Pediatric Neurology Flashcards
What are the main tasks of a pediatric neurologist?
FIgure out the timing (congenital, statis or progressive) and location of the lesion
Why is timing the lesion often difficult? What tricks can you use?
IT’s tricky in kids because symptoms aren’t always obvious at birth. Sometimes you don’t notice a congenital issue until months later.
Use you your knowledge of how the blood supply to areas of the brain changes during devlopment
In children, will an upper motor neuron present with hypertonia or hypotonia?
Oddly enough, it will be hypotonia
but their reflexes will be brisk
In children, a bilateral leg paralysis is likely an issue in the ___ while in an adult, the same symptom is likely an issue in the ____
brain
spinal cord
Newborns are ___pyramidal. Bilateral, contralateral, ipsilateral?
extrapyramidal
mostly bilateral innervation (so strokes won’t be apparent until a few months later when they start to not use an arm)
What is the traction pull looking for in a newborn?
you pull them along the table with their legs - look for normal tone in the lower extremities
What test will look at tone of the upper extremities for infants?
the vertical suspension test - you hold them up by their armpits and check to make sure they can keep themselves suspended with their head up
What is the galant reflex?
you run your finger down the side of the baby’s spine and watch for them to sort of arch toward that side. then repeat on the other side and look for asymmetry
Why is it important to check the thumbs and fist of a newborn?
most newborns will clench their fists with the thumbs on the outside
if they have brain damage, they will clench their hands with the thumbs on the inside
Why is the skin an important aspect of the pediatric neuro exam?
it can be an indicator of a neurological dysfunction that otherwise doesn’t show up on neuro exam
NF, TS, myeloencephalopathy, hypomelaninosis of Ito, Surge-Weber, Von Hippel Landau
If a traumatic brain injury occurs to a child, their recovery time may be better than that of an adult with the same injury because…
the brain is more plastic in children, allowing non-injured brain to take over the function of the injured brain
When will a congenital stroke present?
May not have any physical exam findings until 6-12 months of age
What is the most valuable tool in the pediatric neuro exam
the neurologist’s eyes!
Many seizures turn out to not be seizures. What are some things that should be on the differential?
syncope, panic attack, gastro esophageal reflux - vagal reflex, tic disorder
If a child is said to have CP but didn’t start to have symptoms until age 4, what should you do?
Start looking for other diagnoses because its probably not CP - likely a leukodystrophy of some kind
