Paediatric Neurology Flashcards
What are examples of paediatric neurological pathologies?
- Congenital anomalies
- Neurogenetic diseases and syndromes
- Neurometabolic diseases and syndromes
- Acquired
- Infection, ischaemia, trauma, tumour
What is crucial from the history to determine differential diagnosis?
- Time course of symptoms crucial to determine differential diagnosis
What should be asked about in the developmental history?
- Motor milestones
- Gross and fine motor skills
- Speech and language development
- Early cognitive development
- Play
- Self-help skills
- Vision and hearing assessment
What are important parts of the examination for neurological pathologies?
- Opportunistic approach
- Appearance
- Gait
- Head size
- Skin findings
- Real world examination (depends on age)
What are some ‘common’ neurological conditions in children?
- Migraine
- Traumatic brain injury
- Tourette syndrome
- Epilepsy
- Brain tumours
- Second most common cancer in children
What are the different classifications of headache?
- Isolated acute
- Recurrent acute
- Chronic progressive
- Chronic non-progressive
What should be asked when presenting complaint is headache?
- Typical episode
- Any warning?
- Location?
- Severity?
- Duration?
- Frequency?
What examinations should be done for headache?
- Growth parameters, OFC, BP
- Sinuses, teeth, visual acuity
- Funduscopy
- Visual fields (craniopharyngioma)
- Cranial bruit
- Focal neurological signs
- Cognitive and emotional status
What are the 2 most common kinds of headache?
- Migraine
- Tension type headache
What are features of migraine?
- Associated abdominal pain, nausea, vomiting
- Focal symptoms/signs before, during, after attack
- Visual disturbance, paresthesia, weakness
- Pallor
- Aggravated by bright light/noise
- Relation to fatigue/stress
- Helped by sleep/rest/dark, quiet room
- Family history often positive
Compare and contrast migraine and tension headache:
- pain distribution and character
- associated symptoms
- exacerbating/relieving factors
- FH
What are red flag signs for:
- raised ICP
- analgesic overuse headache
What are indications for neuroimaging for headache?
- Features of cerebellar dysfunction
- Features of raised intracranial pressure
- New focal neurological deficit
- Such as new squint
- Seizures, especially focal
- Personality change
- Unexplained deterioration of school work
Migraine - management
- Acute attack
- Analgesia, triptans
- Prophylaxis
- At least 1/week to justify
- Drugs – Pizotifen, Propranolol, Amitryptyline, Topiramate, Valproate
What drugs can be used for migraine:
- acute attack
- prophylaxsis
- Acute attack
- Analgesia, triptans
- Prophylaxis
- At least 1/week to justify
- Drugs – Pizotifen, Propranolol, Amitryptyline, Topiramate, Valproate