Pediatric - Neurology Flashcards
Cerebral Palsy
Condition resulting in impaired movement and posture due to an abnormality in the motor system. Most common type is spastic due to upper motor neuron weakness.
Interventions for Cerebral Palsy
PT, OT, speech therapy, education and recreation. Use of mobilizing devices, safe environment, sitting upright after meals and medication.
Signs and symptoms of head injury
EARLY SIGNS
- Increased ICP
- McEwan’s sign (cracked pot sound on percussion of head)
- Headache
- N&V
- Diplopia and seizures
LATE SIGNS
- Reduced consciousness level
- Bradycardia
- Lowered motor responses
- Posturing
Interventions for head injury
- Monitor Airway
- Monitor for signs of increased ICP
- Decrease stimuli
- Monitor ops and neuro ops
- Seizure precautions
Seizure precautions
- NPO
- IV fluids
- Antiseizure medications
Hydrocephalus
Imbalance of CSF absorption or production caused by malformations, tumors, hemorrhage, trauma or infection. Results in enlargement of head and increase ICP.
Surgical Intervention for Hydropcephalus
Prevent further CSF accumulation by bypassing the blockage and draining it to where it will be reabsorbed.
Meningitis
Infection process of the CNS caused by bacteria or viruses. Diagnosis via a lumbar puncture.
What should the CSF from a lumbar puncture look like if it is positive for meningitis?
- Cloudy CSF
- Elevated protein
- Decreased glucose
Interventions for meningitis
- Respiratory isolation for 24 hours after antibiotic administered.
- Antibiotics
- Antipyretics
- Monitor neuro obs
- Monitor for edema
Interventions for submersion injury
- Ventilatory and circulatory support
- Monitor for cerebral edema
- Monitor for aspiration pneumonia
- Monitor neuro obs
Reye’s Syndrome
Acute encephalopathy which follows a viral illness characterized by cerebral edema and fatty changes to the liver. Diagnosed via liver biopsy.
Use of aspirin in contraindicated in children due to its association with Reye’s syndrome.
Signs and symptoms of Reye’s Syndrome
- Viral illness prior to onset
- Fever
- N&V
- Altered hepatic function
- Progressive neurological deterioration
- Increase in blood ammonia levels
Interventions for Reye’s Syndrome
- Rest and decreased stimulation
- Assess near ops
- Monitor hepatic function
- Fluid balance
- Monitor for impaired coagulation
Tonic-clonic seizure
Stiffening of limbs, losing consciousness and falling to the floor with the eyes rolling back (tonic) followed by muscle spasms and jerking (clonic).
Absence Seizures
Begins with no warning. People stare without moving, lasts less than 15 seconds and is followed by an instant return to alterness.
Myoclonic Seizures
Brief, shock-like jerks of muscle. Person is awake and alert throughout.
Atonic seizures
Causes muscles to go limp resulting in slumping or crumpling to the floor.
Neural Tube Defects
A CNS defect where the neural tube (pre-spine) fails to close during embryonic development. Defect is normally surgically closed after birth.
Spina bifida occulta
Type of neural tube defect in which the spinal cord arches but it still intact.
Spina bifida cystica
Type of neural tube defect in which there is a saclike protrusion of the spinal cord outside the body.
Meningocele
Type of neural tube defect in which there is a protrusion of the meninges in a saclike cyst outside the body.
Mylomeningocele
Type of neural tube defect in which there is a protrusion of the meninges, CSF, nerve roots and spinal cord outside the body. Usually accompanied by neurological defects in the individual.
Decorticate posturing indicates
A lesion in the cerebral hemisphere or disruption of the corticospinal tracts
Decerebrate posturing indicates
Decerebrate posturing indicates damage in the diencephalon, midbrain, or pons.
Decorticate Posturing
An abnormal flexion of the upper extremities and an extension of the lower extremities with possible plantar flexion of the feet.
Decerebrate Posturing
An abnormal extension of the upper extremities with internal rotation of the upper arms and wrists and an extension of the lower extremities with some internal rotation.
