Neurology Flashcards
what is a febrile convulsion
generalised tonic-clonic seizure occurring in child with fever
what is a breath holding attack
child is upset/crying/worked up and stops breathing, becomes cyanotic and loses consciousness
- recover within 1 minute
what is a reflex anoxic seizure
occurs when child is startled
- vagnus nerve sends signals to heart for it to stop beating
- child goes pale, collapses and may have some seizure like muscle twitching
- heart returns to normal within 30s and child regains consciousness
what are the types of epileptic seizures
focal seizures absence seizures atonic seizures myoclonic seizures tonic seizures clinic seizures tonic-clonic seizures
where to focal seizures occur
temporal lobe
difference between
- simple focal seizure
- complex focal seizure
simple = without loss of consciousness complex = with loss of consciousness
symptoms of focal seizure
hallucinations
deja vu
memory flashbacks
repetitive movements on autopilot
Tx of focal seizures
- 1st line
1st line: carbamazepine / lamotrigine
2nd line: sodium valproate
how does an absence seizure present
child becomes blank, stares into space, unresponsive then upruptly returns back to normal
- typically lasts 10-20 s
- majority stop having seizures as they grow up
tx of absence seizures
1st line: sodium valproate or ethosuximide
how does a atonic seizure present
sudden loss of muscle tone causing collapse - ‘drop attack’
tx of atonic seizures
1st line: sodium valproate
2nd line: lamotrigine
presentation of a myoclonic seizure
sudden brief jerks in arms + legs
what is juvenile myoclonic epilepsy
early morning myoclonic seizures
daytime absences
tx of myoclonic seizures
sodium valproate
presentation of a tonic seizure
stiffening of muscles in back / arms / legs
presentation of a clonic seizure
rhythmic jerking movements
presentation of a tonic clonic seizure
‘grand mal’ seizure
- loss of consciousness
- muscle tensing + rhythmic jerking movements
- post ictal period
- may experience tongue biting / incontinence
tx of tonic-clonic seizures
1st line: sodium valproate
2nd line: lamotrigine
what is sodium valproate’s mechanism of action?
what are the side effects?
increases GABA activity
- teratogenic
- liver damage / hepatitis
- hair loss
- temor
what is lamotrigine’s mechanism of action?
what are the side effects?
blocks sodium channels
- Steven Johnston syndrome
what channels does carbamazepine act on?
what are the side effects of carbamazepine?
sodium channels
- agranulocytosis
- aplastic anaemia
- induces p450 system
what is hydrocephalus
increased CSF within brain/spinal cord
either due to
- overproduction
- problem with draining / absorption
signs of hydrocephalus in an infant
enlarging head size
bulging fontanelles
poor feeding / vomiting
papilloedema
most common congenital cause of hydrocephalus
aqueductal stenosis leading to decreased drainage
management of hydrocephalus
Ventriculoperitoneal shunt
what is cerebral palsy
permanent neurological problems resulting from hypoxic damage to the brain around the time of birth
what is an infantile spasm
repeated flexion of head, arms + trunk followed by extension of arms (‘Salaam attack’)
- poor prognosis
- progressive mental handicap
EEG changes in an infantile spasm
hypsarrhythmia
most common cause of headache in children
migraine
