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Clinical Conditions II > Neurologic Disorders in Childhood > Flashcards

Neurologic Disorders in Childhood Flashcards

1
Q

Children with intellectual disabilities have difficulties in both ….

A

Intellectual functioning (communicating, learning, problem solving) and adaptive behavior (everyday social skills, routines, hygiene)

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2
Q

Possible signs of intellectual disability

A

children may:

  • sit up, crawl, or walk later than other children
  • learn to talk later or have trouble speaking
  • find it hard to remember things
  • have trouble understanding social rules/ appropriate behavior
  • have trouble seeing the results of their actions
  • have trouble solving problems
  • have problems with receptive/expressive language
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3
Q

Causes of intellectual disability

A
  • genetic syndromes
  • environmental causes
  • nutritional
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4
Q

environmental causes of intellectual disability

A
  • alcohol
  • prenatal infection
  • early childhood central nervous system infections
  • TBI
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5
Q

Intellectual Disability Management

A
  • Timely identification and referral
  • Early Intervention services, special education, & vocational rehabilitation
  • Interdisciplinary care to manage ID and comorbidities (medical and mental health)
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6
Q

Autism Spectrum Disorder

A

ASD is defined in terms of persistent, significant impairments in social interaction and communication as well as restrictive, repetitive behaviors and activities.

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7
Q

What type of disorder is ASD?

A

neurobiological

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8
Q

how is ASD diagnosed?

A

behaviorally

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9
Q

Newest terminology for ASD

A

Neuroatypical

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10
Q

What ASD is:

A
  • Primarily a disorder of communication, social relating and sensory processing
  • Can occur in conjunction with any other disability
  • A disorder of higher-level processing
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11
Q

Common neurological issues in individuals with ASD

A
  • Apraxia
  • Sensory processing problems
  • Epilepsy
  • Cognitive impairments
  • Failure to develop speech
  • Doesn’t respond to name
  • Auditory discrimination problems
  • Lack of eye contact
  • Hypotonia
  • Difficulty with motor planning
  • Toe walking
  • Lack of fear – risk takers/impulsive
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12
Q

Possible causes of ASD

A

Many factors: likely environmental and genetic

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13
Q

Management of ASD

A
  • No cure and no “one size fits all” treatment
  • Early Intervention (EI), educational services, behavioral/communication therapies
  • Aimed to help children learn critical social, communication, functional, and social behavioral skills
  • Adjunctive medications to address: hyperactivity, antipsychotics, antidepressants, anti-anxiety, Epilepsy, sleep disorders, and nutritional deficiencies
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14
Q

Physical management of ASD

A
  • Vestibular activities
  • Activities to increase proprioception
  • Deep pressure
  • Vibration
  • Physical exercise
  • Jogging
  • Swimming
  • Equine-assisted therapy
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15
Q

Seizure

A

A transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain

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16
Q

Epilepsy

A
  • A disease of the brain characterized by an enduring predisposition to generate epileptic seizures, and by the neurobiologic, cognitive, psychological, and social consequences of this condition
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17
Q

Criteria for Epilepsy

A
  • At least two unprovoked (or reflex) seizures occurring >24 hours apart
  • At least one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years
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18
Q

What size of the brain do generalized seizures affect?

A

Both sides of the brain

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19
Q

General Seizures- Absence (petit mal)

A

rapid blinking or a few seconds of staring into space

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20
Q

Generalizes seizures- Tonic-clonic (grand mal)

A 
• Cry out
• Lose consciousness
• Fall to the ground
• Have muscle jerks or spasms
*person may feel tired after
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21
Q

Focal Seizures

A

Located in just one area of the brain

22
Q

Simple Focal Seizures

A

Affect a small part of the brain

twitching; change in sensation - strange taste or smell

23
Q

Complex Focal Seizures

A

can make a person with epilepsy confused or dazed (unresponsive for up to a few minutes)

24
Q

Focal Seizures- Secondary generalized seizures

A

begin in one part of the brain, but then spread to both sides of the brain (i.e. a focal seizure, followed by a generalized seizure)

25
Q

Unprovoked (Epileptic) Seizures

A

Absence of a temporary or reversible factor lower the threshold and producing a seizure at that point in time

26
Q

Provoked (Non-Epileptic) Seizures

A 
Presence of a temporary or reversible factor including:
• Fever
• Substance withdrawal
• Concussion/TBI
• Lack of sleep
• Flashing lights
• Tumor 
• COVID-19 virus infection
• Dehydration
• Side effect of medication (pain, antidepressants)
27
Q

Down Syndrome

A

Trisomy 21: The most frequent chromosomal abnormality among live-born infants and the most common genetic cause of intellectual disability in
the world

28
Q

is the prevalence of DS increasing or decreasing?

