Clinical Perspective - Pediatric Neurology Flashcards
What is the most common reason for seizures in children?
Febrile seizures due to rapid rise in temperature
Presentation of these actions indicates an intact brainstem.
Rolling from tummy-back and sitting up independently
What is sun-setting?
Downward eyes in a baby that may indicate hydrocephalus
What is the suck-swallow reflex?
Instinctual reflex to suck anything that stimulates the roof of the mouth
What gross motor action appears around 9mo?
Crawling, pulling to stand
What food is most associated with infantile botulinum poisoning?
Honey
What is the Rooting reflex?
Opening of the mouth when the cheek is rubbed
What action corresponds with the development of the higher cortex?
Pull to stand and equilibrium
What social milestone is associated with 8mo?
Child will look in the same direction as the caregiver - looks at what the caregiver is looking at
What social milestone is usually achieved by 5mo?
Recognizing caregiver
What fine motor movement presents around 5mo?
The involuntary grasp reflex disappears and infants begin to explore their environment with their hands and place objects in their mouth
What is proto-imperative pointing and when does it develop?
Pointing at a desired object - develops 12-14mo
What is Chusing’s Triad?
A possible sign of hydrocephalus in children, includes hypertension, bradycardia, and respiratory depression
What figure can be drawn by a child at age 4?
Cross
What figure can be drawn by a child at age 3?
Circle
By this age, a baby can “manipulate” their environment by crying, etc.
4mo
True/False. Swimming is a primitive reflex.
True
Port-wine stains involving the V1 & V2 branches of CN V are characteristic of this pediatric neurocutaneous disorder.
Sturge-Weber Syndrome
At what age can a child draw a triangle?
5yo
By what age does a child know the difference between real and imaginary?
4yo
Werdnig-Hoffman disease is a form of muscular atrophy with onset in the first few months of life. Changes are reversible with early intervention. What symptoms are associated with the disease?
Weak cry, hypotonia, respiratory distress, head lag, tongue fasciculations, “frog legs”
Around what age do infants understand object permanence?
9-10mo
What is the primary reason for speech delay?
Hearing issues
Around what age does chest support with arms in a prone manner present?
3 months
What is the most common cause of bacterial meningitis in newborns?
Strep agalactiae
What gross motor action appears around 6mo?
Sitting with truncal support
This principle is believed to allow an infant to achieve their social milestones in a predictable manner.
Attachment theory
At what age will a child understand its name?
6mo
By what age does a baby develop the concept of “stranger danger?”
6mo
When does a child develop simple play, bringing objects to their caregiver?
18mo
By what age should a child know 150-200 words?
15mo
By what age will a baby respond to their name by turning their head?
10mo
When can a child draw a square?
4.5yo
What should be the response of the Babinski test in a newborn?
Up going toes - this response disappears between 12-18mo with toes going down in older children and adults
At what age can a child draw a diamond?
6yo
What are potential causes of abnormal head shape in a baby?
Craniosynostosis or plagiocephaly
What is the atonic-neck reflex?
Turning of a newborn’s head causes arm motion
What is the most common cause of febrile seizures in children?
HSV-6
You are reviewing the chart of a child at your clinic. The chart describes ash leaf spots, Shagreen patches, and adenoma sebaceum. What disease does this child have?
Tuberous Sclerosis
What is craniosynostosis?
Premature closing of cranial sutures. Closure of one suture results in abnormal head shape, but closure of multiple sutures causes cognitive impairment
What action coincides with midbrain development in a newborn?
Postural righting response
Children develop the ability to walk up/down stairs in various stages. What are they and when do they generally present?
2 years - Ascend/descend with both feet on each step
3 years - Ascend with alternating feet, but descend with both feed on each step
4 years - Ascend/descend with alternating feet
What is the most common cause of meningitis in babies >6mo and older children?
Strep pneumoniae
What language can a child express by 15mo?
Mama, dada, and one other word
When does the parachute reflex present?
Generally between 8-10mo
Which develops first? Receptive or expressive language?
Receptive language - expressive language follows
When does the development of the higher cortex begin?
9-12mo
“Cooing” presents around what age?
2mo
What is the most common cause of headaches in children?
Tension headaches
A what age will a baby smile in response to a stranger’s smile?
2mo - social smile
Parallel play, playing alongside another child but not with the child, develops when?
2yo
Grasping of the fingers and toes in response to stimulation is called…?
Palmer & Planter Grasps
When does complex play develop?
30mo
A child may begin putting words together by what age?
2 years
Failure of the Moro Test/Startle Reflex (abduction and extension of the arm) may indicate what type of injury in a newborn?
Brachial plexus injury
What reaction should a newborn have in response to light?
Involuntary closing of the eyes - Blinking Reflex
True/False. By 5yo the head is approximately adult size and shape.
False. The head is adult size and shape by approximately 2yo
In the Galant test, an infant’s back is stroked on one side. What is the normal response?
The baby will bend to the stimulated side
What are the most common pediatric neurocutaneous disorders?
Neurofibromatosis, tuberous sclerosis, Sturge-Weber, von Hippel-Lindau, ataxia-telangiectsia
What is the primary difference between Neurofibromatosis Types 1 & 2?
Type 1 is more severe and has pediatric onset, whereas Type 2 does not have onset until after 18yo
What social milestones develop around 3yo?
Aggression, fantasy, fear, sharing, playing with some other children
A child develops adult skills and can play “dress up” by this age.
5yo
What expressive language milestone presents at 6mo?
Babbling
True/False. Walking/Stepping is a primitive reflex that presents around 8mo.
False. Involuntary walking/stepping is present at birth and later returns as a voluntary behavior.
What causes Neurofibromatosis Type 1?
Mutation in NF1 gene
A child can begin to recognize common words and extract words when?
8-10mo
What is proto-declarative pointing and when does it develop?
Pointing to share an experience - develops around 16mo
What are the most common causes of communicating hydrocephalus in babies?
Meningitis, subarachnoid hemorrhage
What figure can be drawn by a child at age 2?
Straight line
This reflex disappears around 4mo and indicates an intact brainstem in a newborn.
Atonic neck reflex - prevents the baby from rolling onto its stomach
By what age should a stranger be able to fully understand what a child is saying?
4 years old
What are potential complications of Sturge-Weber Syndrome?
Glaucoma, Blindness
What are the clinical features of Neurofibromatosis Type 1?
Cafe au lait spots, axillary freckling, cutaneous neurofibromas, iris hamartomas (Lisch nodules)
Around what age does an infant develop the ability to walk?
12months
