia T2 MRI
High CSF lactate
Leigh’s
Aka
Subacute necrotizing encephalomyelitis
What is the gene mutation in glucose transporter deficiency?
SLC2A1 - GLUT1 transporter
High serum : csf glucose
Ketogenic diet
What is the diagnosis ? Temporary visual loss Eye pain Central scotoma RAPD
Optic neuritis
What is the inheritance and genetic mutation in SMA?
Autosomal recessive
Survival motor neurone gene
SMN 1 - absent
SMN2 - varying degrees
What is the treatment for SMA?
Nusinersin - antisense oligonucleotide
What is the inheritance of Charcot Marie Tooth?
Autosomal dominant (Except type 4 AR)
what is the diagnostic test for Guillain Barre syndrome ?
Anti ganglioside antibodies
But takes weeks
Guillain barre is steroid responsive - true / false
False
IVIG
What is the treatment for myesthenia gravis?
Pyridostigmine
- Anticholinesterase
What is the risk with central core disease ? And what is the treatment ?
Malignant hyperthermia
Dantrolene
What is the diagnostic test for duchenne’s ?
MLPA
Multiplex ligation dependent probe amplification analysis
What is the treatment for Duchenne?
Steroids - only treatment proven to improve strength
What is the inheritance of congenital myotonic dystrophy ? And what is the mutation ?
Autosomal dominant
CTH triplet repeat in DMPK gene
> 50 repeats full penetrance
Anticipation with maternal transmission
What is the most common cause of viral myositis?
Influenza B
What are the EEG findings in absence seizures ?
Generalised spike and wave
What is the treatment for absence seizures ?
Ethosuxamide
What is the diagnosis ?
Myoclonic jerks on wakening
Exacerbated by sleep dep
Juvenile myoclonic epilepsy
What is the treatment for juvenile myoclonic epilepsy ?
Sodium valproate
Lamotrigine for women
What are the EEG findings of West syndrome ?
Aka infantile spasms
Hypsarrhythmia
What is the mutation in Dravet syndrome ?
SCN1A
Sodium channel
What test should you order if you suspect Doose syndrome (jerk and drop myoclonic atonic seizures)
Paired CSF serum glucose
What are the EEG findings in Lennox Gestaut syndrome ?
Poorly organised
Very slow spike and wave
Low voltage
What is the diagnosis ?
Loss of acquired language skills
Auditory verbal agnosia
Landau Kleffner syndrome
Do treat the EEG
What is the diagnosis ?
Seizure during sleep
Associated vomiting eye deviation
EEG shows continuous spike and wave in occipital lobe
Panayiotopoulos syndrome
What is the diagnosis? Focal seizure during sleep Face mouth tongue guttural sounds Consciousness retained Transient post ictal mouth droop
Childhood Epilepsy with Centrotemporal spikes
What is the treatment for Childhood Epilepsy with Centrotemporal Spikes ?
Carbamazepine low dose in evening
Only if seizures are problematic
What is the drug with side effects of gingival hypertrophy, hirsutism and acne ?
Phenytoin
Dilantin
Na channel Blocker
What antiepileptic is associated with DRESS syndrome ?
Carbamazepine
Sodium channel blocker
Enzyme inducer
What antiepileptic is associated with pancreatitis and weight gain?
Sodium valproate
Epilim
Sodium channel blocker + GABA ergic
Enzyme inhibitor - lamotrigine toxicity
What antiepileptic is associated with visual field defect and retinopathy ?
Vigabatrin
Sabril
Inhibits GABA transaminase
What antiepileptic gives renal stones and acidosis ?
Topiramate
Carbonic anhydrase inhibitor
Sodium channel blocker
GABA ergic
What antiepileptic is associated with behavioural and sleep disturbance ?
Levetiracetam
Keppra
Binds to synaptic vesicle 2A modulates kainate receptor
What antiepileptic enhances slow inactivation or sodium channels?
Lacosamide
What nerve gives you a winged scapula?
Long thoracic - innervates serratus anterior
What genetic mutation results in lissencephaly?
LIS1
What genetic mutation causes x linked lissencephaly with abnormal genitalia?
ARX
What genetic mutation gives Retts?
MECP2
What is the diagnosis?
Gelastic seizures + precocious puberty
Hypothalamic hamartoma
What is the gene mutation for malignant migrating epilepsy ?
KCTN1
What is the genetic mutation associated with 5th day fits aka benign familial neonatal convulsions
KCNQ2