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Paediatrics > Neurology > Flashcards

Neurology Flashcards

1
Q

Features of TTH

A

Diffuse, bilateral
“Band like”
Present most of the time
Constant ache with little variation

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2
Q

Features of migraine

A 
Hemi cranial pain Throbbing 
Pulsatile 
Abdo. pain 
Vomiting 
Releived by rest/dark/ quiet room  
Photophobia/ phonophobia 
Visual, sensory, motor aura
\+ve FH
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3
Q

Pointers to increased intracranial pressure

A

Aggravated by activities that raise ICP
e.g coughing, bending straining
Woken from sleep with headache/vomiting
Papilloedema

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4
Q

Pointers to analgesic overused headaches

A 
Particularly relevant to TTH
Vicious cycle 
Back before allowed to use another dose
Paracetamol/NSAIDs
Particular problem with compound analgesics e/g Cocodamol
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5
Q

Indications for neuroimaging

A 
Features cerebellar dysfunction 
Increased ICP signs 
New focal neurological deficit 
Seizures
Personality change 
Unexplained deterioration at schoo,
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6
Q

Rx for TTH

A 
Aim reassurance
No sinister cause 
MDT approach 
Acute attacks = simple analgesia 
Prevention = amitriptyline
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7
Q

Rx for medication overuse headaches

A

Stop analgesics

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8
Q

Acute attack Rx for migraine

A

Pain relief (triptans)

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9
Q

Preventative Rx for migraine

A

Pizotifen, Propanolol, Amitryptiline, Topiramate, Valproate

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10
Q

Most common types of primary headaches

A

TTH

Migraine

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11
Q

Dx criteria for epilepsy

A

Tendency to recurrent (at least 2), unprovoked (spontaneous) epileptic seizures

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12
Q

2 broad types of epileptic seizures

A

Generalised

Partial

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13
Q

does a single seizure = epilepsy

A

no

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14
Q

Causes of epileptic seizures

A 
Often idiopathic
Infection 
Hyponatraemia 
glc
Trauma 
Metabolic defects 
Tuberous sclerosis 
CNS tumour 
Arrhythmia
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15
Q

Rx for generalised seizures

A

Sodium Valproate

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16
Q

Who is sodium valproate CI in

A

F of child bearing age

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17
Q

Rx for focal seizures

A

Carbamezepine

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18
Q

New AEDs examples

A

Lamotrigine
Levatiracetam
Perampanel
Gabapentin

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19
Q

Other therapies to Rx epilepsy

A 
Steroids 
Immunoglobulin 
Ketogenic diets 
VNS 
Surgical
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20
Q

What is the purpose of AEDs

A

Used to control seizures not cure epilepsy

21
Q

Types of non-epileptic seizures

A 
Acute Symptomatic seizures 
Reflex anoxic seizure
Syncope 
Parasomnias e.g night terrors 
Behavioural stereotypies 
Psychogenic seizures
22
Q

What is the commonest cause of acute symptomatic seizure in childhood

A

Febrile convulsion

23
Q

What is a febrile convulsion

A

Convulsion that occurs in 3mnths-5yrs
Associated with fever
But without evidence of intracranial infection or defined cause for seizure

24
Q

Ix for epilepsy

A 
Hx
Video recording 
EEG (convulsive seizures)
MRI brain 
Genetics (e.g tuberous sclerosis)
Metabolic tests
25
Q

What is a generalised seizure

A

Affects both lobes of the brain

Generalised

26
Q

What is a focal seizure

A

Affects only one part of the brain

27
Q

Types of Childhood epilepsy syndromes

A

Infantile Spasms (West Syndrome)

Benign Rolandic Epilepsy (BRE)

Juvenile Myoclonic Epilepsy (JME)

Lennox-Gastaut Syndrome (LGS)

Childhood Absence Epilepsy

28
Q

Inheritance mode of Duchenne Muscular Dystrophy

A

X-linked recessive pattern

29
Q

Which gender are affected by Duchenne Muscular dystrophy

A

Male

30
Q

How many muscular dystrophies are there

A

9

31
Q

What is the milder form of Duchennes known as

A

Becker

32
Q

Clinical features of Duchennes

A

Symmetrical proximal weakness
Bulky calf muscles
Gowers Sign +ve
Waddling gait

Scoliosis

Cardiomyopathy
Resp. involvement in teens

33
Q

Ix for Duchennes

A

Elevated Creatinine Kinase
Muscle biopsy
EMG

34
Q

Why is Benign Rolandic Epilepsy called benign

A

Because many children outgrow it by adolescents

35
Q

Describe benign rolandic epilepsy syndrome

A 
Simple partial seizures
Often nocturnal 
Prodrome: Tingling feeling in mouth 
Speech can be affected 
Jerking of the mouth
36
Q

Name some childhood epilepsy syndromes

A 
Benign Rolandic Epilepsy 
Childhood absence seizures 
Juvenile Myoclonic Epilepsy 
Lennox Gastaut Syndrome 
Infantiles Spasms (West Syndrome)
37
Q

Explain Childhood absence seizures syndrome

A 
Seizures occur frequently 
V. brief (few scs)
Often go unnoticed 
Look bland or stare
Eyelids may flutter 
Unresponsive to surroundings 
Abrupt onset 
Abrupt offset
38
Q

Rx for absence seizures

A

Ethosuximide

39
Q

What 3 types of seizures occur in juvenile myoclonic epilepsy

A

Myoclonic
Tonic cloni
Absence

40
Q

What is the trigger for seizures in 40% juvenile myoclonic epilepsy

A

Photosensitivity

Flashing/flickering lights

41
Q

What types of seizures can occur in Lennox Gastaut Syndrome

A 
Tonic 
Atonic
Myoclonic 
Tonic clonic 
Atypical absences
‘drop attacks’
42
Q

Rx for Lennox Gastaut Syndrome

A

Difficult to treat

Sodium valproate 1st line generally

43
Q

Describe seizures in infantile spasms (west syndrome)

A

Brief spasms or jerks
Involving head, trunk, extremities
Happen in clusters (episodes 1-2 secs)
Typically occur before sleep, after waking

44
Q

When does infantile spasm syndrome typically begin

A

First year of life

45
Q

What does EEG show in infantile spasm

A

Hypsarrhythmia

46
Q

Rx for infantile spasms

A

Vigabatrin
Ketogenic diet
Prednisolone

47
Q

What can infantile spasms develop into/

A

Lennox Gastaut syndrome

48
Q

What do many children with Lennox-Gastaut syndrome

A

Learning difficulties

Behavioural problems

49
Q

when does Juvenile Myoclonic Epilepsy occur

A

Adolescents

Typically 12-18yrs

Paediatrics (13 decks)

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