Peds: Neurology

Question 1

What are some ‘red flags’ in children with headaches?

Answer 1

HA in child < 5 yrs

new (explosive onset) & worsening HA

worst HA of life

unexplained fever

night time or early morning awakenings w/ HA or V

HA worse w/ straining

posterior HAs

neurological deficit

posture HA

neurocutaneous stigmata

Question 2

What are some S/S of cerebral palsy?

Answer 2

spasticity of limbs (75%, most common form)

PE: spasticity, hyper-reflexia, +/- ataxia, involuntary movements

often co-exists with speech, vision, hearing, hearing, seizures, mental retardation

Question 3

How is cerebral palsy diagnosed?

Answer 3

brain MRI to identify lesion

Question 4

What is microcephaly?

Answer 4

head circumference > 2 SD below mean

Question 5

What should be suspected if chest circumference > head circumference (up to age 6 months)?

Answer 5

microcephaly

Question 6

What are some S/S of microcephaly?

Answer 6

developmental delay

neuro problems (seizure, spasticity)

sloped forehead closed fontanelle

prominent sutures

Question 7

What is macrocephaly?

Answer 7

head circumference > 2 SD above mean

Question 8

What should be suspected if there is rapid growth (increase intracranial pressure) → hydrocephalus, neoplasms

Question 9

What is the main S/S of macrocephaly?

Answer 9

transillumination of skull

Question 10

What is a seizure?

Answer 10

sudden, transient disturbance of brain function manifested by involuntary motor, sensory, autonomic or psychic phenomena, alone or in combo

often accompanied by altered or LOC

Question 11

What are some causes of seizures?

Answer 11

metabolic

traumatic

anoxis

infectious

genetic mutations

spontaneous

Question 12

What is the diagnostic tool used to assess seizures?

Answer 12

EEG

consider brain MRI if significant cognitive or motor impairment

Question 13

What is the treatment for seizures?

Answer 13

benzodiazepines

anti-epileptic treatment

Question 14

What are the 3 criteria of febrile seizures?

Answer 14

1. age 3 months-6 years
2. fever > 38C
3. non-CNS infection/inflammation

Question 15

What is the treatment for febrile seizures?

Answer 15

reassurance

treat fever

Question 16

What is status epilepticus?

Answer 16

seizure lasting at least 15 minutes or series of seizures without complete recovery > 30 minute period

Question 17

What makes status epilepticus a medical emergency?

Answer 17

can result in hypoxia & acidosis

depletion of energy stores, cerebral edema, structural damage

high fever, hypotension, respiratory distress

can cause death

Question 18

What are the typical causes of status epilepticus in kids?

Answer 18

infection

metabolic disorder

uknown (in 50%)

Question 19

What are some treatment options for status epilepticus?

Answer 19

benzodiazepine

phenytoin

phenobarbital

Question 20

What is Tourette’s Disorder?

Answer 20

inherited neurological disorder manifested by motor & phonic tics

Question 21

What are some S/S of Tourette’s Disorder?

Answer 21

tics are clinical hallmark

urge prior to tic

male > female

motor tics- sudden, brief, intermittent movements

vocal/phone tics- sudden, brief, intermittent utterances

may be associated w/ ADHD, OCD

Question 22

What is the treatment for Tourette’s Disorder?

Answer 22

education/habit reversal

treatwith dopamine blockers if interfering with school/job