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Paediatrics > Neurology > Flashcards

Neurology Flashcards

1
Q

What percentage of infants experience at least one febrile seizure?

A

0.5-1%

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2
Q

What proportion of infants who have had a febrile seizure have an additional seizure?

A

30%

RIsk is higher the younger the child

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3
Q

What is the risk of developing epilepsy following febrile seizures?

A

Only slightly greater than the rest of the population

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4
Q

What type of seizure does not occur in newborns and very rarely occurs in children < 2

A

Generalised tonic-clonic

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5
Q

What is the most common seizure type seen in Lennox-Gastaut syndrome?

A

Astatic seizures (drop attacks)

Also tonic-clonic and atypical absence

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6
Q

How can absence seizures be induced?

A

Hyperventilation

Ask the child to blow on a piece of paper or windmill for 2-3 minutes

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7
Q

What is the treatment for absence seizures?

A

Ethosuximide

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8
Q

What is the definition of a simple febrile convulsion?

A

A generalised tonic-clonic seizure lasting < 15 minutes that does not recur within the same febrile illness

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9
Q

What are the features of a complex febrile convulsion?

A
  • Focal features at onset or during the seizure
  • Duration of more than 15 minutes
  • Recurrence within the same febrile illness
  • Incomplete recovery within 1 hour
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10
Q

What role does paracetamol play in febrile convulsions?

A

Does NOT reduce the risk of further febrile convulsions

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11
Q

What EEG pattern is seen in absence seizure

A

3Hz spike and wave

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12
Q

What is the first line treatment for focal epiliepsy (including with secondary generalisation)?

A

Carbamazepine

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13
Q

What is the earliest sign of dose-related toxicity with carbamazepine use?

A

Diplopia, starting 30-60 minutes after the morning dose

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14
Q

What allele should be screened for in patients with Asian origin before starting carbamazepine?

A

HLA-B*1502

Risk of SJS

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15
Q

How can temporal lobe epilepsy associated with hippocampal sclerosis be treated surgically?

A

Temporal lobectomy

Up to 80% of patients have long term control

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16
Q

How are neonatal seizures treated?

A

Phenobarbitone IM/IV immediately

Stopping the seizure immediately is critical

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17
Q

When and how does intervention occur during a febrile seizure?

A

After 5 minutes - midazolam

After another 5 minutes - midazolam

After another 5 minutes - phenytoin/phenobaritone

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18
Q

Within what age group do febrile seizures occur?

A

6 months - 5 years

Mostly 12-18 months

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19
Q

Why is magnesium sulfate given to mothers at risk of preterm delivery?

A

Prevention of cerebral palsy

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20
Q

What are the most common delayed motor milestones in children with cerebral palsy?

A

Not sitting by eight months (corrected for gestational age [GA])

Not walking by 18 months (corrected for GA)

Early asymmetry of hand function (hand preference) before one year (corrected for GA)

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21
Q

Which type of cerebral palsy is most common in preterm infants?

A

Spastic diplegia

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22
Q

What is the most common type of cerebral palsy?

A

Spastic (70-80%)

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23
Q

Which region of the brain is involved in spastic cerebral palsy?

A

UMN of pyramidal tract

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24
Q

Which region of the brain is affected in athetoid/dyskinetic cerebral palsy?

A

Basal gangia

25
Q

Which region of the brain is affected in ataxic cerebral palsy?

A

Cerebellum

26
Q

Kernicterus is most associated with which type of cerebral palsy?

A

Dyskinetic

27
Q

Periventricular leukomalacia is most commonly associated with which type of cerebral palsy?

A

Spastic diplegia

28
Q

How are the two genders affected differently by muscular dystrophy?

A

Duchenne and Becker’s only affect males (x-linked recessive)

29
Q

When do clinical features of muscular dystrophy appear?

A

Duchenne: 2-5 years

Becker: no earlier than 15

30
Q

Where does muscular weakness begin in muscular dystrophy?

A

Proximal lower limbs

Then spreads to upper body and distal areas

31
Q

Epilepsy is most likely to occur in which type of cerebral palsy?

A

Spastic quadriplegia

32
Q

How is a diagnosis of Hirschprung’s disease confirmed?

A

Full-thickness rectal biopsy

33
Q

What are 3 antispasmodics which can be used for cerebral palsy?

A

Botulinum toxin

Baclofen

Dantrolene

Benzodiazepines

34
Q

What is the mechanism of baclofen?

A

GABA analogue

35
Q

What is athetosis?

A

Abnormal muscle contraction causes involuntary writhing movements

Seen commonly in cerebral palsy

36
Q

What is dystonia?

A

Sustained or repetitive muscle contractions result in twisting and repetitive movements or abnormal fixed postures

37
Q

How can glucose on CSF help distinguish viral from bacterial meningitis?

A

Bacterial: low

Viral: normal

38
Q

How can CSF protein levels help distinguish viral from bacterial meningitis?

A

Viral: slightly elevated

Bacterial: high

39
Q

How can the CSF:blood glucose ratio on CSF help distinguish viral from bacterial meningitis?

A

Viral: normal

Bacteria: low (decreased CSF glucose)

40
Q

What is the triad of rasied ICP (Cushing’s)?

A
  1. Systemic hypertension
  2. Bradycardia
  3. Respiratory depression
41
Q

What is craniosynostosis?

A

The premature fusion of one or more cranial sutures

Surgically managed

42
Q

What are the CSF findings in Guillain-Barre syndrome?

A

Elevated protein (increased permeability of the blood-nerve-barrier)

Normal cell counts

Albuminocytologic dissociation

43
Q

What is spinal muscular atrophy?

A

A group of autosomal recessive motor neuron diseases

Caused by apoptosis of lower motor neurons

44
Q

Which supplement is often used for migraine prevention?

A

Riboflavin (B2)

45
Q

What are the main types of CP?

A
  1. Spastic
  2. Ataxic
  3. Dyskinetic
46
Q

When in the course of acute rheumatic fever does Sydenham’s chorea occur?

A

1-8 months after inciting infection

Antibody cross-reaction with the basal ganglia and cortical structures

47
Q

How long do symptoms of Sydenham’s chorea persist?

A

3-4 months, sometimes persisting up to 2 years

48
Q

What type of CP is associated with chronic bilirubin encephalopathy?

What is the specific movement pattern?

A

Dyskinetic

Choreoathetoid

Chorea (irregular migrating contractions) and athetosis (twisting and writhing)

49
Q

What is the most common feature of chronic bilirubin encephalopathy?

A

High-frequency sensorioneural deafness

50
Q

A “milk maid’s grip” is characteristic of which encephalopathy?

A

Sydenham’s chorea

51
Q

What is a decorticate posture?

A
52
Q

What is a decerebrate posture?

A
53
Q

What is spina bifida occulta?

A

Failure of one or more vertebrae to close completely

The spinal cord, meninges and overlying skin remain intact

54
Q

What is a meningocele?

A

A neural tube defect

The meninges protrude through the gap made by failed of the closure of a vertebrae

55
Q

What is a myelomeningocele?

A

A neural tube defect

The meninges and spinal cord protrude through the gap made by failed of the closure of a vertebrae

56
Q

What is the most common cause of meningitis in children and teens?

A

Neisseria meningitidis

57
Q

What is the empirical treatment for meningitis in neonates and children < 2 months?

A

Cefotaxime + benzylpenicillin/amoxycillin

Add acyclivir if encephalitis is suspected

58
Q

What is the empirical treatment for meningitis in infants and children > 2 months?

A

Ceftriaxone + dexamethasone

Add acyclivir if encephalitis is suspected

Paediatrics (24 decks)

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