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Neurology > Pediatric Neurology > Flashcards

Pediatric Neurology Flashcards

1
Q

What Are the features of Epilepsy?

A

> 2 unprovoked seizures

  • Hyper synchronous disch of cortical neurons
  • Gen vs. Partial
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2
Q

What are the different types of Generalized seizures?

A 
Absence
Myoclonic
Atonic 
Tonic
Clonic Tonic Clonic
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3
Q

What are the different types of Partial seizures?

A

Simple Partial: No AoC

Complex Partial: any AoC

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4
Q

Absence Seizure

A

Staring episode with cessation of activity

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5
Q

Myoclonic Seizure

A

Brief Jerking muscle movements

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6
Q

Atonic Seizure

A

Loss of Tone

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7
Q

Clonic Seizure

A

Regualrly repeated muscles jerking

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8
Q

Tonic Clonic

A

Grand Mal Seizure

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9
Q

What is an Epilepsy Syndrome?

A

Constellation of features describing a unique epileptic phenomenon
Type, Age, Course, EEG Abn, Drug of Choice

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10
Q

What are the features of Childhood Absence Epilepsy?

A

Petit Mal Seizures
4-14 yo resolves by 18yo
EEG: Gen 3Hz spike and slow wave disch

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11
Q

What is the Tx of Childhood Absence Epilepsy?

A

Ethosuximide**
Valproic Acid
Lamotrigine

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12
Q

What are the Traits of Rolandic Epilepsy(BCE with Centrotemporal spikes)?

A

2-12yo
Infreq Partial Seizures
During sleep or on waking
EEG Centrotemporal Spikes

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13
Q

What is the Tx of Rolandic (centrotemporal) Epilepsy?

A

Carbamazepine or Oxcarbazapine

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14
Q

What are the features of Juvenile Myoclonic Epilepsy?

A

12-18yo
Myoclonic Jerks
EEG: 3-6 Hz polyspikes and wave
Photic Stim

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15
Q

What is the Tx of Juvenile Myoclonic Epilepsy?

A

Life long Tx
Valproic Acid
Levetiracetam
Lamotrigine

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16
Q

What are the features of Febrile Seizures?

A

Most common childhood seizures
Assoc with Fevers >38C
3mon- 6yo
No prev history

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17
Q

What is the difference between Simple and Complex Febrile Seizures?

A

Simple: Gen 15 min >1/day

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18
Q

What are the risk factors of febrile seizures?

A

High Fever, viral infection, immunization of MMR and DPT, FHx

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19
Q

What is the Primary Concern in Peds Febrile Seizure?

A

Need to rule out meningitis

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20
Q

What is included in the workup of Febrile Seizure?

A

LP if Signs of meningitis, not fully vccinated for Hib and Strep Pneumo, or Pt taking Abtx
Imaging if neuro deficits, macrocephaly, Inc ICP

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21
Q

What is the Tx of Febrile Seizures?

A

Abort Seizure: Benzos

Diazepam, lorazepam, midazolam

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22
Q

What are the traits of Infantile Spasm?

A

Spasm that starts in infancy. Epileptic encephalopathy

in clusters, on awaking, assoc with devt arrest/reg

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23
Q

What are the 3 types of Infantile spasm?

A

Flexion: limbs and head
Extension: limbs and head
Mixed: flex neck/arms, ext legs

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24
Q

What are the types of Infantile Spasm?

A

Symptomatic- IDed Etiology and Devt Delay

Cryptogenic-No known et. and normal devt

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25
Q

What are the causes of infantile spasm?

A

CNS malformation, Tuberous Sclerosis, hypoxic Ischemic Encephalopathy, inborn errors of mets, Chromosomal Abn, congenital infection

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26
Q

What is seen on EEG in Infantile Spasm?

A

Hypsarrhythmia

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27
Q

What is the Tx of Infantile Spasm?

A

ACTH

Vigabatrin

28
Q

What are the SA of ACTH?

A

HTN, Hyper Gly, GI Bleed

Immune Supression

29
Q

What are the SA of Vigabatrin?

A

Visual field restriction: Permanent?

30
Q

What are the Features of Lennox-Gastaut Syndrome?

A

Different Types of Seizures including: tonic Seizures, Atypical absence, complex partial, and myoclonic seizures
Mental Retardation
EEG:

31
Q

What are the features of Neonatal Seizures?

A

1st month of life
NB cant have generalized seizures.
Focal Tonic, Focal Clonic, or myoclonic

32
Q

What is the Etiology of Neonatal seizure?

A 
Hypoxic Ischemic Encephalopathy, CNS infection, IC Bleed, brain malf
Hypoglycemia
Hypocalcemia
Hyponatremia
Inborn error of Mets
33
Q

What is included in the workup for neonatal seizure?

A

Glu, Ca, Mg, Lytes
CSF
MRI for ischemia, stroke, bleeding, malf

34
Q

What is the Tx of Neonatal Seizure?

A

Phenobarbatol

Fosphenytoin

35
Q

What is difference between Jitteriness and seizure?

A

Jitter: similar to tremor induced by stimand stopped by holding extremity

36
Q

What is Guillian Barre Syndrome?

