Neurology-Notes Flashcards
Lethargy?
deep and prolonged unconsciousness
profound slumber
but still somewhat arousable
Causes of altered mental status?
AEIOU TIPS A: alcohol, ingested toxins E: epilepsy, encephalitis, endocrine, electrolytes I: infection, insulin O: overdose, opiates, oxygen deprived U: uremia T: trauma, temp I: insulin, infections P: psychosis S: stroke, shock, space occupying lesions
Sturge Weber Syndrome?
seizure disorder
port wine stain face
leptomeningeal angioma-ID, episceral hemangioma
increased intraocular pressure, early onset glaucoma
give antiepileptics, can remove the cortex
What’s the deal with tuberous sclerosis?
seizures hamartomas MRG cardiac rhabdomyoma ash leaf spots renal angiomyolipoma shagreen patches subependymal astrocytoma
What is the workup for tuberous sclerosis?
echo
head ct-calcificed tubers in cerebrum near ventricles
renal CT
CXR
NF1?
cafe au lait spots
lisch nodules (pigmented iris hamartomas)
optic gliomas
pheochromocytomas
w/u with MRI of brainstem, spine
NF2?
bilateral CN8 palsies
screen for visual changes, learning disabilities, hearing loss
w/u with MRI
Von Hippel Lindau?
cavernous hemangioma
bilateral RCC
hemangioblastoma in retina, brainstem, cerebellum
Ataxia telangiectasia?
cerebellar dysfunction
telangectasia of the mucosa
Iga deficiency-lung infections
What is benign focal epilepsy of childhood?
awake, focal seizures involve the face, pharynx, arm conscious, unable to speak drooling, gagging EEG: discharge in central and midtemporal electrodes Tx: carbamazepine
Juvenile myoclonic epilepsy?
generalized spike and wave on EEG
treat with valproic acid
Infantile spasms?
massive myoclonic seizures with flexion and extension of trunk
EEG: hypsarrhythmia
treat with ACTH or valproic acid, clonazepam
drop seizures
Febrile seizure…which age do you do an LP?
todd’s paralysis?
sudden LOC
motor deficit improves within 24 hours, that is how you know it is not a stroke
Pilocytic astrocytoma?
cerebellum tumor
GFAP+
rosenthal fibers
Medulloblastoma?
cerebellum highly malignant compresses the 4th ventricle-hydrocephalus mets to spinal cord Homer-Wright rosettes small blue cells
Ependymoma?
ependymal cells in 4th ventricle
causes hydrocephalus
perivascular rosettes
Craniopharyngioma?
benign bitemporal hemianopsia from rathke pouch remains calcified. most common supratentorial tumor in kids. kind of like a pituitary adenoma for kids.
Think about arnold chiari malformation leading to hydrocephalus when you have a meningocele or myelomeningocele….need?
head CT
With communicating hydrocephalus…what happened?
decreased CSF absorption
have to think about infection
Arnold chiari malformation?
herniation of cerebellar tonsils thru foramen magnum
aquaductal stenosis and hydrocephalus
get ataxia, gait abnormalities, hydrocephalus, myelomeningocele
Dandy walker malformation?
cystic expansion of 4th ventricle atrophy of cerebellar vermis get increasing head size prominent occiput ataxia delayed motor development hydrocephalus spina bifida
