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Pediatric Neurology Flashcards

1
Q

What Are the features of Epilepsy?

A

> 2 unprovoked seizures

  • Hyper synchronous disch of cortical neurons
  • Gen vs. Partial
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2
Q

What are the different types of Generalized seizures?

A 
Absence
Myoclonic
Atonic 
Tonic
Clonic Tonic Clonic
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3
Q

What are the different types of Partial seizures?

A

Simple Partial: No AoC

Complex Partial: any AoC

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4
Q

Absence Seizure

A

Staring episode with cessation of activity

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5
Q

Myoclonic Seizure

A

Brief Jerking muscle movements

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6
Q

Atonic Seizure

A

Loss of Tone

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7
Q

Clonic Seizure

A

Regualrly repeated muscles jerking

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8
Q

Tonic Clonic

A

Grand Mal Seizure

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9
Q

What is an Epilepsy Syndrome?

A

Constellation of features describing a unique epileptic phenomenon
Type, Age, Course, EEG Abn, Drug of Choice

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10
Q

What are the features of Childhood Absence Epilepsy?

A

Petit Mal Seizures
4-14 yo resolves by 18yo
EEG: Gen 3Hz spike and slow wave disch

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11
Q

What is the Tx of Childhood Absence Epilepsy?

A

Ethosuximide**
Valproic Acid
Lamotrigine

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12
Q

What are the Traits of Rolandic Epilepsy(BCE with Centrotemporal spikes)?

A

2-12yo
Infreq Partial Seizures
During sleep or on waking
EEG Centrotemporal Spikes

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13
Q

What is the Tx of Rolandic (centrotemporal) Epilepsy?

A

Carbamazepine or Oxcarbazapine

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14
Q

What are the features of Juvenile Myoclonic Epilepsy?

A

12-18yo
Myoclonic Jerks
EEG: 3-6 Hz polyspikes and wave
Photic Stim

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15
Q

What is the Tx of Juvenile Myoclonic Epilepsy?

A

Life long Tx
Valproic Acid
Levetiracetam
Lamotrigine

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16
Q

What are the features of Febrile Seizures?

A

Most common childhood seizures
Assoc with Fevers >38C
3mon- 6yo
No prev history

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17
Q

What is the difference between Simple and Complex Febrile Seizures?

A

Simple: Gen 15 min >1/day

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18
Q

What are the risk factors of febrile seizures?

A

High Fever, viral infection, immunization of MMR and DPT, FHx

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19
Q

What is the Primary Concern in Peds Febrile Seizure?

A

Need to rule out meningitis

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20
Q

What is included in the workup of Febrile Seizure?

A

LP if Signs of meningitis, not fully vccinated for Hib and Strep Pneumo, or Pt taking Abtx
Imaging if neuro deficits, macrocephaly, Inc ICP

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21
Q

What is the Tx of Febrile Seizures?

A

Abort Seizure: Benzos

Diazepam, lorazepam, midazolam

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22
Q

What are the traits of Infantile Spasm?

A

Spasm that starts in infancy. Epileptic encephalopathy

in clusters, on awaking, assoc with devt arrest/reg

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23
Q

What are the 3 types of Infantile spasm?

A

Flexion: limbs and head
Extension: limbs and head
Mixed: flex neck/arms, ext legs

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24
Q

What are the types of Infantile Spasm?

