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Paediatrics > Paediatric neurology > Flashcards

Paediatric neurology Flashcards

1
Q

What are some developmental points which are important for any paeds history?

A 
Motor milestones
Speech and language development
Early cognitive development
Play esp. symbolic play and social behaviour
Self-help skills
Vision and Hearing assessment
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2
Q

Which syndrome is associated with about 1% of OCD and ADHD sufferers?

A

Tourette

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3
Q

What are some clinical classifications of headaches in kids?

A

Isolated acute
Recurrent acute
Chronic progressive
Chronic non-progressive

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4
Q

What are some useful examinations in headaches?

A 
Growth parameters
Sinuses
Teeth
Visual acuity
Fundoscopy
Visual fields
Cranial bruits
Cognitive and emotional status
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5
Q

What are some signs and symptoms associated with childhood migraine?

A 
Abdominal pain
Nausea
Vomiting
Visual disturbance
Paraesthesia
Weakness
Pallor
Photosensitivity
Fatigue
Symptoms eased by dark quiet setting
Family history
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6
Q

How does pain the differ between migraine and tension headache?

A

Migraine hemicranial, throbbing pain

Tension headache diffuse and symmetrical band-like distribution of pain

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7
Q

How does persistence of pain differ between migraine and tension headache?

A

Migraine relieved by rest

Tension headache present most of the time

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8
Q

What are some signs which point to a raised ICP causing the pain?

A

Aggravated by activities raising ICP like coughing, passing, stool, bending
Woken from sleep
Vomiting

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9
Q

What are some signs which point to analgesic overuse causing the pain?

A

Headache is back before allowed to use another dose
Paracetamol/ NSAIDs
Particular problem with compound analgesics eg. Cocodamol

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10
Q

What might indicate neuroimaging for headahce?

A 
Cerebral dysfunction
Raised ICP
New focal neurological deficit eg. new squint
Seizures
Personality change
Unexplained deterioration of school work
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11
Q

What are some preventative meds given at least 1 week after migraine?

A 
Pitzotifen
Propanolol
Amitryptyline
Topiramate
Valproate
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12
Q

Do we use any meds for prevention in TTH?

A

Can use amitryptyline

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13
Q

How do we manage acute TTH attacks?

A

Simple analgesia

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14
Q

Why do we discourage analgesics in chronic TTH?

A

Often overuse is the cause

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15
Q

What is an epileptic seizure?

A

An abnormal excessive hyper synchronous discharge from a group of (cortical) neurons

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16
Q

What are some causes of acute symptomatic seizures?

A

Hypoxia-ischaemia
Hypoglycaemia
Infection
Trauma

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17
Q

What is a febrile convulsion?

A

Seizure occurring in infancy/childhood

Associated with fever but no evidence of infection

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18
Q

What kind of seizure would be indicated by a jerk/shake movement?

A

Clonic
Myoclonic
Spasms

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19
Q

What kind of seizure usually causes stiffness?

A

Tonic

20
Q

What kind of seizure usually causes falls?

A

Atonic
Tonic
Myoclonic

21
Q

What kind of seizure causes vacant attacks?

A

Absence

Complex partial

22
Q

What is affected in decreased inhibition during an epileptic fit?

A

GABA

23
Q

What is affected in excessive excitation during an epileptic fit?

A

Glutamate

Aspartate

24
Q

What are the 3 chemical triggers of epileptic fits?

A

Decreased inhibition
Excessive excitation
Excessive influx of Na and Ca ions

25
Q

What is the moa of an epileptic fit?

A

Summation of a multitude of electrical potentials results in depolarization of many neurons which can lead to seizures, can be recorded from surface electrodes (Electroencephalogram)

26
Q

What is are some good questions for a stepwise approach to epilepsy
diagnosis?

A

Is the paroxysmal event epileptic in nature?
Is it epilepsy?
What seizure types are occurring?
What is the epilepsy syndrome?
What is the etiology?
What are the social and educational effects on the child?

27
Q

What is EEG useful for?

A

Identifying seizure types
Seizure syndrome
Aetiology

28
Q

What are some good tests for determining seizure aetiology?

A

MRI

EEG

29
Q

What are the 1st line treatment options for generalised epilepsies?

A

Sodium valproate

Levetiracetam

30
Q

Which group should not be prescribed sodium valproate?

A

Girls

31
Q

What is an option for drug-resistant epilepsies?

A

Ketogenic diet

32
Q

What is first line for focal epilepsies?

A

Carbamazepine

33
Q

What are some new AEDs with fewer side effects?

A

Lamotrigine
Perampanel
Levatiracetam

34
Q

When does the anterior fontanelle usually close?

A

1-3 years

35
Q

What is the standard measurement of head size?

A

Occipitofrontal circumference

36
Q

What is plagiocephaly?

A

Flat head

37
Q

What is brachycephaly?

A

Short head or flat at back

38
Q

What is scaphocephaly?

A

Boat shaped skull

39
Q

When should you expect a neuromuscular (NM) disorder?

A 
Baby ‘floppy’ from birth
Slips from hands
Paucity of limb movements
Alert, but less motor activity
Delayed motor milestones
Able to walk but frequent falls
40
Q

What are some signs of Duchenne Muscular Dystrophy?

A 
Delayed gross motor skills
Symmetrical proximal weakness
Elevated creatine kinase
Cardiomyopathy
Resp involvement
41
Q

What is a blood result to be expected in Duchenne Muscular Dystrophy?

A

Elevated Creatine Kinase

>1000

42
Q

What are some genes associated with DMD?

A

Xp21

Dystrophin

43
Q

How does symmetrical proximal weakness in DMD present?

A

Waddling gait
Calf hypertrophy
Gower’s sign positive

44
Q

What is a positive Gower’s sign?

A

Child gets up from prone position by going onto all-fours then extending legs and arms, forming a triangle
Hands then lifted onto thighs and child “crawls” up thighs to upright position
Weakness of proximal hip muscles

45
Q

What cells are affected by spinal muscular atrophy?

A

Anterior horn cell

Paediatrics (25 decks)

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