Peadiatrics - Neurology & Tumours Flashcards
What are some red flags of headaches in children?
Pappiloedema, visual loss Any neurological symptoms Recurrent, worse in mornings vomiting growth problems < 3 years old diabetes insipidus symptoms
What are some symptoms of brain tumours in children?
headache and vomiting
papilloedema, squint, nystagmus
ataxia
personality/behaviour change
What are Wilm’s tumours and symptoms of it?
the most common renal tumours in childhood
Abdominal mass, haematuria
Abdo pain, anaemia, anorexia
What is a neuroblastoma and some common symptoms?
Tumour in neural crest tissue of adrenal medulla or sympathetic nervous system
pallor, weight loss, abdo mass, hepatomegaly, bone pain, limp
When would an enlarged lymph node in a child require biopsy?
No apparent cause persistent unusual spot e.g. supraclavicular fever, weight loss organomegaly CXR - abnormal
What is leukemia?
What symptoms would children show?
When bone marrow produces increased number of abnormal or immature WBC
Children present with signs of bone marrow infiltration = fever, fatigue, frequent infections, organomegaly, anaemia, bruising
How common are febrile convulsions?
Initial and relapses
3% in 6 months - 6 years
10% risk if 1st degree relatives
30-40% have further esp. if child is younger, the convulsion occurs earlier in illness or at lower temperature, family history
What are complex febrile convulsions?
focal
prolonged > 5 minutes
multiple in 1 illness
increased risk of epilepsy to 4-12%
Name 3 features of a non-epileptic attack
resist eyes being opened, shoulder shrugging, emotional, pelvic thrusting, partially responsive, purposeful moving esp. toe tapping
What is a febrile convulsion?
epileptic seizure (usually short, generalised tonic-clonic) with fever without intracranial infection
How would you treat epilepsy?
drugs e.g. Keppra
vagal nerve stimulation
surgery
What is epilepsy? Name 3 types
excessive and hypersynchronous electrical activity and typically in cerebral cortex
gelastic, atonic, tonic, frontal lobe, focal, myoclonic, absence
What are some causes of cerebral palsy?
infection, hypoxic, haemmorhages
prenatal congenital
postnatal trauma
Name the 4 types of cerebral palsy
spastic
dyskinetic/dystonia
ataxia
mixed
How would you diagnose and treat absence seizures?
hypoventilation & EEG (3hz spike wave)
Ethosuzimide
How would you treat juvenile myoclonic epilepsy?
Keppra
Valporate - avoid in females
Lamotrigene
What is jevnile myoclonic epilepsy? What condition is it related to?
10% people with absence seizures develop it
morning symptoms e.g. knocking over cereal
mycolonic seizures - brought on by sleep deprivation
What are the 4 main types of spastic cerebral palsy?
UMN symptoms
hemiplegic
quadriplegic
diplegic
What are the 4 types of MND?
amyotrophic lateral sclerosis (most common)
Progressive bulbar palsy (PMP)
progressive muscular atrophy (PMA)
primary lateral sclerosis (PLS)
How would you treat MND?
Riluzole - sodium channel blocker
Baclofen - GABA agonist
Supportive
What is the definition of a febrile seizure?
A seizure in association with a fever with no definable intracranial cause
What is defined as a simple vs. complex febrile seizure?
Simple: under 15 mins, not recurring in 24 hours
Complex: over 15 minutes, focal or recurring within same febrile illness - 4-12% risk of developing epilepsy
What are some complications of Wilm’s tumours?
malnutrition
metastases
hypertension
renal impairment
What are some long term complications of childhood oncological disease?
haemotylogical malignancy
educational difficulties
short stature
infertility
What would you see on an MRI for MS?
multiple hyperintense inflammatory white matter lesions
