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4th Year Child Health > Paediatric Neurology 1 - Acute > Flashcards

Paediatric Neurology 1 - Acute Flashcards

1
Q

What is the mechanism of a reflex anoxic seizure?

A

When a child suffers a minor injury such as a bump, it triggers the vagal reflex, causing transient bradycardia and circulatory impairment. The child will go pale, limp and lose consciousness for a few seconds before recovering rapidly.

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2
Q

At what age are breath holding spells most common?

A

Infantile - any age from 6 months to about 18 months.

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3
Q

Breath holding spells will have a post-ictal phase, true or false?

A

False

This is one of the key points in distinguishing between a breath holding incident and an actual seizure

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4
Q

List some viral causes of meningitis:

A 
Mumps
Coxsackie
Echovirus
HSV
Poliomyelitis
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5
Q

List the bacterial causes of meningitis:

A

Neisseria Meningitis (meningococcal)
Streptococcus Pneumoniae (pneumococcal)
Haemophilus influenza B (rare since vaccine)
Group B strep, Listeria and E coli (newborns)

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6
Q

What diagnostic test is done to confirm meningitis?

A

Lumbar puncture

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7
Q

What tends to precede a viral meningitis?

A

Viral infection such as gastroenteritis or pharyngitis

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8
Q

What are the classic symptoms of meningitis?

A

Drowsy child with headache, neck stiffness and fever.
Younger children will be irritable with high pitched cry.
May have suffered from febrile convulsions
Positive Kernig’s sign
Petechial purpuric non blanching rash

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9
Q

On a LP, what reading indicates worse prognosis?

A

Low glucose in the CSF

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10
Q

What other pathologies may lead to stiff neck?

A

Tonsillitis
Otitis media
Lymphadenitis
Subarachnoid bleed

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11
Q

What is the acute treatment of meningitis?

A

Unknown organism: Ceftriaxone IV
If pre-brain hernia signs treat with mannitol
ABCDE with fluid access
Give dexamethasone with first dose of antibiotic

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12
Q

What are some complications of meningitis?

A 
Secondary abscesses
Subdural effusion
Hydrocephalus
Ataxia
Paralysis
Deafness
Epilepsy
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13
Q

Why do we give dexamethasone in patients with meningitis who do not have septic signs?

A

It reduces risk of deafness by decreasing the inflammation of the meninges themselves

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14
Q

What is the most common cause of encephalitis?

A

HSV

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15
Q

How is HSV encephalitis treated?

A

Aciclovir IV

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16
Q

In HSV encephalitis, what might the EEG / MRI show?

A

Temporal lobe involvement

17
Q

What syndrome can occur if aspirin is used to treat a child suffering from a viral illness e.g. influenza, chicken pox etc, and what is it?

A

Reye’s syndrome

Non infectious encephalitis w/ personality change, lethargy and raised ICP. Can lead to hepatic failure

18
Q

How is Reye’s syndrome managed?

A

Aggressive supportive therapy and ICP lowering methods

19
Q

List some metabolic causes of paediatric coma’s:

A 
Hypoglycaemia
Diabetic ketoacidosis (Hyperglycaemia)
Adrenal insufficiency
Cerebral oedema
Hyper/hypo natraemia
Urea cycle disorders etc
20
Q

What are some causes of a raised ICP in children?

A 
Head injury
Subdural bleeding
Micro encephalitis
Hypoxia
DKA
Reye's syndrome
Tumours
21
Q

List some signs and symptoms of a raised ICP:

A 
Listless
irritable
Headache
Diplopia
Vomiting
Tense fontanelles
Decreased responsiveness
Cushing's triad
Papilloedema
Hydrocephalus
22
Q

What is Cushing’s triad?

A

This is a trio of raised BP, slow pulse and abnormal breathing patterns. It is a warning sign of imminent coning

23
Q

What are the most common brain tumours in children?

A 
Astrocytoma of brainstem
(Gliomas in general)
Medullablastomas
Neuroblastomas
Pinneal tumours
Retinoblastoma
Mid brain and third ventricle tumours
24
Q

Why is sinusitis usually only a problem in older children?

A

Frontal sinuses do not develop until after 10 years old

25
Q

When do febrile convulsions usually occur?

A

Ages 6 months to 5 yers old

26
Q

What are the common sources of a febrile convulsion?

A

URTI
UTI
Meningitis

27
Q

What % of children will suffer a febrile convulsion at some point?

A

3%

28
Q

What congenital brain abnormalities may lead to global developmental delay?

A

Hydrocephalus

Microencephaly

4th Year Child Health (7 decks)

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