Neurology Quiz: Diagnosis in Epilepsy Cases

Case Study 1: 14-Year-Old Boy with Progressive Weakness

• 14-year-old boy with a history of epilepsy presents with progressive weakness and tingling in lower limbs.
• Symptoms started two days ago, with facial, trunk, and upper limb involvement absent.
• Previous illness included fever and runny nose occurring 10 days prior to presentation.
• Physical examination shows 3/5 muscle strength in both lower limbs and absent reflexes.
• Vital signs: Blood pressure 120/80 mmHg, heart rate 85/min, respiratory rate 18/min, temperature 37.4°C.
• Most likely diagnosis: Guillain-Barré Syndrome, characterized by acute limb weakness and sensory changes.

Case Study 2: 5-Year-Old Boy with Seizure

• 5-year-old boy experienced a convulsion affecting all limbs lasting 3 minutes, with drooling and loss of consciousness.
• Recent history includes runny nose, mild cough, and fever lasting 3 days.
• Currently active with a mildly congested throat on physical examination.
• Vital signs: Blood pressure 120/80 mmHg, heart rate 98/min, respiratory rate 22/min, temperature 37.9°C.
• Most appropriate treatment option is Paracetamol for managing fever.

Sudden Infant Death Syndrome (SIDS) Prevention

• Use of a pacifier at bedtime may decrease the incidence of SIDS.
• Prone sleep position, soft sleeping mattresses, and sleep position support devices are not recommended for SIDS prevention.

Circumcision Considerations

• Circumcision should be avoided in cases of hypospadias due to potential complications.
• Phimosis, unilateral cryptorchidism, and posterior urethral valve are conditions where circumcision may still be considered.