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Pediatrics > Neurology > Flashcards

Neurology Flashcards

1
Q

What are headache red flags?

A

wakens child from sleep, sudden increasing severity, change in pattern, gradually increase in severity/frequency (increased ICP)

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2
Q

Red flags on physical exam?

A

growth in head circumference (b/c sutures are open), papilledema, focal neuro deficits

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3
Q

Examples of migraine variants

A

paroxysmal torticollis, cyclic vomiting, abdominal migraine, confusional migraine, benign paroxysmal vertigo

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4
Q

Conditions to r/o w/migraine variants

A

posterior fossa pathology, epilepsy, tumors, GI d/o, urea cycle d/o, drug abuse

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5
Q

What is paroxysmal torticollis?

A

attacks of head tilt from SCM spasm, can cause vertigo and/or vomiting

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6
Q

What is benign paroxysmal vertigo?

A

attacks of vertigo w/nystagmus and vomiting followed by sleep

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7
Q

What is abdominal migraine?

A

acute, severe midline abd pain w/nausea, vomiting, anorexia, pallor lasting 1-72hrs

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8
Q

What is cyclic vomiting syndrome?

A

vomiting attacks, 1-4x’s/hr for up to 5 days not attributable to other causes

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9
Q

What is confusional migraine?

A

episodes of disorientation/combativeness, end in HA

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10
Q

What is pseudotumor cerebri (idiopathic intracranial HTN)?

A

increased ICP w/o a mass or hydrocephalus possibly resulting from impaired CSF reabsorption (similar to communicating hydrocephalus)

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11
Q

What are the risk factors for pseudotumor?

A

girls, overweight, 8-13yo, sinus thrombosis, head injury, SLE, chronic CO2 retention

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12
Q

Signs and sx’s of pseudotumor?

A

HA, papilledema, vision changes, pulsatile tinnitus, CN VI paresis (cannot abduct), vomiting, pain w/eye mov’t, increased ICP w/nml ventricle size

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13
Q

What test do you need to do to diagnose pseudotumor?

A

CT/MRI of head to r/o mass, especially BEFORE doing a LP–otherwise cause hemorrhage w/mass if you do an LP

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14
Q

How do you treat pseudotumor?

A

wt loss, diuretics, LP, glucocorticoids, lumboperitoneal shunt, optic n decompression

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15
Q

What is the definition of epilepsy?

A

Recurrent/repeat seizures w/o an identifiable cause

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16
Q

What are examples of symptomatic seizures? i.e. seizure w/a cause

A

infxn, trauma, hypoxia, malignancy, hypoglycemia, hyponatremia, hydrocephalus

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17
Q

What are EEGs used for?

A

Seizure type classification or subclinical seizure (see it on EEG but not otherwise visible)

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18
Q

What are abortive medications and their route of admin?

A

lorazepam-IV; diazepam-oral, rectal; midazolam-nasal, oral, rectal; phenobarbital, fosphenytoin, levotiracetam if benzos don’t work

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19
Q

What are characteristics of febrile seizure?

A

6mos to 5yo, MC childhood seizure, temp >38, can occur before or after fever, peaks 18-24mos, no other causes, seizure caused by pathogen NOT by the temp (other sources say caused by rapid temp rise), most are simple febrile seizures, often 1st sign of illness

20
Q

Criteria for simple febrile seizure?

A

< 30min total, generalized, no recurrence in 24 hrs, no focal features

21
Q

Criteria for complex febrile seizures?

A

> 15min and > 30min total, > 1 seizure in 24hrs, focal features, prolonged

22
Q

What is the DDx for febrile seizures?

A

chills/rigors, meningitis, encephalitis, tumor, metabolic d/o, neuro d/o (developmental delay)

23
Q

When should you consider an LP for febrile seizure?

A

less than 18mos old–think meningitis! esp if they have + PE findings.

24
Q

What is the risk of epilepsy in children with febrile seizures?

A

2% will go on to Dx of epilepsy

25
Q

What is the risk of recurrent febrile seizures?

A

10% but higher if < 1yo (other sources say 30% recurrence)

26
Q

What are infantile spasms (West syndrome)?

A

an epilepsy syndrome, need 1 of 3: spasms, mental retardation, abnormal EEG findings. Often 4-8mo, d/t damaged brain

27
Q

What are the tx’s for West syndrome?

A

ACTH, anti epileptics, ketogenic diet

28
Q

What are s/sx’s of neurofibromatosus type 1?

A

cafe au lait spots, Lisch nodules, freckling, neurofibromas, optic glioma, osseous lesion

29
Q

What are s/sx’s of neurofibromatosis type 2?

A

CN VIII tumor (acoustic neuroma), neurofibroma, meningioma, glioma, schwannoma, cataract

30
Q

What is a hamartoma?

A

benign tumor/normal tissue growing in an abnormal place or abnormally rapidly, e.g. Lisch nodule

31
Q

What are complications of neurofibromatosus?

A

scoliosis, HTN, learning disabilities, tumors, hypothalamus d/o

32
Q

What are s/sx’s of tuberous sclerosis?

A

seizures/infantile spasms, calcified tumors, mental retardation, hypopigmented skin lesions, shagreen patch (orange peel lesion), sebaceous adenomas, subungual fibroma

33
Q

What are s/sx’s of Sturge-Weber dz?

A

port wine stain, seizures, mental retardation, intracranial calcifications, hemiparesis, cerebral atrophy on CT

34
Q

What is Guillain Barre syndrome?

A

acquired inflammatory demyelinating polyradiculoneuropathy following an infection

35
Q

What are s/sx’s of Guillain Barre syndrome?

A

ascending paresthesias and weakness/paralysis, decreased DTRs, ileus, bladder dysfxn, autonomic dysregulation

36
Q

What is transverse myelitis?

A

inflammation of the spinal cord w/perivascular cupping (lymphocytes build up around vasculature) occuring after viral illness

37
Q

What are s/sx’s of transverse myelitis?

A

back pain at lesion, progressive leg weakness, areflexia, spincter dysfxn, sensory loss

38
Q

When do most cases of infanitle botulism occur?

A

95% between 3wks and 6mos old

39
Q

How do infants get botulism?

A

unprepared foods! spores can germinate in infants guts < 1yr old but not older than 1yo

40
Q

What are s/sx’s of infantile botulism, what is the tx?

A

symmetric descending paralysis, poor feeding, weak cry, ptosis, apnea–tx is supportive w/botulism IgG

41
Q

How long do tics last in children?

A

1mo to 1 yr

42
Q

What are some diagnostic criteria for Tourette’s Syndrome?

A

tics nearly qd for > 1yr, no tic free periods > 3mos, motor and vocal tics, onset before age 18

43
Q

What are s/sx’s of spinal muscle atrophy type I (Werdnig-Hoffman dz)

A

hypotonia, weakness, low muscle mass, tongue fasciculations, spared EOM, die by age 2-3yo

44
Q

The DDx for microcephaly includes:

A

trisomies, TORCH infxn, hypoxia, Tay Sachs, toxins, metabolic d/o

45
Q

DDx for macrocephaly?

A

pseudomacrocephaly, increased ICP, megalencephaly, familial, thick skull

Pediatrics (17 decks)

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