Flashcards in Pediatric Neurology Deck (19):
Possible causes of febrile headache
Associated infection (strep, flu, mono, rubeola)
Is bacterial meningitis or viral meningitis more common in pediatrics?
When do you not do a lumbar puncture?
When there are signs of increased intracranial pressure. May cause brain stem herniation.
Incidence of types cancer in pediatrics:
2. relapsed leukemia
3. brain tumors
Possible causes of afebrile headaches
space-occupying lesion (brain tumor, hydrocephalis)
acute dental disease
acute glaucoma/inflammatory disease of the eye/orbit
muscular contraction (tension)
One hemisphere of the brain
Simple partial: No LOC
Complex partial: impaired consciousness, staring >20 seconds
Generalized seizures: Absence (petit mal)
Brief staring episode (10-20 seconds)
Almost always begin in childhood
Generalized seizures: Tonic
increase in muscle tone, characteristic postures
usually consciousness is partially or completely lost
brief (several minutes) postictal state
Generalized seizures: Tonic-clonic (grand mal)
increased muscle tone, jerking, followed by flaccid coma
incontinence may occur
postictal state for up to an hour, headache
Generalized seizures: Atonic
sudden loss of muscle tone
may result in head drop or falling to the ground
Diagnosis of seizures
- Investigate underlying cause with labs, LP (with fever)
- CT or MRI head for all new onset seizures
- EEG to determine classification
Consider referring patient with seizures if...
Seizures continue despite therapeutic drug levels.
Regression of developmental skills or cognitive function occurs.
Side effect of meds is not tolerable.
- majority are tonic clonic
- most last less than 5 minutes
- rule out meningitis
- acetaminophen, cooling measures for fevers
Neurofibromatosis (von Recklinghausen disease)
- progressive neurocutaneous disorder that does not affect intelligence
- cafe au lait spots, Litsch nodules (in iris), axillary/inguinal freckling, seizures
Names and functions of the cranial nerves
CN I: Olfactory: smell (S)
CN II: Optic: vision (S)
CN III: Oculomotor: up and down (M)
CNIV: Trochlear: down and out (M)
CN V: Trigeminal: mastication, neuralgia (B)
CN VI: Abducens: looking sideways (M)
CN VII: Facial: scrunch face, anterior taste (B)
CN VIII: Vestibular/acoustic: hearing, balance (S)
CN IX: Glossopharyngeal: gag reflex, posterior taste (B)
CN X: Vagus: swallow, carotid reflex, talking (B)
CN XI: Spinal accessory: shrug shoulders (M)
CN XII: Hypoglossal: moves tongue (M)
"Some say marry money but my brother says big boobs matter most"
"On Old Olympus Towering Tops A Fin And German Viewed Some Hops"
- fever, bulging fontanel, irritability, lethargy, poor feeding, vomiting, nuchal rigidity, headache, cranial nerve palsy, ataxia, hyperesthesia, Kernig's sign (bend Knees up, neck goes up), Brudzinski's sign (bend neck up, knees go up)
- CSF shows increased protein, decreased glucose
- increased head circumference, bulging fontanel, irritability, loss of developmental milestones, headache (worst in AM, vomiting, increase in frequency), ataxia, hemiparesis, cranial nerve palsies, seizures, papilledema, positive Babinski's (over 1 year old)
-refer to neurosurgery
- dilation and pulsation of external carotid artery
- common (no aura) and classic (with aura)
- family history, triggers
- unilateral, dull or throbbing headache, insidious
- may have n/v, aphasia, numbness/tingling, vision field defects, photophobia, phonophobia
- CT, VDRL/RPR, ESR, CMP, CBC
- headache diary, improve general health, medications