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Questions and Answers
Tics, are;
Tics, are;
Tourette syndrome criteria met all, except one:
Tourette syndrome criteria met all, except one:
When Tics are the main problem, in Tourette syndrome, first line therapy include:
When Tics are the main problem, in Tourette syndrome, first line therapy include:
In Hemiplegic cerebral palsy we can see all, except one:
In Hemiplegic cerebral palsy we can see all, except one:
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Several drugs can be used to treat spasticity, including all, except one:
Several drugs can be used to treat spasticity, including all, except one:
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A person with ADHD - predominantly which type, has a hard time 'putting on the brakes' before acting (choose the right word)
A person with ADHD - predominantly which type, has a hard time 'putting on the brakes' before acting (choose the right word)
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Children with ADHD often have a smaller:
Children with ADHD often have a smaller:
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By what age is autism usually diagnosed:
By what age is autism usually diagnosed:
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Which of the following is a sign of autism:
Which of the following is a sign of autism:
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Which of the following causes autism:
Which of the following causes autism:
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Study Notes
Tics and Tourette Syndrome
- Tics are stereotyped motor behaviors that are unlike stereotypies, as they are less predictable and often last only a few seconds or less.
- Tics can occur repeatedly, in clusters, or in longer patterns and tend to "wax and wane" and change over time.
- Tics are more common under circumstances of stress, anger, excitement, or anxiety.
Tourette Syndrome Criteria
- To meet the criteria for Tourette syndrome, an individual must have both vocal and motor tics, which are complex and persistent over time.
- The tics must last for at least 1 year, and the individual must not have any other underlying conditions that could be causing the tics.
Therapy for Tourette Syndrome
- The first-line therapy for Tourette syndrome when tics are the main problem includes clonidine, followed by haloperidol and pimozide if clonidine is ineffective or not well-tolerated.
Hemiplegic Cerebral Palsy
- In hemiplegic cerebral palsy, an individual may exhibit tiptoe walking, muscle hypotonia, ankle clonus and Babinski sign, and an increase in deep tendon reflexes.
- Weakness of the hand and foot dorsiflexors and equinovarus deformity of the foot may also be present.
Treatment of Spasticity
- Several drugs can be used to treat spasticity, including oral diazepam, baclofen, and dantrolene.
- Levodopa is not typically used to treat spasticity.
ADHD
- An individual with ADHD, predominantly of the hyperactivity-impulsivity type, has a hard time "putting on the brakes" before acting.
- Children with ADHD often have a smaller frontal lobe cortex.
Autism
- Autism is usually diagnosed by 18 months to 2-2.5 years of age.
- Signs of autism include:
- Not reacting or responding when the name is called at 2 years old.
- Not seeming interested in the reactions of others, especially parents.
- Not seeming aware of the feelings of others.
Causes of Autism
- There is no known single cause of autism, and it is not caused by cold parenting or poor prenatal nutrition.
Neuromuscular Disorders
- Spastic paralysis is characterized by an increase in deep tendon reflexes and muscle tone.
- Flaccid paralysis is characterized by a decrease in deep tendon reflexes and muscle tone.
- Myasthenia gravis is characterized by rapid fatigue of muscles, with progressive worsening over the day or with repetitive activity.
Muscular Dystrophy
- Duchenne muscular dystrophy is an X-linked disorder characterized by a waddling gait and progressive muscle weakness.
- On EMG, myotonic phenomena (myotonic discharges with specific sounds) and a decrease in motor action amplitude can be seen.
Epilepsy
- Absence seizures are characterized by a sudden loss of awareness, accompanied by a blank stare and cessation of any ongoing activity.
- Generalized 3-Hz spike-and-wave activity is typically seen on EEG during absence seizures.
- Valproic acid is the first-choice therapy for childhood absence epilepsy.
Benign Rolandic Epilepsy
- Affected children usually have focal motor seizures involving the face and arm, with abnormal movement or sensation around the face and mouth, drooling, and rhythmic guttural sound.
Infantile Spasms
- Infantile spasms are characterized by brief contractions of the neck, trunk, and arm muscles, followed by a phase of sustained muscle contraction lasting less than 2 seconds.
- Hypsarrhythmia is a characteristic EEG pattern seen in infantile spasms, consisting of chaotic high-voltage slow waves, spikes, and multifocal spikes.
Idiopathic Intracranial Hypertension
- Patients with idiopathic intracranial hypertension (pseudotumor cerebri) exhibit daily debilitating headaches, diplopia, abducens palsy, transient visual obscurations, and papilledema.
Muscle Disorders
- Juvenile myoclonic epilepsy is a type of epilepsy characterized by muscle jerks, especially in the early morning or with sleep deprivation.
Neurocutaneous Syndromes
- Neurofibromatosis type 1 is characterized by six or more café-au-lait spots larger than 5 mm, Lisch nodules, neurofibromas, and optic gliomas.
- Neurofibromatosis type 2 predisposes patients to multiple intracranial and spinal tumors, including bilateral acoustic schwannomas, schwannomas of other cranial and spinal nerves, meningiomas, and gliomas.
Tuberous Sclerosis
- Tuberous sclerosis skin lesions include hypomelanotic macules (ash leaf spots), facial angiofibromas (adenoma sebaceum), and shagreen patches (elevated, rough plaques).
Sturge-Weber Syndrome
- Sturge-Weber syndrome is associated with an ipsilateral facial port-wine stain.
Leukodystrophy
- Metachromatic leukodystrophy (MLD) is characterized by periventricular deep white matter signal change, leading to a "butterfly pattern" on MRI.
Meningocele and Dandy-Walker Malformation
- In a meningocele, the skin of the back is apparently intact, but defects of the underlying bone or spinal canal are present.
- Dandy-Walker malformation is diagnosed on the basis of complete or partial agenesis of the cerebellar vermis, cystic dilation of the fourth ventricle, and an enlarged posterior fossa.
Macrocrania and Lissencephaly
- Macrocrania is characterized by enlargement of the brain, and may be associated with an increase in skull thickness.
- Lissencephaly represents a severe defect in cortical migration, resulting in a smooth brain without sulcation (agyria).
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Description
Explore the characteristics of tics and the criteria for diagnosing Tourette syndrome. Learn about the differences between stereotypies and tics, and the factors that trigger them.
