W2 - Acute Neurological Presentations in Kids Flashcards
what is status epilepticus
recurrent or continuous seizure activity lasting longer than 30
minutes in which the patient does not regain
baseline mental status
OR
2 or more convulsive seizures in 30 minutes
without gaining consciousness between them.
what can cause a seizure
epilepsy
cute bacterial meningitis
metabolic or electrolyte imbalance
trauma
stroke
encephalitis
what could cause reduced consciousness
hypoxia
infection
intoxication
trauma
metabolic
seizure
raised intracranial pressure
what is a febrile convulsion
tonic-clonic seizure
AND
temperature >38C
what is more common simple or complex seizures
simple (70% of cases)
what are the features of a simple seizure
6 months to 6 years
<10 MINUTES
GTCS
Complete recovery in 1hr
No recurrence in 24 hrs
what are the features of a complex seizure
Focal onset
>15 minutes
Seizure recurrent in 24 hrs
or the same illness
u Incomplete recovery after an
hour
what is the risk of further seizure
30%
what are some of the risk factors of recurrent seizures
early age of onset
family history of febrile seizure
lower temperature (<40)
what drugs do you want to give within 5mins to stop the seizure
midazolam or lorazapam
what is the risk of going on to develop epilepsy
1%
(if not other risk factors)
when would you scan a child after a seizure
New focal onset seizures
New onset, persistent focal neurology
Signs of meningism
Trauma
Concern of non-accidental injury
how to DESCRIBE a seizure
D - describe (tonic clonic)
E - epileptic
S - syndrome
S - seizure type (focal or general)
RIBE
what is dystonia
movement disorder
- Sustained muscle contraction
- Twisting, repetitive movements
- Abnormal posturing
what is the aetiology of dystonia
unknown
damage to basal ganglia that control movement
what are the 3 types of dystonia
idiopathic
genetic
acquired
what are some of the causes of acquired dystonia
birth related
medications
lead poisoning
carbon monoxide poisoning
trauma/stroke
what could trigger or exacerbate chronic dystonia
pain
GI disturbance - GORD
dental - ulcers
Ortho - dislocations
Infection
Weaning or drugs
Surgical procedures
Anaesthetics
what are some of the complications of status dystonicus
high temp
pain
exhaustion
rhabdomyolysis
dehydration
acute renal failure
bulbar dysfunction
respiratory insufficiency
death
how do you treat dystonia
hydrate
pain relief
anticholinergic
GABA
Dopaminergic agents
what are some of the red flags for headaches
Persistent and recurrent
Balance/ co-ordination/ gait
abnormalities
Persistent/ recurrent vomiting
Abnormal eye movements
Blurred or double vision
Behaviour change
Seizures
Abnormal head position
Delayed puberty
what must you NEVER forget to investigate with someone with seizures or altered/reduced consciousness
glucose
what are the 3 key red flags for neurological conditions
reducing consciousness
progressive worsening headache
evolving neurological signs or focal deficit
what could indicate a more serious or insidious cause of headache
Younger child (<4 years)
Abnormal neurological signs
Nocturnal headache
Associated with postural change
Increased with efforts
what is guillian barre syndrome
Acute immune-mediated polyneuropathy
Peripheral nerve myelin is target of an immune attack
what is cerebral palsy
anything that causes damage to the brain while its developing
what can cause acute flacid paralysis
todds paresis
hemiplegic migraine
infection
- GBS
what is torticollis
tilting of head due to diplopia
