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Clinical Conditions II > Lecture 2: Pediatric Neuro Conditions I > Flashcards

Lecture 2: Pediatric Neuro Conditions I Flashcards

1
Q

most common developmental disability

A

Intellectual disability

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2
Q

Children with IDs have significant problems with:

A
  1. intellectual functioning
  2. Adaptive behavior
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3
Q

Signs of intellectual disability

A
  • Sit, up, crawl, or walk later than other children
  • Learn to talk later, or have trouble speaking
  • find it hard to remember things
  • have trouble understanding social rules/appropriate behaviors
  • have trouble seeing the results of their actions
  • trouble solving problems
  • problems with receptive/expressive language
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4
Q

Management of Intellectual disability

A
  • Timely identification and referral
  • Early intervention services, special education & vocational rehab
  • Interdisciplinary care to manage ID and comorbidites
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5
Q

Autism Spectrum Disorder Definiton

A
  • persistent, significant impairments in social interaction and communication as well as restrictive, repetitive behaviors and activities.
    • Wide spectrum
    • Neurobiological disorder
    • Behaviorally diagnosed
    • Apparent early in life
    • Lasts for the lifetime
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6
Q

ASD newest terminology

A

Neuroatypical

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7
Q

ASD is primarily a disorder of ___

A

communication, social relating and sensory processing

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8
Q

ASD can occur with ___ disability

A

any other

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9
Q

ASD is a disorder of ____ processing

A

disorder of higher-order processing

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10
Q

What ASD is not:

A
  • a mental illness
  • Behavioral disorder
  • Emotional disorder
  • hopeless condition
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11
Q

Neuro issues common in individuals with ASD

A
  • Apraxia
  • Sensory processing problems
  • Epilepsy
  • Cognitive impairments
  • Failure to develop speech
  • doesn’t respond to name
  • auditory discrimination problems
  • lack of eye control
  • hypotonia
  • difficulty with motor planning
  • toe walking
  • lack of fear - risk takers/impulsive
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12
Q

ASD prevelance

A
  • 18.5/1000 (1/54)
  • 4.3X more prevelant in boys
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13
Q

ASD pts have ___ unimodal sensory connectivity

A
  • Increased unimodel sensory connectivity
    • (motor, auditory, visual)
    • the greater the clinical severity associated with greater unimodal connectivity
    • ppl w difficulty sensory processing have higher connectivity
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14
Q

ASDs have ____ supramodel connectivity

A
  • Decreased supramodel connectivity
    • higher cognitive functioning - default mode, dorsal-attention, executive and salience
    • the higher the clinical severity, the lower supramodel connection
    • pts who have a hard time w social interactions (more severe) have decreased supramodel connections
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15
Q

ASD causes

A
  • environmental and genetic
  • no evidence between MMR vaccine and ASD
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16
Q

Management of ASD

A
  • No cure or one size fits all model
  • Early Intervention
    • Social, communication, functional, and social behavioral skills
  • No medications impact underlying pathology
    • Some medications to address: hyperactivity, antipsychotics, antidepressants, anti-anxiety
    • Epilepsy, sleep disorders, nutritional defencies
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17
Q

Seizure definition

A

transient occurence of signs/symptoms due to abnormal excessive or synchronous neuronal activity in the brain

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18
Q

epilepsy

A

enduring predisposition to generate epileptic seizures with cognitive, psychological and social consequences of the condition

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19
Q

Epilepsy criteria

A
  • ≥ 2 unprovoked seizures occurirng > 24 hours apart
  • One unprovoked seizure has similar probability of recurrence risk as 2 unprovoked seizures
  • Diagnosis of epilepsy syndrome
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20
Q

Generalized seizures

A

affect both sides of the brain

  1. (petit mal)
  2. Tonic-clonic (grand mal)
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21
Q

petit-mal seizure (absence)

A
  • Generalized seizure
  • rapid blinking or a few seconds of staring into space
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22
Q

tonic-clonic (grand mal)

A
  • Generalized seizure
  • Cry out
  • Lose consiousness
  • Fall to the gorund
  • Have muscle jerks or spasms
  • pt may feel tired after clonic-tonic seizure (grand mal) ; monitor for post-seizure state
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23
Q

Focal (partial seizures)

A
  • Located in just one side of the brain
  • Simple focal
  • complex focal
  • secondary generalized seizures
24
Q

Simple focal seizure

A

Focal (partial seizure)

Affect a small part of the brain (twitching; change in sensation - stange taste or smell)

