Neurology Flashcards
What are the four clinical patterns of headache disorders?
- Isolated acute
- Recurrent acute
- Chronic progressive
- Chronic non-progressive
What may be examined in a headache examination?
- Growth parameters, OFC, BP
- Sinuses, teeth, visual acuity
- Fundoscopy
- Visual fields (craniopharyngioma)
- Cranial bruit
- Focal neurological signs
- Cognitive and emotional status
What headache signs may point to raised ICP?
- Aggravated by activities that raise ICP eg. Coughing, straining at stool, bending
- Woken from sleep with headache +/- vomiting (Supine state)
What signs may point to analgesic overuse headache?
- Headache is back before allowed to use another dose
- Paracetamol/ NSAIDs
- Particular problem with compound analgesics eg. Cocodamol
When may there be indications for neuroimaging in headache?
- Features of cerebellar dysfunction
- Features of raised intracranial pressure
- New focal neurological deficit eg. new squint
- Seizures, esp focal
- Personality change
- Unexplained deterioration of school work
Give some examples of mimics to epilepsy?
- Acute symptomatic seizures
- Reflex anoxic seizure
- Syncope
- Parasomnias
- Behavioural stereotypies
- Psychogenic non-epileptic seizures
- Febrile convulsion
Why may diagnosis be challenging in childhood onset epilepsy?
- Non-epileptic paroxysmal disorders are more common in children
- Difficulty in explaining
- Difficulty in interpretation and synthesising information
What may EEG be useful for?
-Identifying seizure types, seizure syndrome and aetiology
When do posterior fontanelles close?
2-3 months after birth
When do anterior fontanelles close?
1-3 yrs
When should head circumference measurements be taken?
- Routine btween birth-3yrs
- Any child with neurological symptoms/developmental complaints
What is the definition of microcephaly?
OFC <2SD
If <3 = moderate/severe
What are some causes of microcephaly?
- Antenatal/Postnatal
- Genetic
- Environmental
What is the definition of macrocephaly?
OFC>2SD
What other physical abnormalities may present in macrocephaly?
- Facial feature changes,
- Hepatosplenomegaly,
- Bony deformities
