Neuro Flashcards
CP is a diagnosis of exclusion usually made around ________ of age and by a pediatric neurologist after observing the child for a while.
18mo
Patients with CP may have severe _____ impairment but no ______ impairment
Physical
Cognitive.
CP is/is not a progressive disease.
Is NOT. It just has s/s that appear or disappear as the child ages and neuron connections intensify.
MD is/is not a progressive disease and usually occurs in ______
IS
Males (x-linked)
Compare and contrast Duchenne and Becker MD
Duchenne - x-linked, shortened life span (20-30yrs), most common, age at onset 2-6yo, respiratory/cardiac impairment, scoliosis, intellectual impairment, contractures, Gower sign, lordic/waddling gait.
Becker - age of onset 2-16years, slower than Duchenne, survive to middle age,
What is Gower sign?
Where a child has to use their hands to walk up their legs when they’re trying to stand up.
Tx for MD?
Long term steroids, biologics/gene therapies , PT/OT, assistive devices, multiD team approach.
Most common S/s of GBS in kids
Bilateral calf pain, refusal to walk, diffuse weakness.
GBS follows a _____ or _____ illness after about ______
Respiratory or GI viral
10 days
_____ lab elevation in GBS
CK
Median age of GBS/BACM is _____
6.6yo
Bell’s palsy can last for
1-9 weeks
Consider _____ disease in Bell’s Palsy
Lyme Disease
Epilepsy is _______
2 unprovoked seizures >24hrs apart
Differentiate between infantile spasms and febrile seizure
Infantile spasm = <6mo
Febrile seizure = 6mo-5yrs
Absence and tonic-clinic are types of ______
Generalized seizures
MRI or CT scan is ______ indicated for seizure work up unless _____
NOT usually
Need to rule out stroke or tumor as cause of seizures.
Febrile seizures usually occur early on in a viral illness (<24hrs). They can be Simple or complex. If first seizure happens >24hrs after start of illness, then consider ________
Bacterial cause
Tx for febrile seizures:
Anti-pyretics have not been proven to decrease risk of recurrent febrile seizures, HOWEVER it may help child feel better to keep eating and drinking and make parents feel better that they are doing something - no harm.
Also possible to do Diazepam every 8 hours during illness may be considered.
In what instances would you consider an LP to evaluate a febrile seizure?
If strong suspicion for bacterial illness (meningitis)
Or if 6-12mo and have NOT gotten Hib or pneumococcal vaccines yet.
Infantile spasms or “west syndrome” is what 3 characteristics? Tx?
Epileptic spasms accompanied by developmental regression with EEG findings of hypsarrythmia. May be mistaken for startle reflex, hiccups , very brief “jack knife” occurring in clusters when tired.
Adrenocorticotropic hormone. (ACTH)
Status epilepticus is a seizure that lasts _____
> 30mins with some interruption
20min without interruptions.
The drug _______ can potentially worsens seizures especially this type _______
Carbamazepine
Absence or partial.
Instead of aura with migraines, kids may have ________. Adults usually have unilateral migraine where as kids it is not uncommon to have bilateral behind the eyes (frontotemporal).
Change in mood/temprament, and appetite.
Young kids can have _____ with migraines
Cyclical vomiting syndrome or Abdominal migraine
Triptans (maxalt) are FDA approved for kids. ______
> 6yo.
Pseudotumor cerebrii - increase in ICP without MRI changes. Papilledema. LP for dx. Overweight females.
Avoid ______ forms of contraception in adolescents with migraine.
estrogen component.
Electrolyte used for migraine prophylaxis?
Mg
Most common organisms casing fever under 2 months?
Over 2 months?
GBS, E. Coli
Strep pneumonia, GBS, meningitisis and h flu.
How can you assess dysmetria in a child?
They’re unable to judge distance - they can’t pass the block - over pass or under pass.
When do children grow out of their wide set ambling gait?
Around age 6 is when tandem walking should begin. They walk on heel to toe
4 factors that influence a child’s likelihood to have a second seizure and 2 factors that do NOT
Family Hx, abnormal EEG, nocturnal seizures, complex seizure
Age and duration of seizure do not influence.
Sturge Webber - what is this?
Port wine stain on the face (much more concerning than stork bite - on back of head or neck).
Neuro cutaneous disorder with angiomas. Residual embryonal blood vessels,
Concerning if involving the upper part of the face over eye (V1 -ophthalmic branch)
Choroidal angiomas grow under the skin on the vessels and cause damage to brain tissue around them
Seizures, stroke like episodes and hemiparesis.
