Week two cases Flashcards
Why is an ECG advisable after a GTCS?
GTCSs can be cause by cerebral hypoxia resulting from cardiac rhythm disturbances
What aspects of a person’s medical history should be taken into account to find an underlying cause of epilepsy?
Birth history: Prematurity, difficult delivery, postnatal difficulties such as hypoxia or jaundice Childhood milestones/developmental delay Seizures in childhood/infancy Significant head injuries CNS infection Family history of epilepsy Medications Recreational drugs/alcohol
What are febrile convulsions? What is their relevance to epilepsy?
They are brief seizures seen during fever most common in children around 18 months old (more so in boys than girls). A proportion of children who have these develop epilepsy later in life . This is often in the form of seizures originating from the temporal lobe. It is associated with atrophy and scarring of this area.
What is the one AED where serum levels are closely correlated with efficacy?
Phenytoin
In MS what does a visual disturbance effecting one or both eyes tell you about the lesion of the defect?
If the lesion effects one eye it will be anterior to the optic chiasm in the relevant optic nerve retina or eye. if the lesion is behind this point it will effect both eyes
A relative afferent pupillary defect is a sign to which cranial nerve?
2
What vitamin deficiency can cause optic neuropathy that mimics neuritis?
vitamin B12
Damage to what four areas can cause gait ataxia?
Cerebellum and its connections (cerebellar ataxia), the dorsal columns of the spinal cord (sensory ataxia) Peripheral nerve/nerve roots (sensory ataxia) Vestibular apparatus and its connections
gait ataxia accompanied by urinary incontinence suggests a lesion where?
The dorsal columns spinal chord
gait ataxia accompanied by sensory loss or altered sensation indicates a lesion where?
the peripheral nerves/ nerve roots
gait ataxia accompanied by vertigo and nausea indicates a lesion where?
the vestibular apparatus