A

Symptomatic- IDed Etiology and Devt Delay

Cryptogenic-No known et. and normal devt

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25
What are the causes of infantile spasm?
CNS malformation, Tuberous Sclerosis, hypoxic Ischemic Encephalopathy, inborn errors of mets, Chromosomal Abn, congenital infection
26
What is seen on EEG in Infantile Spasm?
Hypsarrhythmia
27
What is the Tx of Infantile Spasm?
ACTH | Vigabatrin
28
What are the SA of ACTH?
HTN, Hyper Gly, GI Bleed | Immune Supression
29
What are the SA of Vigabatrin?
Visual field restriction: Permanent?
30
What are the Features of Lennox-Gastaut Syndrome?
Different Types of Seizures including: tonic Seizures, Atypical absence, complex partial, and myoclonic seizures Mental Retardation EEG:
31
What are the features of Neonatal Seizures?
1st month of life NB cant have generalized seizures. Focal Tonic, Focal Clonic, or myoclonic
32
What is the Etiology of Neonatal seizure?
``` Hypoxic Ischemic Encephalopathy, CNS infection, IC Bleed, brain malf Hypoglycemia Hypocalcemia Hyponatremia Inborn error of Mets ```
33
What is included in the workup for neonatal seizure?
Glu, Ca, Mg, Lytes CSF MRI for ischemia, stroke, bleeding, malf
34
What is the Tx of Neonatal Seizure?
Phenobarbatol | Fosphenytoin
35
What is difference between Jitteriness and seizure?
Jitter: similar to tremor induced by stimand stopped by holding extremity
36
What is Guillian Barre Syndrome?
Demyelinating Polyneuropathy caused by immune system | Common cause of acute flaccid paralysis in children
37
What is the Clincal Presentation of Guillian Barre Syndrome?
Parestheia in feet => ascending paralysis => can't walk Cranial Neuropathy: facial spasm, drooling, swallowing difficulty, diplopia Resp muscle failure
38
How is Guillian barre Synd Diagnosed?
Symmetric Leg weakness w/ diminished Reflex Sensory exam normal Mental exam intact
39
What is seen on CSF analysis in Guillian Barre Synd?
Albuminocytological dissociation | Normal in first week
40
What is the Tx ofGuillian Barre Syndrome?
Cardioresp Monitor in ICU | IVIG 2g/kg or Plasmapheresis
41
What is Charicteristic of Duchenne Muscular Dystrophy?
XLR mutation in Dystrophin Presents by 3yo Slowly progressing Wheelchair by 12yo Dilated Cardiomyopathy
42
What is the Mos common cause of Death in Duchenne Muscular Dystrophy?
Resp Failure by age 20
43
What is Gower Sign?
Gets up from the ground using upper limbs to help. Sign of DMD
44
How is DMD diagnosed?
Male, prox muscle weakness, elevated CPK, genetic testing, muscle biopsy
45
What is the Tx of DMD?
Daily dose of Prednisolone or deflazacort to slow disease progression
46
What are the most common causes of Acute Ataxia in children?
Post infectious cerebellar ataxia, intoxication, and Guillian Barre Synd
47
What are the traits of Post infectious cerebellar ataxia?
gradual improvement Hx of recent infection Balance Disturbance Dysarthria and Nystagmus
48
What are the traits of Cerebral Palsy?
Static Motor Encephalopathy Peripheral hypertonia, Axial Hypotonia Assoc: seizures, devt delay, cog delay, learning diff, Vision and hearing problems
49
What are the Classifications of Cerebral Palsy?
Spastic Hemiplegia Spastic Diplegia Spastic Quadriplegia Diskinetic CP:
50
What are the complications of Cerebral Palsy?
Skin ulcers Constipation, poor feeding Hip disloc, scoliosis Aspiration pneumonia, etc
51
What are the features of migraines?
Recurrent HA w/ N/V and Photophobia | Throbbing and bilateral in younger children
52
What is the classification of Migraines?
``` Migraine w/out aura Migraine w/ aura Complicated Aura Hemiplegic Basilar Ophthalmoplegic Confusional ```
53
What is the Tx of Migraines?
Rest in dark room Acetamin, Ibuprofen Ondansetron for N/V Triptans for Severe attacks
54
What is used for Migraine Prophylaxis?
Cyproheptadine: SA: inc appetite and sleepy Topiramate: SA: WL, stones, cog impairment Amitriptyline: SA: Sleepy, Cardiac Arrhythmia Propanolol
55
Who is Cyproheptidine best for? Topiramate? Amitriptyline?
1) Younger Children 2) Obese and Epileptics 3) Depression
56
What are the lifestyle modifications for migraines?
Adequate and regular sleep, Hydration, Exercise, not skipping meals, Avoid stressors and triggers
57
What are the features of Neurocutaneous Syndromes
Neuro Disorders w/ skin lesions: Neurofibromatosis, Tuberous Sclerosis, Sturge Weber
58
What are the Diagnostic Criteria of Neurofibromatosis?
1) >6 Cafe-au-lait spots 5mm prepub, 15 postpub 2) 2 axillary or inguinal freckling 3) 2 neurofibroma or 1 complex 4) Optic Glioma 5) 2 Lisch Nodules 6) Sphenoid Dysplasia or Long Bone abnormal 7) 1st deg relative w/ NF1
59
What are the traits of Tuberous Sclerosis?
Inc Risk of epilepsy, cog delay, tumors
60
What are the skin diagnostic Criteria for Tuberous Sclerosis?
Skin: Hypomelanotic macules, Facial Angiofibroma, shagreen patch, Nail fibroma
61
What are the CNS diagnostic Criteria for Tuberous Sclerosis?
Subependymal nodules, cortical tubers, giant cell astrocytoma
62
What are the Eye diagnostic Criteria for Tuberous Sclerosis?
Retinal Hamartoma
63
What are the Heart diagnostic Criteria for Tuberous Sclerosis?
Cardiac Rhabdomyoma
64
What are the Kidney diagnostic Criteria for Tuberous Sclerosis?
Renal Angiomyolipoma
65
What are the Lung diagnostic Criteria for Tuberous Sclerosis?
Lymph-angio-leio-myo-matosis | In adults
66
What are the traits of Sturge-Weber Syndrome?
Port wine stain in V1 and V2 trigeminal branch distribution. Unilateral CNS issues Glaucoma

Neurology (9 decks)

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