Module 12: Childhood Neuro Disorders (c)

Question 1

Neural Tube Defects

Answer 1

1. Caused by an arrest of the normal development of the brain and spinal cord
2. Significant risk with MATERNAL FOLATE DEFICIENCY
   - Pre-conception supplementation w/ folic acid can reduce neural tube defects by up to 70%

Question 2

Neural Tube Defects

-Anterior Defects

Answer 2

1. Brain and face abnormalities

Question 3

Neural Tube Defects

-Posterior Defects

Answer 3

1. Result in different myelodysplasias which is a defect in the formation of the spinal cord

Question 4

Neural Tube Defects

-Most Common Defects?

Answer 4

1. Anencephaly — part of the brain and/or skull are missing
2. Encephalocele — Herniation or protrusion of the brain and meninges through a skull defect — creates sac-like structure

Question 5

Neural Tube Defects

-Meningocele

Answer 5

1. Cyst like sack of meninges w/ spinal fluid
2. Defect does NOT involve the spinal cord or nerve roots
3. No neuro deficits or Sx’s
4. Can occur in cervical, thoracic, and lumbar spine

Question 6

Neural Tube Defects

-Myelomeningocele

Answer 6

1. Herniation of the meningocele

Question 7

Craniosynostosis

Answer 7

1. Premature closure of the cranial sutures
2. Fusion of the cranial suture prevents skull growth and results in an asymmetric shape of the skull
3. Surgical intervention needed

Question 8

Microencephaly

Answer 8

1. Brain growth that is significantly below normal

2. ZIKA infection can cause microencephaly

Question 9

Congenital Hydrocephalus

Answer 9

1. Usually present at birth and is caused by an imbalance in production and reabsorption of CSF
2. Increased pressure w/in the ventricular system dilates the ventricles and compresses brain tissue

Question 10

Static Encephalopathies

-Info & Patho

Answer 10

1. Injury before or during birth — Result of prenatal or perinatal hypoxia, hemorrhage or infection
2. Diverse group of non-progressive syndromes that affect the brain and cause motor dysfunction beginning in early infancy
   - Cerebral palsy is a static encephalopathy and is a movement disorder w/ abrnormal muscle tone and posture
3. Manifestations
   - Spastic — CP can be spastic w/ increased tone — increased muscle tone, exaggerated reflexes, and rigidity
   - Dystonic — CP characterized by extreme difficulty w/ fine motor movements involving cerebellum — Stiff, abrupt movement
   - Ataxic — Cerebellar involvement manifests w/ gain disturbances & instability
4. Children may have a mix of various subtypes — Increased risk of seizure

Question 11

Acute Encephalopathies

-Info

Answer 11

1. Drug induced — Accidental ingestion of drugs — Environmental toxin exposure — Lead poisoning
2. Meningitis
   — Mononuclear pleocytosis — Elevated WBC in CSF with mononuclear cells
   —Polymorphonuclear leukocytes would indicate BACTERIA
3. Lead poisoning causes:
   - Irreversible neurologic damage
   - Developmental delays
   - Ataxia, stupor, coma, seizures

Question 12

Acute Encephalopathies

-Patho

Answer 12

2 Major Types

1. Lead poisoning — 2-3 yrs old at greatest risk of damage
   - Lead impairs uptake of Iron, causing anemia, it damages renal tubules and increases permeability of the nervous system
2. Meningitis — Inflammation of the meningeal covering of the brain and spinal cord