Neurology-Notes

Question 1

Lethargy?

Answer 1

deep and prolonged unconsciousness
profound slumber
but still somewhat arousable

Question 2

Causes of altered mental status?

Answer 2

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

Question 3

Sturge Weber Syndrome?

Answer 3

seizure disorder
port wine stain face
leptomeningeal angioma-ID, episceral hemangioma
increased intraocular pressure, early onset glaucoma
give antiepileptics, can remove the cortex

Question 4

What’s the deal with tuberous sclerosis?

Answer 4

seizures
hamartomas
MRG
cardiac rhabdomyoma
ash leaf spots
renal angiomyolipoma
shagreen patches
subependymal astrocytoma

Question 5

What is the workup for tuberous sclerosis?

Answer 5

echo
head ct-calcificed tubers in cerebrum near ventricles
renal CT
CXR

Question 6

NF1?

Answer 6

cafe au lait spots
lisch nodules (pigmented iris hamartomas)
optic gliomas
pheochromocytomas

w/u with MRI of brainstem, spine

Question 7

NF2?

Answer 7

bilateral CN8 palsies
screen for visual changes, learning disabilities, hearing loss
w/u with MRI

Question 8

Von Hippel Lindau?

Answer 8

cavernous hemangioma
bilateral RCC
hemangioblastoma in retina, brainstem, cerebellum

Question 9

Ataxia telangiectasia?

Answer 9

cerebellar dysfunction
telangectasia of the mucosa
Iga deficiency-lung infections

Question 10

What is benign focal epilepsy of childhood?

Answer 10

awake, focal seizures
involve the face, pharynx, arm
conscious, unable to speak
drooling, gagging
EEG: discharge in central and midtemporal electrodes
Tx: carbamazepine

Question 11

Juvenile myoclonic epilepsy?

Answer 11

generalized spike and wave on EEG

treat with valproic acid

Question 12

Infantile spasms?

Answer 12

massive myoclonic seizures with flexion and extension of trunk
EEG: hypsarrhythmia
treat with ACTH or valproic acid, clonazepam
drop seizures

Question 13

Febrile seizure…which age do you do an LP?

Question 14

todd’s paralysis?

Answer 14

sudden LOC

motor deficit improves within 24 hours, that is how you know it is not a stroke

Question 15

Pilocytic astrocytoma?

Answer 15

cerebellum tumor
GFAP+
rosenthal fibers

Question 16

Medulloblastoma?

Answer 16

cerebellum
highly malignant
compresses the 4th ventricle-hydrocephalus
mets to spinal cord
Homer-Wright rosettes
small blue cells

Question 17

Ependymoma?

Answer 17

ependymal cells in 4th ventricle
causes hydrocephalus
perivascular rosettes

Question 18

Craniopharyngioma?

Answer 18

benign
bitemporal hemianopsia
from rathke pouch remains
calcified.
most common supratentorial tumor in kids. kind of like a pituitary adenoma for kids.

Question 19

Think about arnold chiari malformation leading to hydrocephalus when you have a meningocele or myelomeningocele….need?

Answer 19

head CT

Question 20

With communicating hydrocephalus…what happened?

Answer 20

decreased CSF absorption

have to think about infection

Question 21

Arnold chiari malformation?

Answer 21

herniation of cerebellar tonsils thru foramen magnum
aquaductal stenosis and hydrocephalus

get ataxia, gait abnormalities, hydrocephalus, myelomeningocele

Question 22

Dandy walker malformation?

Answer 22

cystic expansion of 4th ventricle
atrophy of cerebellar vermis
get increasing head size
prominent occiput
ataxia
delayed motor development
hydrocephalus
spina bifida