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Neuro 13 Peds Neuro

Pediatric Neurology

What is the treatment of acute dystonia and how does it differ from the treatment of tardive dyskinesia? Acute dystonia: tx with anticholinergics (benztropine or diphenhydramine) Tardive dyskinesia: switch to atypical or low potency neuroleptics
What EEG pattern is seen in cases of absence seizures? Spike and wave pattern 3 cycles/second
What are the MC primary sources of mets to the brain? Lung, Breast, Melanoma. Also kidney (renal cell CA), and GI (colon CA)
Downward displacement of the cerebellar tonsils and medulla through the forman magnum Arnold Chiari Malformaion
Which type of Arnold Chiari is most common and is often asymptomatic? Type 1. May see HA and/or cerebellar sx. Type 2 usually has other neuro anomalies.
What other neuro anomalies are associated with an Arnold-Chiari malformation? Hydrocephalus, syringomyelia, and myelomeningocele
What is the preferred tx for febrile seizures? Acetaminophen or ibuprofen. NO ASPIRIN!
Which element of the quad/triple screen is abnormal in cases of neural tube defect? AFP is elevated
What neural tube defect matches the following description?: incomplete closure of the dorsal vertebral arches, often at the lumbosacral junction spina bifida occulta
What neural tube defect matches the following description?: condition where the above defect is severe enough for there to be herniations of the meninges meningocele
What neural tube defect matches the following description?: a more severe defect in which the spinal cord and meninges have herniated through myelomeningocele
What neural tube defect matches the following description?: failure of closure of the anterior portion of the neural tube resulting in lack of forebrain, meninges, and parts of the skull anencephaly
What is the definitive treatment for persistent hydrocephalus? Surgical shunt
An infant has persistent primitive reflexes, involuntary grimacing, tendency to drool, and delayed psychomotor development. What is the diagnosis? Dystonic Cerebral palsy
Neonate with lethargy, decreased spontaneous movement, hypotonia, and suppressed primitive reflexes. WHat is the cause? Cerebral palsy with encephalopathy
Name 3 disorders associated with cerebral palsy. 1. Mental retardation 2. Epilepsy 3. Sensory impairment (speech, hearing, vision)
Retinoblastoma can be detected from what part of the PE? Fundoscopic exam: look for absent red reflex
What is the next step when a retinoblastoma is suspected on PE? US and CT
What does cerebral palsy look like in a neonate? Lethargy, decresed spontaneous movement, hypotonia, and suppressed primitive reflexes
What 4 medications are often used to treat spasticity in cerebral palsy? Dantrolene, baclofen, benzos, botox
MCC seizures in children? Febrile seizures
When should an LP be performed in a child with febrile seizures? 1. If meningitis is suspected 2. Any child <12mos
What drug class should NOT be used to treat febrile seizures? Anticonvulsants
Name 2 malformations associaged with hydrocephalus in children. 1. Arnold-Chiari type 1 2. Dandy-Walker
What is the difference btwn non-communicating and communicating hydrocephalus? Non-communicating: obstruction of CSF circulation in 4th cerebral ventricle Communicating: dysfunction of subarachnoid cisterns or arachnoid villi
AR disorder caused by absence of hexosaminidase A. Tay-Sachs dz
What is the f'n of hexosaminidase A? Enzyme req'd for lipid ganglioside metabolism (absent in Tay Sachs)
What are the ophthalomologic findings in Tay Sachs? Cherry red spots on retina
What is the proper dosage in a normal child-bearing woman of folate to prevent neural tube defects? 400mcg/d
What is the appropriate dose of folate in a woman with a past history of having a child with neural tube defects or a woman on anticonvulsants (carbamazepine, valproic acid)? 4mg/d
What are the 4 components of the quad screen? AFP, beta-hCG, estriol, inhibin A
What changes in AFP are seen with neural tube defects? Increased AFP (also seen in omphalocele and gastroschisis)
MC intraocular tumor in children? Retinoblastoma
What gene mutation is associated with retinoblastoma? RB1
Created by: sarah3148