A 6 year old child presents with a history of recurrent headaches. The neurological examination is unremarkable except for seven brown macules on the skin that vary in diameter from 1 to 2 cm. Clinical examination reveals several freckles in the axilla and the inguinal region. What is the most probably underlying condition?
An 8 year old male is brought by the paramedics to the emergency department after having an episode of generalised tonic-clonic seizures. The seizures started at 10:55. The paramedics gave him buccal midazolam at 11:04 and waited for the seizures to end, until 11:06. Afterwards, they gave him oxygen via face mask and set up a venous line. His blood glucose at that moment was 5.2 mmol/L and he remained unconscious during the whole trip to the hospital. The paramedics arrived at the emergency department at 11:16 and you observe that he has a patent airway and a good air entry. His RR is 12 and his O2 saturation is 98% on 10L O2. His heart rate is 122 bpm and his CRT is 2 seconds. At 11:19, you observe that the child is not responsive to pain and he starts experiencing subtle but persistent jerking movements of his jaw and left upper limb. You notice that the child’s pupils are deviated to the right and are bilaterally constricted. It’s 11:20. What should you do next?
A 6 year old child presents with unilateral headache that affects the left side of his head and face. His left eye is red and he scores 7/10 on pain assessment. The headache develops suddenly and unexpectedly after he returns from school. He has a history of six such episodes this year. Which of the following is the most probable diagnosis?
A 5 month old girl was admitted to the emergency department with reduced movement of her right arm. History reveals she was born at term, 4.5 kg and via natural delivery. Her mother reports her head was stuck for a while before she was fully delivered. Postnatal examination revealed reduced movement of her right arm as well but was thought to improve over time. The baby cannot sit and her right arm is flaccid, internally rotated, adducted, and extended. The reflexes are absent in the right arm. Which of the following investigations would provide the most useful information?
A 14-year-old boy arrives at the clinic with difficulty walking and foot drop. On examination, there is weakness in dorsiflexion and eversion of the right foot. A small area of sensory loss over the dorsum of the right foot is also present. Which of the following is the most likely diagnosis?
A 15-year-old girl arrives at the hospital complaining of resting tremors in both arms. Ataxia and dysarthria are also observed along with occasional involuntary grimacing of the face. The patient is most likely suffering from which of the following?
A 6 year old child presents with a history of headaches that usually appear in the evening. The episodes started 6 months ago and the pain presents on both sides of the head. He perceives it as a tightť feeling. His overall health is normal and he admits to be able to continue his daily activities regardless of the pain. Which of the following is the most probable diagnosis?
A 5 week old boy presents with a history of jerky movements involving both upper and lower limbs. The parents admit that this happens 2-3 times during sleep, without waking him up. He feeds well and doesn’t seem to cry more than normally. He was a term baby, born without any perinatal complications. The neurological examination turns out normal. Parents worry he has seizures as they have a 3 year old nephew with epilepsy. What is the most probable diagnosis?
A 7-month-old abandoned baby with congenital non-communicating hydrocephalus is hosted by a clinic at its new-born hostel. A CT scan of the baby’s brain reveals what might be a blockage of the ventricular system between the third and the fourth ventricles. Which of the following is the most likely blocked structure?
A 13-year-old girl presents with a rash in her lower limbs. The rash appeared a few days after an upper respiratory infection and was associated with persistent haematuria. Renal biopsy revealed immunoglobulin G (IgG) glomerular immune deposits. What is the most probable diagnosis?