Chapter 52: The Child with a Neurologic Alteration Flashcards
Causes include increased ICP, infection, and tumors
seizures
Symmetric and rhythmic, consisting of alternating contraction and relaxation of major muscle groups
clonic phase
Results after an injury that may have occurred prenatally, perinatally, or postnatally
cerebral palsy
Treatment goals for a child with hydrocephalus is to _________________ and ________________ from increased ICP.
reduce disability, prevent death
Saclike protrusion is filled with CSF, meninges, nerve roots, and spinal cord
spina bifida cystica: myelomeningocele
Treatment for rapidly-progressing Guillain-Barré Syndrome
IV immunoglobulin (IVIG)
Symptoms include photophobia, phonophobia, nausea, vomiting, and irritability
migraine
Cushing’s triad
widening pulse pressure
bradycardia
irregular respirations
Severe complication of increased ICP
brain stem herniation
Key diagnostic feature is lumbar puncture
meningitis
The ________________, which later forms the ___________________, is formed in the first few weeks of pregnancy before the mother knows that she is pregnant.
neural tube, spinal cord
If a brain bleed occurs without a fracture in an infant or young child, suspect ___________________. This is a sign of ________.
shaken baby syndrome, abuse
Patients with spina bifida are at an increased risk of developing ________ allergies
latex
If fatal, people with Guillain-Barré Syndrome will most often die from ____________________ such as __________________
respiratory complications, respiratory paralysis
Only a limited functional area in one hemisphere of the brain is involved with symptoms seen on only one side of the body
focal seizure
Common in children who play sports
concussion
Very brief episodes of altered consciousness with typically no muscle activity
absence seizures
Myelomeningoceles are the most _________ form of spina bifida and are often accompanied by a diagnosis of ________________.
severe, hydrocephalus
Treat status epilepticus with with benzodiazepines: _____________, _____________, ______________
Then give __________________
Then give ____________________
diazepam, lorazepam, midazolam, phosphenytoin, phenobarbital
____________ (an osmotic diuretic) or _________ saline can help decrease ICP
Mannitol, hypertonic
Sustained, generalized stiffening of muscles, including diaphragm, lasting a few seconds
tonic phase
Mildest form of spina bifida with few manifestations other than a tuft of hair or dimple
spina bifida occulta
Raccoon eyes and Battle sign indicate ____________________.
basilar skull fracture
Monitor CBC, liver enzymes, and medication levels closely with these medications
antiepileptic medications
lacks ability to think clearly and rapidly
confused
Alternative treatment for epileptic seizures
strict ketogenic diet
Manifestations in an infant include poor feeding or vomiting; irritability, restlessness, or lethargy; bulging fontanel; high-pitched cry; increased head circumference; separation of cranial sutures; distended scalp veins; eyes deviated downward (“setting sun” sign); and increased or decreased response to pain.
increased ICP
Most common infectious process affecting CNS
meningitis
Saclike protrusion containing meninges and CSF
spina bifida cystica: meningocele
Manifestations in a child include headache, diplopia, mood swings, slurred speech, papilledema (after 48 hours), altered LOC, and nausea and vomiting (especially in morning).
increased ICP
Before the suture lines have closed, the infant with hydrocephalus will have a(n) _________________ with rapidly growing ____________________________.
enlarged head, head circumference
A ___________________________ is placed to drain excess CSF. It enters the _____________ and follows a drain into the ____________________ where it is reabsorbed and excreted
ventriculoperitoneal shunt, ventricles, peritoneal cavity
awakens easily but exhibits limited responsiveness
lethargic
Develops as the result of an imbalance of production and absorption of CSF
hydrocephalus
Brain bleed between the dura mater and the brain
Often (arterial, venous)
subdural hematoma, venous
Characterized by rapidly progressing limb weakness (progressive ascending paralysis), loss of deep tendon reflexes, and acute demyelinization of the nerves
Guillain-Barré Syndrome
Can be a complication of neurosurgery, systemic infection, or sinus or ear infection
meningitis
two types of spina bifida cystica
meningocele, myelomeningocele
Consists of brief paroxysmal behavior caused by excessive discharge of neurons
seizure
May originate as a viral infection or reaction to influenza vaccine
Guillain-Barré Syndrome
Another concussion occurs before first concussion has healed
second impact syndrome
Cause abrupt arrest of activity and impairment of consciousness
tonic-clonic seizures
Lack of ______________ in the early days of pregnancy is thought to result in spina bifida
folic acid
Prolonged seizure activity that lasts more than 5 minutes or multiple seizures in a brief period
status epilepticus
Ventricles within brain become dilated and result in symptoms of ICP
hydrocephalus
No herniation of spinal cord or meninges
spina bifida occulta
lacks ability to recognize place or person
disoriented
Babies with spina bifida cystica must be born by this method
Cesarean section
_________________ extremities are common in myelomeningoceles due to the restriction of fetal movement in utero. One example of this is ____________.
Deformed, club foot
Mild to incapacitating headache sometimes preceded by an aura and can coexist with depression and anxiety
migraine
sleeps and, once aroused, has limited interaction with environment
obtunded
Causes include head injuries, infection, hypoxia, tumors, aneurysms, or hydrocephalus
increased ICP
Never give ______________ to a child with increased ICP because it can cause ____________
lumbar puncture, herniation
Headache characterized by generalized pain, band-like tightness or pressure, tight neck muscles, and sore scalp
tension headache
This treatment may be implemented if child is not responsive to antiepileptic medications and seizure activity is great
Vagus nerve stimulator
Diagnosed when the pressure within the skull is sustained at ___ mmHg for ___ minutes or more
Increased ICP, 20, 5
Cause abrupt loss of postural tone, impairment of consciousness, confusion, lethargy, and sleep
atonic seizures
These can occur if temperature rises rapidly
febrile seizures
Often accompanied by comorbidities such as cognitive impairment; hearing, speech, and visual impairments; and seizures.
cerebral palsy
Chronic, nonprogressive disorder of posture and movement that involves difficulty controlling muscles
cerebral palsy
Brain bleed between skull and dura mater
Often (arterial, venous) and may require surgical evacuation
epidural hematoma, arterial
severe form of spinal bifida
spina bifida cystica
vigorous stimulation produces no response
coma
Color of CSF should always be _______. If not, infection is indicated.
clear
Most commonly congenital but can result from trauma, hemorrhage, brain tumors, or meningitis
hydrocephalus
Autoimmune neurologic disorder of peripheral nervous system
Guillain-Barré Syndrome
Another term for cerebral palsy (before age of 2)
static encephalopathy
Brief, random contractions of a muscle group, followed by loss of muscle tone and forward falling
myoclonic seizures
Treatments for cerebral palsy include ______________ via a pump, __________, and ________ injections.
intrathecal baclofen, benzodiazepines, Botox
awake, alert, oriented, interacts with environment
full consciousness
Symptoms include headache, photophobia, nuchal rigidity, and altered LOC
meningitis
Manifestations vary, but most cases show persistent primitive reflexes, delayed gross motor development, and abnormal muscle tone.
cerebral palsy
requires stimulation to arouse
stupor
Congenital neural tube defects (NTD) that results in an incomplete closure of the vertebrae, which exposes the spinal cord
spina bifida
impairment of reality with hallucinations possible
delirious
