Paeds: Neurology

Question 1

How to assess Intracranial pressure in an infant (On examination)?

Answer 1

Palpate the anterior fontanelle

Question 2

Signs of hypertonia in an infant?

Answer 2

• Resistance to passive extension of limbs
• Scissoring of the lower limbs

Question 3

Signs of hypotonia in an infant?

Answer 3

• Overall floppy, ragdoll like baby
• Ventral position, drooping
• Head lag, when you pull the baby to sit

Question 4

Assymetrical tonic neck reflex, what is it?

Answer 4

‘Fencing posture’. Head turned to one side, arm on that side is extended while other arm is flexed. Dissappears by 6-7 months.

Question 5

Moro reflex. What is it?

Answer 5

Moro reflex: Symmetrical abduction and then adduction of the arms when the baby’s head is dropped back quietly into your hand. Usually disappears by 4 months.

Question 6

A 9 month old baby seizing. EEG shows hypsarrhythmia. Most likely diagnosis?

Answer 6

West’s syndrome

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aka infantile spasms

A form of generalized myoclonic seizures

EEG has a characterisitc hypsarrhythmic pattern.

Often associated with a serious underlying condition and the prognosis is poor.