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Pediatrics/Neurology Flashcards

1
Q

EEG indication in seizure

A

1st time, non febrile seizure

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2
Q

Infantile spasm

A

Onset:4_8m
Brief,repeated symmetric contractions of neck. Trunk,ext.
Salam attack
Lasting 10 -30s

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3
Q

Infantile spasms..associated with:

A

Developmental delay

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4
Q

Another name for infantile spasms

A

West syndrome

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5
Q

Infantile spasms etiology

A

20% unknown: good response to Rx

80%: poor response

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6
Q

Infantile spasms

Can develop into

A

West syndrome

Lennox gastaut

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7
Q

Infantile spasms

EEG

A

Hypsarrhythmia

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8
Q

Rx for infantile spasms

A

ACTH
Vigabatrin
BZD

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9
Q

Lennox gastaut syndrome age

A

3 - 5 yr

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10
Q

Triad forLGS

A

1) multiple seizure types
2) diffuse cognitive dysfunction
3) slow generalized spike. & slow wave EEG

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11
Q

Rx for LGS

A

Valproic acid
BZD
Ketogenic diet

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12
Q

Prognosis of LGS

A

POOR

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13
Q

Juvenile myoclonic epilepsy

A

Janz
12 -16 y
Autosomal dominant, variable penetrance

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14
Q

Juvenile myoclonic epilepsy manifestation

A

Particularly in the morning

Frequently as gtc

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15
Q

Juvenile myoclonic epilepsy EEG

A

3.5-6Hz irregular spike and wave, increase with photic stimulating

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16
Q

Juvenile myoclonic epilepsy Rx

A

Lifelong valproic acid

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17
Q

Juvenile myoclonic epilepsy prognosis

A

Excellent

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18
Q

Absence

A 
Multiple per day generalized or resolve
6-7y
F>M
Strong genetic predisposition 
<30s
No post ictal
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19
Q

Absence EEG

A

3/s

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20
Q

Absence Rx

A

Valproic acid

Ethosuximide

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21
Q

Benign focal epilepsy

A

5-10y
16%of all nonfebrile seizures
Focal motor seizure usually in sleep wake transition state

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22
Q

Benign focal epilepsy consciousness

A

Conscious but aphasic post-ictally

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23
Q

Benign focal epilepsy prognosis

A

Remit in adolescence

No sequel

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24
Q

Benign focal epilepsy EEG

A

Normal background

Spikes in centrotemporal area

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25
Benign focal epilepsy Rx
Infrequent : no | Frequent : carbamazepine
26
When anticonvulsant should be initiated
>2 unprovoked afebrile seizures within 6-12m
27
When D/C anticonvulsant?
Free of seizure for2yrs | Wean over 4-6m
28
MCC of seizure in children
febrile seizure
29
frequency of febrile seizure
3-5% of all children
30
sex predisposition of febrile seizure
M>F
31
peak age for febrile seizure
6m-6y
32
percentage of simple and complex
simple: 70-80% complex: 20-30%
33
complex febrile seizure
1) duration: >15min 2) focal onset or focal features during seizure 3) recurrent seizure >1 in 24h 4) previous neurological impairment or neurological def.
34
risk factors for recurrence of febrile seizure
33% recurrence, 75%recur within 1 yr .50% if <1yr family hx of febrile seizure
35
risk factors for development of epilepsy (for febrile seizure)
developmental or neurological abn. prior to seizure family hx of complex seizure multiple simple febrile seizure
36
LP and septic w/u for febrile seizure
strongly consider if 18m if meningeal signs
37
EEG for febrile seizure
not warranted unless: complex febrile seizure or abn. neurologic finding
38
% of febrile seizure that develop epilepsy
9% in children with multiple risk factors 2% in child with febrile simple seizure 1% general population
39
prophylaxis of febrile seizure
not recommended
40
Rx for recurrent or prolonged seizure
rectal or sublingual lorazepam
41
Red flags for headache
1. new headache 2. worst of their lives 3. acute onset 4. FND 5. constitutional Sx 6. worse in morning 7. worse with bending over, coughing, straining 8. change in level of consciousness
42
CT or MRI for headache
if history or PhE reveals red flags
43
sex predisposition of migraine
F>M after puberty
44
inheritance of migraine
AD with incomplete penetrance
45
common | classic migraine
common: without aura classic: with aura
46
Sx of migraine in infancy
irritability sleepiness pallor vomiting
47
from what age can children use sumatriptan?
>12 yr
48
red flags for tension headache
``` sudden mood changes disturbed sleep fatigue withdrawal from social activities chronic systemic sign( weight loss, FND, anorexia) ```
49
organic headache
red flags and occipital headache
50
causes of hypotonia that respond to rapid treatment
``` hypokalemia hypermagnesemia acidemia toxin, drug hypoglycemia seizure infection intracranial bleeding hydrocephalus ```
51
neurocutaneous syndromes, associated with which tumors?
CNS PNS Viscera Skin
52
likelihood of MR in neurocutaneous syndromes
younger the child at presentation the more likely they are to develop MR
53
NF1 genetics
AD | 50% new mutation
54
another name for NF1
von Recklinghausen dis.
55
NF1 clinical manifestation
learning disorders abn. speech development seizure
56
Dx of NF1
2 or more of: 1) >=6 cafe-au-lait spots(>5mm if prepubertal,>1.5cm post pubertal) 2) >2 neurofibroma of any type or 1 plexiform 3) >2 Lisch nodules 4) optic glioma 5) freckling in the axillary or inguinal region 6) a distinctive bony lesion 7) a 1st degree relative with confirmed NF!
57
NF2 genetics
AD
58
NF2 tumors
intracranial, spinal tumors
59
Dx of NF2
bilateral vestibular schwannomas or a 1st degree relative with NF2 and either a neurofibroma, meningioma, glioma, or schwannomas
60
eye in NF2
posterior subcapsular cataracts
61
Rx of NF2
monitoring for tumor development | surgery
62
Sturge weber syndrome
port wine nevus associated angiomatous malformations of brain causing contralateral hemiparesis and hemiatrophy
63
Sturge weber syndrome association
seizure glaucoma MR
64
TS genetics
AD, 50% new mutations
65
TS characteristics
adenoma cebaceum shagreen patch ash leaf
66
TS associations
cardiac rhabdomyoma kidney angiomyolipoma MR seizure
67
TS CT and MRI
calcification within the subependymal nodules
68
ADEM peak age
5-8 yr
69
ADEM sex predisposition
M>F
70
pathophysiology of ADEM
immune-mediated | similar to MS
71
clinical scenario of ADEM
2d to 4w after a clinically evident infection or vaccination
72
clinical presentation of ADEM
``` headache, N/V pyrexia, malaise rapid onset encephalopathy multifocal deficit seizure pyramidal syndrome cerebellar ataxia brainstem involvement ```
73
LP in ADEM
variable pleocytosis and oligoclonal banding
74
MRI in ADEM
large, multifocal, poorly marginated regions of demyelination affecting bilateral subcortical white matter, and deep grey matter(thalamus, basal ganglia) lesions show complete or partial resolution on follow up
75
Rx of ADEM
high dose corticosteroids
76
prognosis of ADEM
favourable, though some residual deficit often exist

Medicine (3 decks)

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