Child health- neurology Flashcards
what is meningitis
serious infection of the meninges, the outer membranes covering the brain and spinal cord
common causative agents of bacterial meningitis in neonates (0-3months)- think men-in-GEL-itis
group b strep
e.coli
listeria monocytogenes
most common causative agent of bacterial meningitis in infants and young children
h.influenza
what is more common viral meningitis/bacterial meningitis
viral meningitis
common causative organisms of viral meningitis
enteroviruses
mumps
HIV
HSV
influenza
arboviruses
red flag for meningitis
rash
investigations for meningitis
bloods
urinalysis
lumbar puncture
what is encephalitis
acute inflammation of the brain parenchyma
most common causes of encephalitis
viral- usually HSV (most common), VZV, herpes group viruses, enteroviruses, adenoviruses
clinical features of encephalitis
fever (90%)
meningism
personality and behaviour changes- progresses to reduced level of consciousness or even coma
seizures
Focal neurological deficits, such as speech disturbance
management of encephalitis
IV acyclovir
what are febrile convulsions
seizures in children triggered by a fever, usually without any underlying neurological cause
what are reflex anoxic seizures
child gets fright and stops breathing- occurs when child is startled, most commonly when child bumps head
what age range of children can febrile seizures occur in
6 months- 5 years
what is the most common cause of syncope in children
vasovagal episode
triggers of vasovagal episodes (fainting)
prolonged standing
emotional stress
pain
sight of blood
what are breath holding attacks
involuntary episodes where a child holds their breath, usually triggered by something upsetting or scaring them
how old are children who are more likely to have breath holding attacks
babies- between 6 and 18 months
most children outgrow by 4/5 years
what happens in reflex anoxic seizures
Childs heart stops beating- child suddenly goes pale, loss consciousness, seizure like twitching
within 30 seconds heart restarts
what are seizures
transient episodes of abnormal electrical activity in the brain
what is epilepsy
umbrella term for a condition where there is a tendency to have seizures
investigations for epilepsy
EEG
MRI brain
once a child has had one febrile seizure, what is there risk of having a future febrile seizure
30-40%
most common form of muscular dystrophy seen in children
Duchenne muscular dystrophy
what is muscular dystrophy
refers to a group of nine genetic diseases that cause progressive weakness and degeneration of muscles used during voluntary movement
what type of genetic disorders are muscular dystrophy disorders and who are affected
X-linked recessive- only boys affected
muscular dystrophy diseases affect genes responsible for what
dystrophin
in Duchenne muscular dystrophy there is an absence of dystrophy true/false?
true
symptoms of muscular dystrophy
delay in motor development, some have more global delay
when is onset of weakness in muscular dystrophy and where does the weakness usually affect
3-4 years
pelvic and shoulder girdles
what is gowers sign
arms used to compensate for weakness of pelvic girdle muscles getting up from the floor
in Duchenne muscular dystrophy, severe disability is typical by what age
age 10
bloods in Duchenne muscular dystrophy
raised serum creatine kinase
signs of muscular dystrophy
gowers sign
walking on toes
exaggerated lumbar lordosis
calf hypertrophy
waddling gait
diagnostic method for definitive diagnosis of muscular dystrophy
genetic testing
when does death usually occur in those with Duchenne muscular dystrophy
20s- due to cardiac and respiratory failure
what is cerebral palsy
cp is the name given to the permanent neurological problems resulting from damage to the brain around the time of birth (from prenatal to <1 month postnatal)
prenatal causes of cerebral palsy
TORCH infections (80%)
alcohol
perinatal causes of cerebral palsy (10%)
Preterm birth
asphyxia
postnatal causes of cerebral palsy (10%)
meningitis
severe neonatal jaundice
head injury
what is spastic cerebral palsy characterised by and what is a result of
hypertonia and < function (stiff, tight muscles)
results from damage to upper motor neurons
what is dyskinetic cerebral palsy characterised by and what is it a result of
hypertonia and hypotonia
athetoid movements
pro-motor problems
results from damage to basal ganglia
what is ataxic cerebral palsy characterised by and what is it a result of
problems with coordinated movements
results from damage to cerebellum
hemiplegic cerebral palsy =
one arm one leg
paralegic cerebral palsy =
both legs
diplegic cerebral palsy =
both legs, minimal involvement elsewhere
quadriplegic cerebral palsy =
both arms both legs
what is an intraventricular haemorrhage
bleeding into the ventricles inside the brain
in neonates, who are more likely to have intraventricular haemorrhages
premature babies
symptoms of intraventricular haemorrhages
apnoea
decreased reflexes
excessive sleep
lethargy
weak suck
what is hydrocephalus
cerebrospinal fluid building up abnormally within the brain and spinal cord
clinical features of hydrocephalus
enlarged and rapidly increasing head circumference
bulging anterior fontanelle
poor feeding and vomiting
sleepiness
poor tone
management of hydrocephalus
ventriculoperitoneal shunt
prenatal causes of cerebral palsy- TORCH
lots of kids with cerebral palsy cared olympic TORCH in 2012!
toxoplasmosis
rubella
CMV
herpes simplex
main complication of Duchenne muscular dystrophy
dilated cardiomyopathy
what causes a non-blanching rash in meningitis
meningococcal septicaemia= infection of the bloodstream
most common causative organisms of meningitis in ages 10-21
neisseria meningitis
streptococcus pneumonia
listeria monoctogenes only affects:
very young (<3 months)
very old
immunocompromised
