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CH > Neurology > Flashcards

Neurology Flashcards

1
Q

What is the epidemiology of febrile convulsions?

A
  • Provoked by fever in otherwise normal children

- 6months–>5years old (peak at 18months)

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2
Q

What are the clinical features of febrile convulsions?

A
  • Usually occur early in a viral infection as temperature increases.
  • Seizures usually brief <5mins
  • Tonic-clonic
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3
Q

What are the type of febrile convulsions?

A

Simple, complex or febrile status epilepticus

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4
Q

What are the features of simple febrile convulsions?

A

<15mins
Generalised seizure
Typically no recurrence within 24hrs
Complete recovery within 1hr

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5
Q

What are the features of complex febrile convulsions?

A

15-30mins
Focal seizure
May have repeat within 24hrs

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6
Q

What are the features of febrile status epilepticus?

A

> 30mins

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7
Q

What is the prognosis in febrile convulsions?

A
  • Risk of further febrile convulsions 1 in 3.

- Background risk of developing epilepsy= 1%.

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8
Q

What are the risks of further febrile seizure development dependent on?

A
  • Age onset <18months
  • Fever <39 degrees
  • Shorter duration of fever before seizure
  • FHx of febrile convulsions
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9
Q

What is the tx of febrile convulsions?

A

If recurrences, teach parents how to use buccal Midazolam or rectal Diazepam

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10
Q

What are the risks of febrile convulsions for developing epilepsy?

A
  1. FHx epilepsy
  2. Complex febrile seizures
  3. Background of neurodevelopment disorder
  • If no risk factors= 1.5% risk
  • If all 3 risk factors= 50%
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11
Q

What parental advice should be given regarding febrile convulsions?

A

Benign condition
Risk of recurrence
Risk of epilepsy
Risk of developmental delay or LD

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12
Q

What are some of the associations with epilepsy?

A

Cerebral Palsy
Tuberose Sclerosis
Mitochondrial disease

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13
Q

Name some focal seizures

A
  • Focal aware or focal impaired awareness
  • Motor: Jacksonian March (distal–>proximal limb)
  • Non-motor: déjà vu, jamais vu, aura
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14
Q

What is the epidemiology of infantile spasms (West’s Syndrome)?

A

Brief spams in the first few months of life
4-6months old
Often preceded by developmental delay

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15
Q

What are the features of infantile spasms (West’s Syndrome)?

A
  1. Flexion of the head, trunk, limbs–>extension of arms (Salaam attacks) last 1-2s, repeat up to 50x.
  2. Progressive mental handicap.
  3. EEG: hypsarrhythmia
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16
Q

What are the features of Lennox-Gaustat Syndrome?

A
  • May be an extension of infantile spasms
  • Onset 1-5years
  • Atypical absences, falls, jerks
  • 90% moderate-severe handicap
  • EEG slow spike
17
Q

What are the features of Benign Rolandic Epilepsy?

A
  • 3-10years old
  • Tonic clonic seizures during sleep
  • Parasthesia (unilateral face) usually on waking up
18
Q

What are the features of Juvenile Myoclonic Epilepsy?

A
  • Typical onset in teens, more common in girls
  • Responds well to sodium valproate.
  1. Infrequent generalised seizures, often in morn
  2. Daytime absences
  3. Sudden, shock like myoclonic seizure.
19
Q

What are the general AED rules?

A 
Generalised= Na Valproate 
Partial= Carbamazepine 
Absence= Na Valproate or Ethosuximide
20
Q

Sodium Valproate: mechanism and s/e

A

Increases GABA activity, P450 enzyme inhibitor.

S/e: Alopecia, increased weight gain and appetite, hepatitis.

21
Q

Carbamazepine: mechanism and s/e

A

Binds to Na channels, increases their refractory period, P450 enzyme inducer.

S/e: SIADH, visual disturbances

22
Q

Lamotrigene: mechanism and s/e

A

Na channel blocker.

S/e: Stevens-Johnson Syndrome

23
Q

Phenytoin: mechanism and s/e

A

Binds to Na channels, increases their refractory period.

Bad s/e profile “ugly”

24
Q

What are some of the clinical features of Cerebral Palsy?

A

Abnormal tone in early infancy, delayed motor milestones, abnormal gait, feeding difficulties.

Non-motor: LD (60%), epilepsy (30%), squints (30%), hearing impairment (20%)

25
Q

What are some of the causes of cerebral palsy?

A

Antenatal (80%): malformations, congenital infection
Intrapartum (10%): birth, asphyxia, trauma
Postpartum (10%): IVH, meningitis, head trauma

26
Q

What is the classification of CP?

A

Spastic (70%)
Dyskinetic
Ataxic
Mixed

27
Q

What are some of the different neural tube defects?

A

Ancephaly
Encephalocoele
Myelomeningocele
Meningocele

28
Q

What is ancephaly?

A

Failure of brain to develop

29
Q

What is Encephalocoele?

A

Extrusion of the brain through the midline skull defect

30
Q

What is Myelomeningocele?

A

Abnormal spinal cord and exposed defect

31
Q

What is Meningocele?

A

Normal spinal cord, defect covered with skin

CH (7 decks)

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