A

increasing

29
Q

DS Physical Characteristics

A
  • Singular palmar crease
  • epicanthal fold
  • brush field spots
  • protruding, large wrinkled tongue
  • congenital heart disease
  • intestinal defects
  • shortened 5th finger
30
Q

Conditions associated with DS

A
  • Atlantoaxial instability (no diving, wrestling, gymnastics)
31
Q

Is survival rate for DS increasing or decreasing?

A

increasing

32
Q

DS is more likely to be diagnosed with:

A
  • Testicular or blood cancer
  • Mental health conditions
  • Bronchitis
  • Pneumonia
  • GI, Neuro, Thyroid and Bone Diseases
33
Q

DS is less likely to be diagnosed with:

A
  • Solid tumors
  • Heart Disease
  • STDs
  • Influenza
  • Sinusitis
  • Diabetes
34
Q

Spina Bifida Occulta

A

More common

tuft of hair

35
Q

Spina Bifida Meningocele

A

Meninges on outside of lumbrosacral spine but tissues intact

36
Q

Spina Bifida Myelomeningocele

A

Meninges and tissues outside

37
Q

Spina Bifida Lipomyelomeningeocele

A

Meninges and tissues outside + adipose cyst around spinal cord that become entangled and causes further deficits

38
Q

Spina Bifida Risk Factors

A

Likely an interaction of a genetic predisposition with an environmental trigger

39
Q

Reducing risk of Spina Bifida

A
  • 400 micrograms of folic acid
  • Control preexisting conditions (e.g. obesity, diabetes, etc.) prior to conceiving
  • Avoid overheating your body (e.g. sauna, hot tub, fever, etc.)
40
Q

Spina Bifida Associated Medical Conditions

A
  • Latex sensitivity/allergy
  • Hydrocephalus
  • Chiari II Malformation
  • Tethered Cord
  • Bladder/bowel dysfunction
  • Pressure ulcers
  • Spinal deformity
41
Q

Chiari II Malformation

A

Herniated cerebellum due to enlarged foramen ovale

42
Q

Tethered cord syndrome

A
  • central back pain
  • changes in bowel/bladder function
  • LMN sxs
  • tensioning resulting in UMN sxs
  • worsening of foot deformity
43
Q

what is Cerebral Palsy

A

-Disorder of the development of movement and posture causing activity
limitation
-Attributed to non-progressive disturbances that occurred in the developing brain

44
Q

Antenatal risk factors of Cerebral Palsy

A
  • Prematurity and low birth weight
  • intrauterine infections
  • Multiple gestation
  • Pregnancy complications
45
Q

Perinatal Risk Factors for Cerebral Palsy

A
  • Birth Asphyxia

- Complicated labor and delivery

46
Q

Postnatal Risk Factors for Cerebral Palsy

A
  • Non-accidental injury
  • Head trauma
  • Meningitis/ encephalitis
  • Cardiopulmonary arrest
47
Q

1 Risk factor for cerebral palsy

A

Premarturity and low birth weight

48
Q

Classification of Cerebral Palsy- Movement Disorder

A
  • Hypertonia: spasticity, dystonia, rigidity
  • Hyperkinetic- Chorea, dystonia, athetosis, myoclonus, tremor, tics, stereotypes
  • Negative: ataxia, weakness, decreased selective motor control
49
Q

Classification of Cerebral Palsy- Anatomic distribution

A
  • Hemiplegia
  • Diplegia
  • Triplegia
  • Quadriplegia –involvement of head and neck
50
Q

Severity of Cerebral Palsy

A
  • LEVEL I - Walks without Limitations
  • LEVEL II - Walks with Limitations
  • LEVEL III - Walks Using a Hand-Held Mobility Device
  • LEVEL IV - Self-Mobility with Limitations; May Use Powered Mobility
  • LEVEL V - Transported in a Manual Wheelchair
51
Q

Cerebral Palsy- Tone Management

A
  • Oral medications
  • Anti-spasmodic injections
  • Selective Dorsal Rhizotomy (SDR)
  • Baclofen pump implantation
52
Q

Cerebral Palsy- General Classification of Orthopedic Surgeries

A
  • Muscle/Tendon lengthening
  • Tendon Transfers
  • Osteotomies

Clinical Conditions II (11 decks)

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