Paeds - neuro Flashcards
Management of Infantile spasms
`im ACTH daily/oral red
Vigabatrin if tuberous sclerosis
Ix in child with reflex anoxic seizures
ECG
Hb/ferritin
signs of a complex febrile convulsion
Focal seizure
>15 mins
>1 episode in a single illness
Advice to parents of febrile convulsion
Arrange GP review
- 1/3 will recur
- if generalised, no increased risk of epilepsy
- Avoid head trauma
- safety net: non-blanching rash, >5 mins, confusion post octal state, fever >5 days, >1 convulsion in same illness
Drug often used for epilepsy patient with generalised seizures
sodium valproate
Drug often used for epilepsy patient with focal seizures
carbemazepine
When is MRI indicated in ?epilepsy
Focal seizures
<2yo
Poor response to drug tx
Bells palsy - which CN?
7
Which virus is bells palsy commonly associated with
HSV
Complication of bells palsy? why?
Conjunctivitis (eye can’t close)
Pathophysiology behind Duchenne MD?
- X-linked recessive
- Dystrophin mutation –> disrupted Ca-calmodulin complex –>myofibre necrosis
Later features of DMD
Resp failure
Cardiomyopathy
Wheelchair bound by 10-14yo
Scoliosis
2 useful meds for DMD
Predinoslone
VitD and Ca
Becker’s vs duchennes
Beckers is a slower progression
Cause of myotonic MD
nucleotide triplet repeat expansion
Useful (and unusual) management of HIE
Mild hypothermia for 3 days
Features of Tuberous sclerosis
Leaf like patches
Rough patches
Adenoma sebaceum
West syndrome
Focal seizures
Neurofibromatosis
> 6 cafe au last spots
Axillary freckling
Lisch nodule
Neurofibroma
Optic gnome
1st degree relative with NF
Dilated pupil on R side
History of trauma
CN 6 palsy
R sided extradural haemorrhage
Ix in suspected NAI –> cerebral haemorrhage
CT head
full skeletal survey
Ophthalmoscopy
Coagulation screen
Port wine stain - what exactly is it? when should an MRI be done in these patients and why?
Hemangioma
- if it is on the hair line or trigeminal nerve distribution –> risk of epilepsy
