4 types of CP?
Spastic, Athetoid/Dyskinetic, Ataxic, Atonic
motor impairment resulting from brain damage
cerebral palsy
Tx for CP (3)
Symptomatic-
OT/PT/ST,
Antispasmodics- dantrolene, benzos, baclofen
Botox
how to exam headaches
assess on character, location, associated symptoms
most common cause of recurrent HA; pain is bilateral in children, unilateral in teens
migraine
classical migrane symptoms (5)
aura/no aura throbbing N/V Family hx specific triggers
migraine tx? (3)
eliminate triggers
prophylaxis if >2/wk or >4/mo
symptomatic management
tonic seizures
sustained contraction
contraction alternating w/ relaxation
clonic seizure
spasm of muscle or a group of muscle
myoclonic seizure
sustained relaxation of muscle
atonic seizure
febrile seizures tx (3)
airway clear?
benzos if >10-15 min
exclude meningitis
brief loss of environmental awareness- staring into space. Triggered by hyperventilation or flashing lights. Short duration, multiples per day
absence seizures
seizure > 20-30 min. Concern for brain damage
Status epilepticus
infantile spasms tx (3)
ACTH
vigabatrin
ketogenic diet
Onset in 1st year b/w 4-8 mo, developmental regression, hypsarrythmia (chaotic brain waves) on EEG. Twerk stance
-clusters, happen before sleep or sleep awakening
infantile spasms
defective closure of the neural tube at the end of week 4 of gestation –> anamolies of the L/S spinal cord
spina bifida
most severe form of spina bifida, spinal cord or nerve roots exposed
increased risk of latex allergy
meningomyocele
rarest form of spina bifida
only meninges are exposed in cyst-like sac, spinal cord is intact
meningocele
CSF accumulation due to either overproduction or obstruction
hydrocephalus
HTN, bradycardia, altered respiration, increased head circumfrence, bulging anterior fontanelle, CN III or VI dysfunction
hydrocephalus
possible complications of CSF shunt for hydrocele (3)
drains too much or too little:
obstruction
infection
cathether length
fever, headache, abdominal pain, fatigue, elevated BP could indicate what in a pt w/ shunt?
shunt complications
progressive weakness, cardiomyopathy, mild intellectual impairment, progressive proliferation of connective tissue in muscle
muscular dystrophy
which kind of muscular dystrophy is less severe?
Becker
Gower’s sign indicates?
muscular dystrophy
how do you diagnose muscular dystrophy (4)
muscle biopsy
abscence of dystrophin protein
EMG
serum CPK levels
acute idiopathic polyneuritis
Guillain-Barre syndrome
inflammatory peripheral neuropathy
Guillain Barre syndrome
ascending, rapid loss of motor strength, symmetric weakness, sensory symptoms w/out deficits, loss of DTRs, ANS dysfunction
Guillain-Barre syndrome
Guillain-Barre etiology
post-infectious, resp. or GI- commonly Campylobacter jejuni
autoimmune, antibodies form against ACh nicotinic receptors at NMJ- affects striated muscles
myasthenia gravis
ptosis, diplopia, opthalmoplegia, weakness of face/extremities, dysphagias. Symptoms increase throughout day or with exertion
myasthenia gravis
developmental motor delay, progressive weakness of LMN due to degeneration of anterior horn cells
spinal muscle atrophy syndrome
progressive, flaccid weakness; decreased spontaneous movements, hypotonia, decrease or loss of DTR, fasciculations & muscle atrophy. Difficulty sitting, failure to stand, increased drooling
Spinal Muscle Atrophy Syndrome
headache, n/v, loss of balance, speech issues, sleepiness, personality changes, new onset seizures
pediatric brain tumor
peds neuro eval includes?
ROS/hx
head circumference
fontanelles
CN evaluation
developmental delay definition
not reaching a milestone 2 standard deviations below the norm
screening test for developmental delay
Denver II
