Neuro Flashcards
Peds neuro autoimmune:
what conditions to know
- ACA acute cerebellar ataxia
- ADEM acute demyelinating encephalomeningitis (white matter cns)–think multiple sclerosis acute version
- TM transverse myelitis
- GBS guillan barre
febrile seizures
-what is recurrence rate
50% in infants, 30% if >1y
febrile seizures
complex vs simple
<15 min
6mo-6y
generalized
1 in 24h
febrile
First time seizure, not febrile
when to get CT rather than outpt MRI
If AMS, focal defect, focal seizure, <1y, then get CT
otherwise can wait for outpt MRI
sinusitis
definitions (3)
tx
- URI and sxs 10 days no improvement
- 3-4 days of severe infectious, concurrent sxs and high fever
- URI with initial improvement, then worsening at 5-6 days
- augmentin, intransal steroids
PANDAS and PANS
what is this
pediatric autoimmune neuropsychiatric disorder associated with strep
pediatric acute onset neuropsychiatric syndrome
acute OCD and tics, chorea. autoimmune response interfering with basal ganglia, controversial
infantile botulism
-what sxs comes first and precedes others?
constipation can precede other sxs by weeks
neonatal seizure
-what to do
can be subtle
do everything–CT, LP, full septic workup
Peds status epilepticus
- BZD doses–ativan, versed
- second line meds, what choices and what side effects
- Third line meds
- ativan 0.1 mg/kg, versed 0.1-0.3mg/kg iv (only 20 min duration)
- keppra
fospheny (purple glove syndrome)
depakote (liver tox)
phenobarb (apnea)
- versed drip, penobarb, propofol, ketamine–all gtt
ativan vs versed in status epilepticus
duration of action
ativan 4-6h
versed 20min
hyponatremic seizure
tx
3% saline, 5 ml/kg over 20min
hypocalcemic seizure
tx dose
Ca gluconate 10%
0.3ml/kg over 5-10min
careful with sclerosing veins in kids with Ca Cl
Guillain barre vs transverse myelitis
-similarities/differences
- both have decreased DTRs
- TM usu has abrupt onset at a clear spinal cord level usu thoracic, whereas GBS is more progressive
