Flashcards in pediatric neurology Deck (58):
1
definition of epilepsy
occurrence of >2 unprovoked seizures
2
abnormal hyper synchroncous discharge of cortical neurons
epilepsy
3
name that seizure: staring episodes with cessation of activity
absence
4
name that seizure: : brief jerking muscle movements
myoclonic
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name that seizure: loss of tone
atonic
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name that seizure: regularly repeated msucles jerking
clonic
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simple partial is _____alteration in consciousness vs complex partial is ____alteration in consciousness
NO alteration; any alteration
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staring off for less than 20 seconds withOUT loss of tone, or confusion post starting episode
childhood absence epilepsy
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what can absence epilepsy be provoked by?
hyperventilation
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EEG with generalized 3 Hz spike and slow wave discharge
absence seizure
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tx of choice for absence seizure
ethusoximide
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peak onset seizures 5-10 yrs, infrequent partial seizures, tingling in mouth, on face, drooling, dysphasia, speech arrest, unilateral UE movement
benign childhood epilepsy with centrotemporal spikes
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EEG: centrotemporal spikes
rolandic epilepsy
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usually have seizures that occur during sleep
rolandic epilepsy
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drug of choice for rolandic epilepsy
carbamazepine or oxcarbazapine
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EEG: 3-6 Hz polyspikes and wave
juvenile myoclonic epilepsy
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myoclonic jerks, age of onset 12-18, provoked by photic stimulation, AM wakening, lack of sleep
juvenile myoclonic epilepsy
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does juvenile myoclonic epilepsy resolve by end of adolescence years or persist?
persists, requires life long tx
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tx of juvenile myoclonic epilepsy
men: valproic acid
women: levetiracetam, lamotrigine
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fever + seizure w/o CNS infxn
febrile seizure
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febrile seizures occur in what ages
3 months-->6 yrs
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what is the most common seizure in children
febrile seizure
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simple febrile seizure is defined as generalized, less than ____min long, occurs___in a 24 hr period
15 min long; occurs 1x in 24 hrs
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tx to stop febrile seizure
benzo
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Small brief spasm, but one of the most severe epilepsy patterns
infantile spasm
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EEG: hypsarrhythmia
infantile spasm
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drug of choice for infantile spasm
ACTH
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drug of choice for infantile spasm secondary to tuberous sclerosis
vigabatrin
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cahracterized by different types of seizures, mental retardation
lennox gastaut syndrome
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EEG: less than 2.5 spike and slow wave discharges
lennox gastaut syndrome
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neonatal seizures are typically what type of seizure
focal tonic, focal clonic or myoclonic
32
most common etiologies of neonatal seizures (4)
1. hypoxic ischemic encephalopathy
2. CNS infxn
3. intracranial bleeding
4. brain malformation
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best imaging for neonatal seizre
MRI
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preferred tx for neonatal seizure
phenobarbital
35
immune mediated acute inflammatory demyelinating polyneuropathy
guillain barre syndrome
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the most common cause of acute flaccid paralysis in children
guillain barre syndrome
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campylobacter jejuni infxn, symmetri ascending paralysis
guillain barre syndrome
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symmetric legs weakness with diminished or absent DTR
guillain barre syndrome
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incr CSF protein, normal WBC with normal mental exam
guillain barre syndrome
40
what is the most sensitive and specific test for demyelination
nerve conduction study
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tx of guillain barre syndrome
IVIG 2 g/kg or plasmapharesis
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calf hypertrophy, gower's sign, x linked recessive, slowly progressive
duchenne muscular dystrophy
43
msot common causes of acute ataxia in children (3)
1. post infectious cerebellar ataxia
2. intoxication
3. guillain barre syndrome
44
most common cause of acute ataxia in children
post infectious cerebellar ataxia
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rapid onset ataxia that is worst at presentation followed by gradual improvement
post infectious cerebellar ataxia
46
work up of post infectious cerebellar ataxia
brain MRI
47
static motor encephalopathy due to insult to developing brain in first 3 yrs of life
cerebral palsy
48
what is peripheral hypertonia
spasticity and clonus
49
what is axial hypotonia
head lag, truncal hypotonia
50
classic cause of spastic hemiplegia in CP
unilateral perinatal stroke
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cause of spastic diplegia
premature infants with perventricular leukomalacia
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recurrent HA with N/V, photophobia
migraine
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most common type of migraine
migraine w/o aura
54
main med for prevention of migraines in kids
cyproheptadine
55
topiramate is good for tx of mirgrains in what sort of kids
obese, kids with epilepsy
56
what is the main concern associated with tuberous sclerosis
incr risk of epilepsy
57
cardiac rhabdomyoma
tuberous sclerosis
58