Lecture 10: Peds Neuro Flashcards Preview

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Flashcards in Lecture 10: Peds Neuro Deck (15):
1

Febrile seizures: main facts

-most common seizures of childhood
-occur in children 6 mnths-5 yrs of age
-occur in absence of intracranial infxns, metabolic disturbances or h/o febrile seizures

2

Simple Febrile Seizures

-duration < 15 min
-generalized in nature
-single occurrence in 24 hr period
-no previous neuro problems

3

Risk Factors for febrile seizures

-developmental delay
-discharge from neonatal unit after 28 days
-daycare attendance
-viral infxn
-fam hx
-certain vaccines: flu, tetanus, DTP, measles, mumps, rubella
-possible Zn and Fe deficiency

4

Causes of Febrile seizures

-URI
-pharyngitis
-otitis media
-pneumonia
-gastreoenteritis
-roesela infantum
-noninfectious illness

5

Febrile seizure tx

-IV lorazepam
-buccal midazolam if IV not possible

6

Risk factors for recurrence of febrile seizures

-age < 18 mnths
-duration of fever < 1 hr before seizure onset
-first degree relative with hx
-temp < 104

7

Risk factors for future Epilepsy after Febrile Seizures

-complex febrile seizure
-fam hx
-fever duration < 1 hr before seizure onset
-neurodevelopmental abnormality

8

Cerebral palsy

-chronic, static impairment of muscle tone, strength, coordination or movements
-nonprogressive and originated from some type of cerebral insult/injury before birth, during delivery or in perinatal period

9

Most common form of Cerebral palsy

-spasticity of limbs
-monoplegia, hemiplegia, paraplegia (both legs, no arms), quadriplegia

10

Second most common form of CP

-ataxia
-affects fine coordinated motor mvmnts of UE, may also involve LE and trunk

11

Other deficits of Cerebral palsy

-seizures
-mild mental retardation
-severe mental retardation
-disorders of language, speech, vision, hearing and sensory perception

12

PE findings in CP

-spasticity, hyperreflexia, ataxia, involuntary mvmnts
-microcephaly (head is smaller for their age)
-affected limbs in hemiplegia are shorter than others

13

Tx/management of CP

-try to maintain max phys fxn
-get PT occupational and speech therapy, ortho monitoring and special ed involved
-botox may help with spasticity

14

Neurofibromatoses : 2 forms

-Type 1: multiple hyperpigmented macules and neurofibromas; due to mutation of NF 1 gene
-Type 2: 8th CN tumor, often accompanied by other intracranial or intraspinal tumors; mutation in NF 2 gene on chromosome 22

15

Neurofibromatoses findings

-neuro presentation with sx's of tumor
-multiple neurofibromas present and may involve spinal or cranial nerves (8 CN)
-superficial cutaneous nerves show palpable mobile nodules
-axillary freckling, patches of pigmentation
-malignant degen of neurofibromas may lead to peripheral sarcoma
-meningiomas, glioma, bone cysts, pheochromocytomas, scoliosis, and obstructive hydrocephalus may occur