Paeds Neuro Flashcards
Characterise an infantile spasm
Fast, tonic contraction of the trunk and limb muscles with gradual relaxation over 1-2 seconds
Describe seizure seen in juvenile myoclonus epilepsy
Brief, bilateral arrhythmic irks typically of upper limb occurring 1-2 hours after waking
Do you use carbamezapine to treat juvenile myoclonic epilepsy?
NO! It makes it worse
What type of seizure is usually a/w aura
Temporal lobe
What eeg finding do you see in absence seizures?
3 second spike-and-waves
What are common auras for temporal lobe epilepsy ?
Nausea/ abdo pain/ dejavu/ sense of impending doom.
What eeg finding is consistent with benign Rolandic epilepsy?
Centrotemporal spikes
What type of epilepsy resolves by adulthood?
Benign Rolandic epilepsy
Weight gain, hair loss and gingival hypertrophy a/w what drug?
Sodium valproate
What anti-epileptic puts you at risk of stevens-Johnson syndrome? J
Carbamazepine
First line tested for generalised tonic-clonic seizures?
Sodium valproate
When isn’t sodium valproate first line for tonic-clonic seizures ?
Girls of childbearing potential
What is first line treatment for absence seizure (typical or atypical)
Ethosuximide
What is second line treatment for tonic or atonic seizures ?
Lamotrigine
What anti epileptic can impair effectiveness of oral contraceptives?
Topiramate
Define atonic seizure
Partial or complete limp-ness of body. Typically lasts <15 seconds, usually remain conscious
What epilepsy syndromes have myoclonus seizures?
Juvenile myoclonic epilepsy
Lennox-Gastaut syndrome
Progressive myoclonic epilepsy
What MRI findings are highly suggestive of acute disseminated encephalomyelitis ?
Multi focal diffuse white matter changes
What is inheritance of friedreich’s ataxia ?
Autosomal- recessive
What non-neurological finding is associated with friedreich’s ataxia?
Hypertrophic cardiomyopathy
Progressive Cerebellar symptoms, absent deep tendon reflexes, weakness of distal musculature and preserved intelligence suggests what ?
Friedreich’s ataxia
What is characteristic of Landau-kleffner syndrome ?
Acquired aphasia, in previously normal child. + self limiting tonic-clonic seizure
How do benign Rolandic epilepsy cases present?
Frequent, short lived, nocturnal seizures with complete recovery afterwards.
Big head, hands and feet is what syndrome?
Sotos syndrome
Describe infantile spasm
Runs of flexion and extension spasm, with peculiar cry and screaming
Normal development until 6-18 months then gradual regression in girls
Rett syndrome
Focal seizures occurring during sleep suggests what?
Frontal epilepsy
What is first line treatment for West Syndrome?
Vigabatrin
What anti-epileptic may cause peripheral visual field loss?
Vigabatrin
What is threshold for concern regarding weight centiles?
If on <9th centile then dropping one centile space is bad
If 9-91 st centile then a fall across two weight centiles
If >91 then fall across three weight centiles
What is first line treatment for anorexia nervosa?
Focused family therapy
How do proton pump inhibitors work?
Block H+/K+ ATP system in the gastric parietal cells
How should a mother who is classed high risk HIV be treated re birth?
IV maternal zidovudine, lower segment CS, baby to have combo antiretroviral therapy
Describe sturge-Weber syndrome
Pot wine stain forehead and upper eyelid. Seizures resistant to anticonvulsants. Hemiplagia on controlateral side of port wine stain
What is commonest cause of congenital adrenal hypoplasia
21-hydroxy enzyme def
What type of cells in Hodgkin’s lymphoma
Reed Sternberg cells
Describe Lennox-Gestraut syndrome
Intractable seizures, sever. Tonic and atonic. Development stagnation and regression in-between. Sodium valproate first line