A

Demyelinating Polyneuropathy caused by immune system

Common cause of acute flaccid paralysis in children

37
Q

What is the Clincal Presentation of Guillian Barre Syndrome?

A

Parestheia in feet => ascending paralysis => can’t walk
Cranial Neuropathy: facial spasm, drooling, swallowing difficulty, diplopia
Resp muscle failure

38
Q

How is Guillian barre Synd Diagnosed?

A

Symmetric Leg weakness w/ diminished Reflex
Sensory exam normal
Mental exam intact

39
Q

What is seen on CSF analysis in Guillian Barre Synd?

A

Albuminocytological dissociation

Normal in first week

40
Q

What is the Tx ofGuillian Barre Syndrome?

A

Cardioresp Monitor in ICU

IVIG 2g/kg or Plasmapheresis

41
Q

What is Charicteristic of Duchenne Muscular Dystrophy?

A

XLR mutation in Dystrophin
Presents by 3yo
Slowly progressing Wheelchair by 12yo
Dilated Cardiomyopathy

42
Q

What is the Mos common cause of Death in Duchenne Muscular Dystrophy?

A

Resp Failure by age 20

43
Q

What is Gower Sign?

A

Gets up from the ground using upper limbs to help. Sign of DMD

44
Q

How is DMD diagnosed?

A

Male, prox muscle weakness, elevated CPK, genetic testing, muscle biopsy

45
Q

What is the Tx of DMD?

A

Daily dose of Prednisolone or deflazacort to slow disease progression

46
Q

What are the most common causes of Acute Ataxia in children?

A

Post infectious cerebellar ataxia, intoxication, and Guillian Barre Synd

47
Q

What are the traits of Post infectious cerebellar ataxia?

A

gradual improvement
Hx of recent infection
Balance Disturbance
Dysarthria and Nystagmus

48
Q

What are the traits of Cerebral Palsy?

A

Static Motor Encephalopathy
Peripheral hypertonia, Axial Hypotonia
Assoc: seizures, devt delay, cog delay, learning diff, Vision and hearing problems

49
Q

What are the Classifications of Cerebral Palsy?

A

Spastic Hemiplegia
Spastic Diplegia
Spastic Quadriplegia
Diskinetic CP:

50
Q

What are the complications of Cerebral Palsy?

A

Skin ulcers
Constipation, poor feeding
Hip disloc, scoliosis
Aspiration pneumonia, etc

51
Q

What are the features of migraines?

A

Recurrent HA w/ N/V and Photophobia

Throbbing and bilateral in younger children

52
Q

What is the classification of Migraines?

A 
Migraine w/out aura
Migraine w/ aura
Complicated Aura
Hemiplegic
Basilar
Ophthalmoplegic 
Confusional
53
Q

What is the Tx of Migraines?

A

Rest in dark room
Acetamin, Ibuprofen
Ondansetron for N/V
Triptans for Severe attacks

54
Q

What is used for Migraine Prophylaxis?

A

Cyproheptadine: SA: inc appetite and sleepy
Topiramate: SA: WL, stones, cog impairment
Amitriptyline: SA: Sleepy, Cardiac Arrhythmia
Propanolol

55
Q

Who is Cyproheptidine best for? Topiramate? Amitriptyline?

A

1) Younger Children
2) Obese and Epileptics
3) Depression

56
Q

What are the lifestyle modifications for migraines?

A

Adequate and regular sleep, Hydration, Exercise, not skipping meals, Avoid stressors and triggers

57
Q

What are the features of Neurocutaneous Syndromes

A

Neuro Disorders w/ skin lesions: Neurofibromatosis, Tuberous Sclerosis, Sturge Weber

58
Q

What are the Diagnostic Criteria of Neurofibromatosis?

A

1) >6 Cafe-au-lait spots 5mm prepub, 15 postpub
2) 2 axillary or inguinal freckling
3) 2 neurofibroma or 1 complex
4) Optic Glioma
5) 2 Lisch Nodules
6) Sphenoid Dysplasia or Long Bone abnormal
7) 1st deg relative w/ NF1

59
Q

What are the traits of Tuberous Sclerosis?

A

Inc Risk of epilepsy, cog delay, tumors

60
Q

What are the skin diagnostic Criteria for Tuberous Sclerosis?

A

Skin: Hypomelanotic macules, Facial Angiofibroma, shagreen patch, Nail fibroma

61
Q

What are the CNS diagnostic Criteria for Tuberous Sclerosis?

A

Subependymal nodules, cortical tubers, giant cell astrocytoma

62
Q

What are the Eye diagnostic Criteria for Tuberous Sclerosis?

A

Retinal Hamartoma

63
Q

What are the Heart diagnostic Criteria for Tuberous Sclerosis?

A

Cardiac Rhabdomyoma

64
Q

What are the Kidney diagnostic Criteria for Tuberous Sclerosis?

A

Renal Angiomyolipoma

65
Q

What are the Lung diagnostic Criteria for Tuberous Sclerosis?

A

Lymph-angio-leio-myo-matosis

In adults

66
Q

What are the traits of Sturge-Weber Syndrome?

A

Port wine stain in V1 and V2 trigeminal branch distribution. Unilateral
CNS issues
Glaucoma

Neurology (9 decks)

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