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Paediatrics > Paediatric Neurology > Flashcards

Paediatric Neurology Flashcards

1
Q

What areas should be considered in a childs developmental history when taking a neurological history?

A

Gross and fine motor skill development

Speech and language development

Early cognitive development

Play and social behaviour

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2
Q

What should we loook out for on a neurological examination of a child?

A
  • Appearance
  • Gait
  • Head size
  • Skin
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3
Q

What are the most common neurological conditions children suffer with?

A

Migraine

Traumatic brain injury

Tourette syndrome

Epilepsy

Brain tumours

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4
Q

What are the different types of headaches that are most likely to have an underlying cause?

A

Isolated acute

Chronic progressive

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5
Q

What are the symptoms of childhood migraine?

A

Abdo pain, nausea and vomiting

Visual disturbance

Pallor

Aggravated by bright light/noise

Helped by sleep/dark quiet room

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6
Q

What are differences in pain experience in migraines compared to tension headaches?

A

Migraine = Hemicranial, throbbing/pulsatile pain

Tension = diffuse, symmetrical and band-like distribution

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7
Q

What features may indicate a headache caused by raised ICP?

A
  • Headache agggravated by coughing, straining etc.
  • Woken from sleep with headache
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8
Q

What would be the indications for imaging in paediatric headache cases?

A

1 - Signs of cerebellar dysfunction

2 - Signs of raised ICP

3 - Seizures

4 - Personality change

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9
Q

How are paediatric migraines treated?

A

Migraine:

  • Pain relief
  • Amitryptyline
  • Propanolol
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10
Q

What is an epileptic seizure?

A

An abnormal excessive hyper synchronous discharge from a group of neurons

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11
Q

What is epilepsy?

A

A tendency to recurrent, spontaneous epileptic seizures

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12
Q

What is a febrile convulsion?

A

Occurs between 3 months and 5 years and associated with fever

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13
Q

What are the mechanisms by which epileptic fits occur?

A

1 - Decreased inhibition (GABA)

2 - Excessive excitation (glutamate and aspartate)

3 - Excessive influx of Na and Ca ions

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14
Q

What are the different types of epileptic seizures?

A

Partial

Generalised (most common)

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15
Q

How is seizure type, seizure syndrome and etiology identified?

A

EEG

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16
Q

How is epilepsy diagnosed?

A

From the history

Video of the event

ECG during seizures

EEG between seizures

Brain MRI

17
Q

How are children with epilepsy managed?

A

Anti-epileptic drugs:

  • Sodium valproate (generalised)
  • Carbamazepine (focal)
18
Q

Apart from medication, what other treatment options are available for epilepsy?

A

Vagal Nerve Stimulation

Surgery

19
Q

What are the signs of a neuromuscular disorder in children?

A

Floppy baby

Objects slipping from hands

Reduced motor activity

Frequent falls when walking

20
Q

What are the potential locations of an NMJ disorder in children?

A

Muscle

NMJ

Nerve

Anterior horn cell

21
Q

Which gene is affected in duchenne muscular dystrophy?

A

Xp21 dystrophin gene

22
Q

What are the clinical signs of duchenne muscular dystrophy?

A

1) Delayed gross motor skills
2) Symmetrical proximal weakness:
- Waddling gait
- Calf hypertrophy
- Gower’s sign +ve
3) Elevated creatinine kinase
4) Cardiomyopathy

23
Q

What is the most likely cause of acute recurrent headaches?

A

Migraine

24
Q

Which headaches are most likely to have a serious underlying cause?

A

Chronic progressive

25
Q

Where do partial seizures occur?

A

One hemisphere on the brain

26
Q

Where do generalized seizures occur?

A

In both hemispheres

27
Q

What are the features of myoclonic seizures?

A

Brief

Shock-like jerks

28
Q

What are the features of clonic seizures?

A

Repeated jerking movements

29
Q

What are the features of tonic seizures?

A

Sudden increase in tone

Legs and arms go extremely stiff

30
Q

What are the features of atonic seizures?

A

Atonic = without tone

Muscles suddenly become limp

31
Q

In Duchenne Muscular Dystrophy what is a positive Gowers sign?

A

When a child needs to use their hands and arms to stand up from a sitting position

Paediatrics (25 decks)

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