Peds: Neurology Flashcards
What are some ‘red flags’ in children with headaches?
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
What are some S/S of cerebral palsy?
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
How is cerebral palsy diagnosed?
brain MRI to identify lesion
What is microcephaly?
head circumference > 2 SD below mean
What should be suspected if chest circumference > head circumference (up to age 6 months)?
microcephaly
What are some S/S of microcephaly?
developmental delay
neuro problems (seizure, spasticity)
sloped forehead closed fontanelle
prominent sutures
What is macrocephaly?
head circumference > 2 SD above mean
What should be suspected if there is rapid growth (increase intracranial pressure) → hydrocephalus, neoplasms
What is the main S/S of macrocephaly?
transillumination of skull
What is a seizure?
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
What are some causes of seizures?
metabolic
traumatic
anoxis
infectious
genetic mutations
spontaneous
What is the diagnostic tool used to assess seizures?
EEG
consider brain MRI if significant cognitive or motor impairment
What is the treatment for seizures?
benzodiazepines
anti-epileptic treatment
What are the 3 criteria of febrile seizures?
- age 3 months-6 years
- fever > 38C
- non-CNS infection/inflammation
What is the treatment for febrile seizures?
reassurance
treat fever
What is status epilepticus?
seizure lasting at least 15 minutes or series of seizures without complete recovery > 30 minute period
What makes status epilepticus a medical emergency?
can result in hypoxia & acidosis
depletion of energy stores, cerebral edema, structural damage
high fever, hypotension, respiratory distress
can cause death
What are the typical causes of status epilepticus in kids?
infection
metabolic disorder
uknown (in 50%)
What are some treatment options for status epilepticus?
benzodiazepine
phenytoin
phenobarbital
What is Tourette’s Disorder?
inherited neurological disorder manifested by motor & phonic tics
What are some S/S of Tourette’s Disorder?
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
What is the treatment for Tourette’s Disorder?
education/habit reversal
treatwith dopamine blockers if interfering with school/job
