neurology

Question 1

what points towards migraine in child headaches ?

Answer 1

associated abdominal pain, nausea, vomiting
focal symptoms before/after - visual, paresthesia, weakness
pallor
aggravated by bright light/noise
relation to fatigue/stress
helped by sleep, rest, dark
FHx +ve

Question 2

how do you treat migraines ?

Answer 2

pain relief, triptans

preventative - pizotifen, propranolol, amitriptyline, topiramate, valproate

Question 3

what causes non-epileptic seizures and mimics in children ?

Answer 3

acute symptomatic - hypoxia, hypoglycaemia, infection, trauma
reflex anoxic seizure - toddlers
syncope
parasomnias
behavioural stereotypes
psychogenic seizures

Question 4

what is a febrile convulsion ?

Answer 4

occurring in infancy between 3 months - 5 years

associated with fever but no intracranial infection

Question 5

how do you manage epilepsy ?

Answer 5

sodium valproate - generalised, not in girls

carbamazepine - first line focal

Question 6

when should you suspect neuromuscular disorder ?

Answer 6

floppy from birth
slips from hands
paucity of limb movement
alert but less activity
delayed motor milestones
frequent falls

Question 7

what is the affected gene in Duchenne muscular dystrophy ?

Answer 7

Xp21, dystrophin gene

males

Question 8

what are symptoms of Duchenne muscular dystrophy ?

Answer 8

delayed gross motor skills
symmetrical proximal weakness - waddling gait, calf hypertrophy

elevated creatinine kinase
cardiomyopathy
respiratory involvement in teens