25
Complex focal seizure
Focal (partial) seizure can make a person with epilepsy confused or dazed (unresponsivle for a few minutes)
26
Secondary generalized seizures
* Begin in one part of the brain, but then spread to both sides of the brain (i.e., a focal seizure followed by a generalzied seizure)
27
Unprovoked (epileptic) seizure disorder
Absence of temporary or reversible factor lower the threshold and producing a seizure at that point in time
28
Provoked (un-epileptic) seizure disorder
* Presence of a temporary or reversible factor: * fever * substance withdrawl * concussion/TBI * Lack of sleep * Flashing lights * tumor * COVID * dehydration * side effect
29
top 4 anti-epileptic drugs
1. sodium valporate (depakote) 2. Phenobarital 3. Cabamazepine (tegretol) 4. Keppra
30
other seizure disroder/epilepsy
* Deep brain stimulation * Keto diet * Resection (laser ablation) * Vagus nerves stim (??)
31
often times have to play with epileptic dosage because of
lethargy
32
Down syndrome AKA
Trisomy 21 * ***most common chromosomal abnormality*** * ***most common genetic cause of intellectual disability*** * Increasing prevalence * Increasing maternal age
33
Down syndrome signs - key sings
1. \*\*Single palmar crease 2. Congenital heart disease (66%) 3. Intestinal defects (3.7%)
34
biggest thing to consider with Downs syndrome
Atlantoaxial instability
35
DS pts more likely to develop
* testicular or blood cancer * mental health conditions * bronchitis * pneumonia * GI, neuro, thyroid, bone disease
36
DS pts less likely to develop
* Solid tumors * Heart disease * STDs * Influenza * Sinuitis * Diabetes
37
Spina bifidia
condiiton where the neural tube fails to close in utero
38
Occulta spina bifida
hairy tuft on lumbosacral region usually no neural defects
39
Meningocele spina bifida
neural tissues in tact w/in the body meninges are external to the body
40
Myelomemingocele spina bifida
neural tissue and meninges are outside of body
41
Lipomyelomemingocele spina bifida
Myelomemingocele symptoms and cyst on the spinal cord
42
spina bifida can occur anywhere from:
lower thoracic to lumbosacral not naming a specific vertebrae - will likely just say region of involvement based on sensory and motor defecits
43
spina bifida prevelance decreasing due to:
**folic-acid supplementation** controlling preexisting conditions prior to conceiving avoid overheating your body **(including fever)**
44
treat every kid with spina bifida as if they have a ____ Allergy
**LATEX** *with increasing exposure comes an increase in severity of an allergic response*
45
Spina bifida - hydrocephalus
something that occured during sac closures that were done after birth & CSF mass would shoot directly back into the brain = hydrocephaly (build up in brain) * less likely when sac closure done in utero (CSF absorbed naturally through lymphatics)
46
Spina bifida - Charli II Malformation (herniated cerebellum)
difficulty breathing and or swallowing reccommend decompression surgery
47
Spina bifida tethered cord symptoms
1. back pain 2. changes in bladder 3. LMN symptoms (causa equina down) 4. UMN signs: tension in spinal cord 5. Feet deformities
48
spinal dedformities in spina bifida
* Hyperkyphosis in lumbosacral region * Kyphoscoliosis in thoracic
49
definition of CP
* disorder of the development of movement and posture causing activity limitation * *attributed to non-progressive disturbances that occured in the developing brain* * *lesion itself in the brain does not proress but the interaction of the lesion and developing body causes proressice motor symptoms*
50
biggest risk factor for CP
Prematurity and LBW (low birth weight)
51
pathophysiology of CP - preterm infant
* periventricular leukomalacia * ischemic ***necrosis to periventricular white mater*** * Periventricular hemorrhagic infarction * ***hemorrhage into germinal matrix and ventricles*** * Affects ascending and decescing tracts * topgraphic and size relationship.
52
pathophysiology of CP - term infant
* Infarction in parasaggital, watershed area, MCA stroke * Basal ganglia and thalamic injury
53
CP *hypertonia*
spasticity, dystonia, rigidty
54
CP *hyperkinetic*
athetosis, chorea, dystonia, myoclonus, tics, tremor
55
CP *negative*
ataxia, weakness, decreased selective motor control
56
CP tone management
* oral medications * anti-spasmodic injections * Selective dorsal Rhizotomy * Bacloen pump implantation
57
CP general orthopedic procedures
Muscle/tendon lengthening Tendon transfers Osteomies Athrodesis

Clinical Conditions II (5 decks)

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