Paediatric Neurology Flashcards
What are the classifications of hydrocephalus?
Whether or not the ventricles communicate with the subarachnoid space.
If non-communication got obstruction is intra-ventricular
If communicating then the obstruction is extra-ventricular
What features will be found on inspection of an infant with hydrocephalus?
Increased head circumference out of proportion with growth
Pressure on the anterior fontanelle is increased
If untreated then sun setting sign of the eyes can be present
In older children what may the presenting features be?
Headche Vomiting Lethargy Irritability Papilloedema
How is hydrocephalus diagnosed?
In young children where the anterior fontanelle is still open USS can be used to assess the ventricles.
In older children CT will be used.
MRI is used to find the location of the obstruction
What is the treatment of hydrocephalus?
Ventriculoperitoneal shunt
What are the intraventricular causes of hydrocephalus?
Aqueduct stenosis
Dandy-Walker syndrome
Tumour
Ventriculitis
What is dandy-walker syndrome?
A congenital condition where the cerebellar vermis is not formed which can lead to hydrocephalus
What is craniosynostosis?
Premature fusion of the cranial sutures leading to abnormal shaped skull, most commonly the sagittal suture which leads to long and narrow skull
What are the 3 main causes of encephalitis in children in the UK?
HSV I+II
Enterovirus
Varicella
What is the definition of cerebral palsy?
A disorder of motor function die to a static lesion of the brain
What are the clinical features of cerebral palsy?
Delayed motor milstones
abnormal tone and posturing in infancy
Feeding difficulties due to oromotor coordination
Delayed speech and language
How is the diagnosis of cerebral palsy made?
It is a clinical diagnosis which is made by assessing tone, reflexes, abnormal movement (chorea), low power, abnormal posture or gait
What are the 4 classification of cerebral palsy?
Spastic
Dyskinetic
Ataxic
Mixed
Where is the brain lesion in spastic cerebral palsy and how may the disease manifest?
Pyramidal pathway which leads to increased done, brisk reflexes and reduced tone. Can affect any or all of the limbs
Where is the brain lesion in ataxic cerebral palsy?
The cerebellum, abnormal gait and past pointing etc
What treatment can be given of children who are experiencing hypertonia as a result of their cerebral palsy?
Botulinum toxin injections
What is West Syndrome? what does it cause and how can it be treated?
epilepsy whereby a 4-6month old child has extremely violent seizures. Treatment is with ACTH
What is Neurofibromatosis type 1, what is the inheritance pattern and what are the important clinical features?
An autosomal dominent condition where by there are neurofibrus lesions in the sin. It is autosomal dominant.
Clinical features:
- more that 6 cafe-au-lait spots
- Lisch nodule (pigmented hamartoma of the eye
- Neurofibromatomas which are palpable on periphery nerves at >8yo
What is Neurofibromatosis type 2?
Similar pathophysiology to type 1 but is known as central neurofibromatosis as it affects the CNS.
Presentation is with seizures, learning difficulty or with a range of central nervous symptoms
