Pediatric Neuro Flashcards
(49 cards)
What is epilepsy?
repeated afebrile seizures without cause, often in ages 4-16 yrs
what is neonatal epilepsy?
< 4 weeks old May or may not have motor symptoms face twitching Responsiveness in and out Prognosis depends on cause (abusive head trauma, maternal substance use, inborn error of metabolism, infection, hypoxic, ischemic, encephalopathy, etc) can develop cerebral palsy
what are infantile spasms (AKA West Syndrome)?
2-12 months seemingly fine before spasms Brief muscle movements, eye rolling Common upon waking up Note lost of milestones - goes backwards Intellectual disability can develop
what is absence “petit-mal”?
Non-obvious intermittent seizures, may not be aware seizure is occurring
No motor symptoms, but have “staring spells”, lose awareness (may be dx w/ ADD)
Young school age children onset and can struggle in school
tx: anti-epileptic
what is Simple partial/focal?
Abnormal smells, hallucinations sudden mood changes (deja vu) one area of body that twitches perceptions of skin tingling/burning conscious
child has decreased level of mentation (impaired consciousness, staring, less responsive). Afterwards, child is tired, disoriented, has a headache and loss of bowel control. what do you suspect?
complex partial epilepsy
child has uncontrollable muscular contraction resulting in a dislocated shoulder which alternates with loss of muscle tone. what type of seizure do you suspect?
generalized tonic-clonic “grand-mal”
seizure >5 minutes send to ER
child has facial twitching and eye movement every few days-weeks, but no loss of consciousness. what do you suspect?
Benign epilepsy of childhood (Rolandic seizures)
no Rx’s needed, will resolve in adolescence
what should you use to evaluate for epilepsy?
electroencephalogram (EEG), MRI
what is the most common type of seizure in childhood?
febrile seizure (between 6 mo-5 years)
febrile 18 mo old has uncontrollable muscle contraction alternating with loss of muscle tone for <15 minutes. what do you suspect?
simple febrile seizure (generalized (tonic-clonic))
what classifies as a complex febrile seizure?
focal OR
duration >15 minutes OR
recurrent w/in 24 hrs.
what should be evaluated in a complex febrile seizure?
lumbar puncture and EEG
what is the tx for simple febrile seizures?
antipyretics
educate and have parents check back if recurrent episode (anticonvulsants not warranted)
what is the tx for complex febrile seizures?
diazepam at onset of febrile illness
what is hydrocephalus?
dilation of ventricles in brain due to increased CSF volume
what causes hydrocephalus?
hemorrhage, infection, tumors, congenital malformation
infant has accelerated rate of head growth, irritability, vomiting, loss of appetite, impaired upward gaze. what do you suspect?
hydrocephalus
what imaging should be used in hydrocephalus?
cranial ultrasound if anterior fontanelle is open
otherwise, CT/MRI
what is the tx for hydrocephalus?
ventriculoperitoneal shunt
a child with a shunt presents w/ fever, lethargy, irritability, and redness of the shunt path. what should you do?
shunt evaluation (head CT, shunt series, CSF evaluation)
what is cerebral palsy?
chronic static impairment of muscle tone, strength, coordination, or movements
what causes cerebral palsy?
Intrauterine or birth hypoxia
Intrauterine bleeding
Congenital malformations (e.g. blood vessels)
Intrauterine or neonatal infections
Neonatal hypoglycemia or acidosis
Kernicterus (uncontrolled increased bilirubin levels)
what type of cerebral palsy is characterized by uncontrolled, painful muscle contractions?
spastic cerebral palsy
